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Access Type

WSU Access

Date of Award

January 2023

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Nutrition and Food Science

First Advisor

Alyssa Beavers

Abstract

Food insecurity is a complex, multifactorial public health issue. A large body of literature reveals food insecurity as a risk factor for diet related chronic diseases, such as type 2 diabetes mellitus, hypertension, coronary heart disease, dyslipidemia, and chronic kidney disease. The diets of individuals experiencing food insecurity has been shown to be high in empty calories, salty products, and added sugars and low in fruits and vegetables. Given the link between diet, chronic disease, and food insecurity, it is particularly important to implement interventions to alleviate food insecurity and improve diet quality, especially during times of crisis, such as the coronavirus (COVID-19) pandemic. During the COVID-19 pandemic, as the prevalence of food insecurity increased due to surging unemployment rates, the closure of in-person activities, and social distancing measures, there was an increased need for food assistance. Given the unprecedent times of the COVID-19 pandemic, there was a lack of understanding on how food purchasing and consumption behaviors can be impacted during pandemics. Additionally, little was known about the perceived experiences related to food insecurity, food access and acquisition, and how food-related organizations responded to the increase in food insecurity during the pandemic. To better understand these factors, this dissertation has three distinct chapters: Chapter 1 examined how the COVID-19 pandemic influenced Michiganders’ food purchasing and consumption behaviors, and concerns over the food system, Chapter 2 examined the Detroit community’s response to the rise in food insecurity during the COVID-19 pandemic, and Chapter 3 examined food security, food assistance usage, and food acquisition behaviors during the pandemic in the city of Detroit. Chapter 1 used a cross-sectional online survey conducted via Qualtrics from 17 June to 29 June 2020 to Michiganders’ to examine food security status, and change in purchase and consumption of fruits and vegetables during the COVID-19 pandemic. Among the 484 respondents, 36.2% were food-insecure. Chapter 1 also found that food-insecure respondents consumed fruits and vegetables fewer times per day than food-secure respondents and were more likely to report decreasing their consumption of fruits and vegetables (total, fresh, frozen, and canned) since the start of the pandemic. Additionally, respondents that reported reducing their purchase of fresh fruit and vegetable, reported it was related to poor quality and availability, high price, reduced store trips, and concerns for contamination. Chapter 2 conducted semi-structured interviews with organizations involved in addressing food-insecurity in Detroit during the pandemic we found that nearly all programs changed to a contactless food distribution format, and most programs experienced an increase in demand for food. Common successes reported by organizations included staff and client COVID-19 safety, and waivers that eased program rules and operations. Common challenges reported include increased need for labor, food, and funding. Chapter 3 used a cross-sectional survey that was conducted among Detroiters’ over the phone and/or online via Qualtrics from December 2021-May 2022. This survey examined the association between the types of food stores Detroiters obtain food from, food security status, and fruit and vegetable intake; the association between food assistance program use and fruit and vegetable intake frequency; and barriers to obtaining food and coping strategies used to afford food during the pandemic. Among the 656 respondents, the prevalence of food insecurity was 52%. We also found that food-insecure respondents consumed fruits and vegetables fewer times per day compared to food-secure respondents. Fruit and vegetable consumption was also significantly less for respondents that participated in the Supplemental Nutrition Assistance Program (SNAP) over the past year. Compared to 0-2 times per month, fruit and vegetable consumption was higher for respondents that shopped at grocery stores 5 times or more in the past month. For shopping at grocery stores, food-insecure respondents were less likely to report a response higher than 0-2 times in the past month (model 1: OR = 0.60, p = 0.001; model 3: OR = 0.65, p = 0.022), but for convenience stores, they were more likely to report a response higher than 0 times in the past month compared to food-secure respondents. A higher percentage of food-insecure respondents reported barriers to obtaining food such as not having transportation or knowing where to get food, had a hard time knowing where to find help to get food, and could not find the types of food preferred by the household. A higher percentage of food-insecure respondents also reported implementing coping strategies to afford food, such as buying different, cheaper foods, buying foods that don’t go bad quickly, stretching food to make it last, and getting food from a food pantry or soup kitchen. The findings from each of the chapters suggest the need for adequate food assistance during the COVID-19 pandemic, and the need for a charitable feeding system strong enough to manage and sustain high volumes of food distribution during times of need. Overall, the findings of this dissertation may help inform policies that focus on how to better meet Michiganders’ food-related needs and the development of sustainable food programs that focus on creating a more food secure Michigan both now and for future times of increased need.

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