Food insecurity is on the rise amid the economic fallout from the COVID-19 pandemic, a disturbing trend that could expose economically challenged people and families to risk factors associated with the coronavirus.

With unemployment increases and school closings, donation programs, school districts and charitable groups have scrambled to keep up with increasing demand for assistance. More than 54 million people may experience food insecurity because of COVID-19 if joblessness and poverty rates exceed levels reached more than a decade ago during the Great Recession, according to an April report from the nonprofit Feeding America.

Food insecurity is defined by the U.S. Department of Agriculture as the inability of a household to consistently provide enough food – generally three meals a day – for every person to live a healthy, active life.

Feeding America and other advocacy groups continue to press Congress to boost hunger programs. So far, two recent relief packages – the Coronavirus Aid, Relief, and Economic Security Act, or CARES, and the Families First Coronavirus Response Act, or FFCRA – have allocated about $850 million for food banks. The acts also included up to $3 billion in funding for a Farmers to Families Food Box Program that buys produce, meat and dairy from farmers and distributes them to nonprofits and schools.

Before the pandemic began in March, food insecurity was at its lowest point since the recession that started in late 2007. Still, that meant 37 million people were considered food insecure. The Feeding America report estimates the number of children experiencing food insecurity could rise from 11 million to 18 million.

The health implications could be stark.

"The research so far shows that food insecurity is associated with many chronic diseases, including high blood pressure, diabetes and asthma," said Dr. Jason Nagata, assistant professor of pediatrics at the University of California, San Francisco School of Medicine.

A 2019 study in the Journal of General Internal Medicine found that nearly twice as many people had diabetes in the food-insecure group as those who were food-secure. The study, which looked at the health of nearly 15,000 U.S. adults ages 24-32, also found those who were food-insecure reported higher rates of hypertension, obesity and obstructive airway disease.

"These also are really important issues to address particularly because of the pandemic," Nagata said. "We know that some of the risk factors for severe illness from COVID-19 are the same medical conditions associated with food insecurity."

In a 2019 Journal of Adolescent Health study that looked at the same sample group, Nagata found food insecurity was associated with poor mental health and sleep disturbances.

"We think that part of the reason for that association are the chronic stressors that people living with food insecurity experience day to day, such as trying to get enough food to provide for themselves and their families," Nagata said.

Black, Latino and Native American people tend to have higher rates of food insecurity, as well as higher rates of infections, hospitalizations and deaths related to COVID-19 than people who are white.

While numerous underlying factors are involved, "long-standing disparities in nutrition and obesity play a crucial role in the health inequities unfolding during the pandemic," researchers said in a July perspective piece in the New England Journal of Medicine. The ability to eat a healthy diet is determined largely by access to affordable, nutritious food – a result of one's proximity to grocery stores and household income available for food.

Charitable groups like 412 Food Rescue are trying to help.

The Pittsburgh-based tech nonprofit uses an app to coordinate a network of drivers who pick up surplus food from grocery stores and restaurants, and deliver it to nonprofits serving people in need, including shelters, affordable housing sites and community groups. In western Pennsylvania, the organization works with 800 food retailers, 600 nonprofit partners and more than 12,000 volunteer drivers.

CEO Leah Lizarondo said 412 Food Rescue pivoted in March to respond to the pandemic by starting home delivery to those in need. Since then, volunteers have delivered to 1,500 food-insecure homes, mostly those with seniors or residents with mobility challenges.

"During a crisis, many people are driven to do something to help, and this isn't an exception," Lizarondo said. "Also compounding that is that most volunteering opportunities are not available during the pandemic because they require people to congregate."

Through 412 Food Rescue, "people are able to give back and volunteer safely," she added.

The organization's technology platform also is licensed by food rescue groups in six other cities in the United States and Canada. Lizarondo hopes to expand to 100 cites by 2030.

Other organizations around the country similarly are adjusting to meet demand. In California, Sacramento Food Bank & Family Services started two temporary drive-thru and touchless distribution sites.

In Wichita, the Kansas Food Bank started providing prepacked disaster boxes to partner agencies. The organization said in its summer newsletter that emergency food assistance due to COVID-19 moved from "need status" to "survival mode" in their communities.

"Food insecurity isn't just about the lack of food, it's about the lack of access to healthy food," Lizarondo said. "If we can alleviate this one challenge, we alleviate one burden for a family."

Editor's note: Because of the rapidly evolving events surrounding the coronavirus, the facts and advice presented in this story may have changed since publication. Visit Heart.org for the latest coverage, and check with the Centers for Disease Control and Prevention and local health officials for the most recent guidance.

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