The Influence of the COVID-19 Pandemic on Household Food Sourcing and Food Security in Rural Appalachia: A Qualitative Study

Background The COVID-19 pandemic and related economic impacts precipitated numerous challenges for households across the socioeconomic spectrum, including changes in household composition, resources, and routines. Various studies have explored how the unique circumstances of 2020-2021 impacted households, particularly with regard to food insecurity, but rural communities remain underrepresented among this literature. Objective To understand how the constellation of pandemic-related ‘shocks’ (eg, job changes; daycare and school closings; food supply disruptions) influenced households’ food sourcing strategies and food security dynamics in rural Appalachian Ohio. Study Design, Settings, Participants This study employed a mixed methods sequential explanatory design. A recruitment postcard was mailed to all residential addresses in the Athens County region of Appalachian Ohio in late June 2020. Adult recipients were invited to complete quarterly surveys, including a demographic questionnaire and the Household Food Security Survey Module (HFSSM). A purposively selected sub-sample of respondents were invited for qualitative, in-depth semi-structured interviews (n=16, May-June 2021); our maximal variation sample included households demonstrating consistent food security (n=7, 44%), episodic insecurity (n=5, 31%), and persistent insecurity (n=4, 25%) during 2020-2021. Measurable Outcome/Analysis A subset of authors conducted iterative rounds of general inductive coding guided by the research objective to discern key themes using NVivo 12 software. Results Regardless of food security status, households employed a complex mix of strategies to support their food needs; in many cases, adults applied lessons learned during previous episodes of food insecurity to stretch resources in the context of household constraints and supply chain limitations. Pandemic-related shocks had ripple effects for many households, including exacerbating the cognitive effort invested in household foodwork (primarily by women). Even so, pandemic-related circumstances enabled positive changes in health behaviors for some and enhanced community connectedness (eg, via food sharing). Conclusion This study highlights the role of life course experiences in equipping households for unexpected shocks to resources and routines. It also reveals how rural households demonstrated resiliency and experienced positive outcomes despite the disruptive nature of this period. Funding None The COVID-19 pandemic and related economic impacts precipitated numerous challenges for households across the socioeconomic spectrum, including changes in household composition, resources, and routines. Various studies have explored how the unique circumstances of 2020-2021 impacted households, particularly with regard to food insecurity, but rural communities remain underrepresented among this literature. To understand how the constellation of pandemic-related ‘shocks’ (eg, job changes; daycare and school closings; food supply disruptions) influenced households’ food sourcing strategies and food security dynamics in rural Appalachian Ohio. This study employed a mixed methods sequential explanatory design. A recruitment postcard was mailed to all residential addresses in the Athens County region of Appalachian Ohio in late June 2020. Adult recipients were invited to complete quarterly surveys, including a demographic questionnaire and the Household Food Security Survey Module (HFSSM). A purposively selected sub-sample of respondents were invited for qualitative, in-depth semi-structured interviews (n=16, May-June 2021); our maximal variation sample included households demonstrating consistent food security (n=7, 44%), episodic insecurity (n=5, 31%), and persistent insecurity (n=4, 25%) during 2020-2021. A subset of authors conducted iterative rounds of general inductive coding guided by the research objective to discern key themes using NVivo 12 software. Regardless of food security status, households employed a complex mix of strategies to support their food needs; in many cases, adults applied lessons learned during previous episodes of food insecurity to stretch resources in the context of household constraints and supply chain limitations. Pandemic-related shocks had ripple effects for many households, including exacerbating the cognitive effort invested in household foodwork (primarily by women). Even so, pandemic-related circumstances enabled positive changes in health behaviors for some and enhanced community connectedness (eg, via food sharing). This study highlights the role of life course experiences in equipping households for unexpected shocks to resources and routines. It also reveals how rural households demonstrated resiliency and experienced positive outcomes despite the disruptive nature of this period.