The Intersectionality of Food Insecurity, Job Insecurity, Healthcare Insecurity, and Mental Health Challenges in NYC Households During Covid-19

ABSTRACT

Our intersectional research explored food insecurity and job insecurity as predictors of healthcare insecurity and mental health challenges among households living in economic instability since the COVID19 pandemic began. The New York City COVID19 Research Team adapted a validated, web based, anonymous survey questionnaire using a Social Determinants of Health Framework. The study oversampled underserved populations with a total of 2,099 participants. We report strong associations between food insecurity and job insecurity among healthcare insecure households, and significant mental health challenges among food insecure and healthcare insecure households. This underscores the need for integrated social policies to protect underserved urban populations.

KEYWORDS:

• Food insecurity
• Job insecurity
• healthcare insecurity
• mental health
• syndemic theory

Acknowledgments

We would like to give a special thanks to all the community partners and participants in the COVID-19 New York City survey at a time when they were experiencing the worst of the early impacts of the pandemic. We thank the community partners at our universities for sponsoring and supporting this study. Finally, we give thanks to the NFACT research collaboration for their partnership. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Food Insecurity is “a condition defined by limited or uncertain access to sufficient nutritious food for an active healthy life” (Wolfson and Leung 2020).

2. Healthcare Insecurity is defined as the inability to access quality healthcare, difficulty engaging in healthcare seeking behaviors, as well as feeling worried, anxious, or insecure about being unable to obtain quality healthcare when needed. “It goes beyond traditional measures of healthcare access by assessing an individual’s subjective sense of vulnerability, lack of control, and worry about getting the health care they need when they need it” (Tomsik et al. 2014).

3. Job Insecurity is a “perceived threat to the continuity and stability of employment as it is currently experienced.” (Shoss 2017).

4. Structural racism are defined as “forms of racism that are pervasively and deeply embedded in systems, laws, written or unwritten policies, and entrenched practices and beliefs that produce, condone, and perpetuate widespread unfair treatment and oppression of people of color, with adverse health consequences. Examples include residential segregation, unfair lending practices and other barriers to home ownership and accumulating wealth, schools’ dependence on local property taxes, environmental injustice, biased policing and sentencing of men and boys of color, and voter suppression policies.” (Braveman et al. 2022)

5. The Supplemental Nutrition Assistance Program (SNAP) is a federal program for nutrition benefits for low-income Americans that are used at stores to purchase food. The program is administered by the USDA Food and Nutrition Service (FNS) through a national network of field offices (U.S. Department of Agriculture).

Additional information

Funding

Funding was provided by the Vincentian Institute for Social Action, St. John’s University.