Abstract P381: Geographic Variation in Financial Strain and Food Insecurity After the COVID-19 Pandemic: Implications for Cardiovascular Health Equity

Abstract

Reduced food security is associated with higher healthcare expenditures and increased risk of coronary heart disease, angina, heart attacks, and hypertension. State-level responses to the COVID-19 pandemic and support policies may contribute to regional differences in financial strain and food insecurity, which could have implications for cardiovascular outcomes. Hypothesis: We assessed the hypothesis that there is geographic variation in financial strain and food insecurity in the United States three years after the start of the pandemic. Methods: This study utilizes weighted data from the U. S. Census Bureau’s Household Pulse Survey Phase 3.10 conducted from August 23 - September 4, 2023. We organized data responses according to the Department of Health and Human Services regions - Boston, New York, Philadelphia, Atlanta, Chicago, Dallas, Kansas City, Denver, San Francisco, and Seattle. Food insecurity was measured using a single survey item about having sufficient food to eat in the last 7 days. Financial strain was defined as difficulty paying expenses in the last seven days. Results: There were 254,966,752 adults in the total sample population, (59%) reported difficulty with expenses due to the COVID-19 pandemic. The Atlanta region reported the most financial strain (13%), while the Denver region reported the least (2%), p-value=0.000. The rate of food insecurity was highest in the Atlanta region at 8% compared with 5% or less in other regions, p-value=0.000. Among the 8 states in the Atlanta region, Black individuals were disproportionately more likely to be food insecure, with the greatest difference for Kentucky, Florida, Tennessee, and South Carolina. All states in the Atlanta region had similar odds of food insecurity, but Mississippi residents were nearly twice as likely to experience food insecurity than residents of other states (OR 1.87, p =0.016). Conclusions: The Atlanta region (i.e., the “Deep South”) consists of the most populous states for non-Hispanic Black people and is experiencing the worst food insecurity and financial strain post-pandemic. The economic toll of the pandemic and post-pandemic inflation may contribute to worsening food insecurity and cardiovascular outcomes in a region that is already burdened by poor cardiovascular health. Multilevel intervention is needed to support full pandemic recovery and avoid exacerbating inequities in cardiovascular disease.