BackgroundIn the aftermath of the COVID-19 public health emergency, it is important to understand the extent of socioeconomic burdens of long COVID, defined as continuation of symptoms after initial infection, including food insecurity. ObjectiveThis study aimed to assess the association between long COVID and family food insecurity among low-income individuals (or any of their family members living with them) who were participants and non-participants of public food assistance programs (SNAP, WIC, and NSLP) in the United States. DesignThe study used an observational cross-sectional design. Participants/settingData on 7,151 adults (aged 18+ years), with family income of <200% of the Federal Poverty line, from the 2022 National Health Interview Survey were analyzed. Main outcome measuresLevel of family food security, based on responses to a set of 10 questions measuring family’s food security during the past 30 days. Statistical analyses performedMultinomial logistic regression models were estimated to obtain relative risk ratios of marginal-, and low-and-very-low- food security, relative to the base outcome of high- food security, for long COVID status. Multivariable models were estimated separately for the full sample, and for sub-groups of food assistance participants and non-participants. A Seemingly Unrelated Regression (SUR) specification was estimated to assess whether the estimates were different across the participant and non-participant sub-groups. ResultsCompared to individuals who never had COVID-19, the adjusted relative risks of experiencing marginal- and low-and-very-low- food security were 1.42 (95% CI: 1.00 – 2.02) and 1.43 (95% CI: 1.08 – 1.91) times higher, respectively, for individuals who had long COVID. While the adjusted risks were not observed to be statistically significant in the participant sub-group, among non-participants, adjusted relative risk ratios were 2.34 (95% CI: 1.43 – 3.82) and 1.56 (95% CI: 1.02 – 2.39), respectively. SUR results revealed that relationships between long COVID and food insecurity were only different for marginal- and not low-and-very-low- levels of food insecurity, between food assistance participant and non-participant groups. ConclusionsStudy findings highlight a significantly higher risk of marginal- and low-and-very-low- food security among low-income adults who had long COVID, especially those who were non-participants of public food assistance programs. Further research is warranted to explore the causal pathways of this relationship for informing policies to mitigate the burden of long COVID.