By Cecille Joan Avila, policy analyst at Boston University School of Public Health. She tweets at @cecilleavila.
Since the start of the COVID-19 pandemic in March 2020, more than 54 million Americans have lost jobs. Because of this loss in wages, two times as many Americans became susceptible to food insecurity, defined by the US Department of Agriculture as “a household-level economic and social condition of limited or uncertain access to adequate food.” Food insecurity was a significant problem even before the pandemic and is linked to worse physical and mental health outcomes for both children and adults.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act was passed to provide immediate assistance for the entire US population struggling with the pandemic. One benefit of the CARES Act was an expansion of unemployment benefits, including a $600/week federal supplement to existing state unemployment insurance. While the $600/week supplement terminated at the end of July 2020, expanded eligibility and duration of unemployment benefits continued through December 26, 2020. These benefits were later extended through March 14, 2021 and included a $300/week federal supplement. The recently signed American Rescue Plan extended these benefits through September 6, 2021.
Existing research suggests an association between unemployment insurance and food insecurity — that unemployment insurance can help reduce it. The COVID-19 pandemic presented a unique opportunity to look at this relationship in a moment of simultaneous difficulty and, for a period, government generosity.
A recent paper by Julia Raifman, ScD, Jacob Bor, ScD, and Atheendar Venkataramani, MD, PhD, contributes to the literature by examining the relationship between unemployment insurance and food insecurity in the context of the pandemic. Academic affiliations include Boston University School of Public Health (Raifman, Department of Health Law, Policy, and Management; Bor, Department of Global Health); and The University of Pennsylvania (Venkataramani, Leonard Davidson Institute for Health Economics, Medical Ethics and Health Policy).
Using the Understanding Coronavirus in America study, researchers looked at nationally representative data collected by the University of Southern California Center for Economic and Social Research between April 1, 2020 and November 11, 2020 over 15 survey waves. They looked at households who earned less than $75,000 in the last 12 months and who reported employment at the start of the pandemic but since lost it. The main exposure of interest was the onset of unemployment benefits, with secondary analyses examining the effect of unemployment insurance both with and without the CARES supplement, and the impact of varying weekly amounts. This population was compared to those who never reported receiving unemployment insurance.
Food insecurity outcomes were measured based on a yes/no response to two questions: “In the past 7 days, were you worried you would run out of food because of a lack of money or other resources?” and “In the past 7 days, did you eat less than you thought you should because of a lack of money or other resources?”
Using difference-in-differences models for the exposures of interest, the researchers compared changes in food insecurity and eating less before and after an individual received unemployment insurance to those who did not receive unemployment insurance. This was under the assumption that both groups would both experience food insecurity in the same way, regardless of unemployment insurance or not. They also conducted a complementary event study model to evaluate and see that parallel trends existed before receipt of unemployment insurance and to reduce bias in treatment timing variation.
This research revealed that for households making less than $75,000 and who reported unemployment during the COVID-19 pandemic, receipt of any amount of unemployment insurance was associated with a 35% reduction in any reported food insecurity. Unemployment insurance was also associated with a 48% decline in reports of eating less due to financial limitations. Larger unemployment benefits resulted in larger reductions in food insecurity.
Researchers found that, in the study population, the greatest prevalence of food insecurity (22.2%) was reported at the beginning of the study period (April 1 – 28). The lowest prevalence food insecurity (8.9%) came in the second-to-last wave of the study period (September 30 – October 26). Despite this decline, these frequencies never equaled that of the employed comparison group.
To document the disparities resulting from structural racism, race and ethnicity data were also collected and included in the analyses. In the study population, participants who reported they were racial, sexual, or gender minorities; or younger; or lower income, were more likely than other groups to report food insecurity or eating less due to cost.
There are a few significant limitations in this study. Being able to distinguish the effects of receiving unemployment insurance benefits from receiving stimulus payments, as they occurred at similar points in time, was difficult. Also, this web-based survey might not accurately represent the totality of the US population, particularly under-represented minorities.
Despite these limitations, these findings contribute to existing literature by confirming the association between unemployment insurance and reduced food insecurity. Beyond that, these findings are significant for policymakers, as it reveals that the amount and length of unemployment benefits matter.
Not only does the research show that more generous supplements can have a greater impact, it also shows what groups are more susceptible to food insecurity, particularly important for policymakers seeking to address both food insecurity and equity.
The current extension of unemployment insurance benefits ends in September. But the need to appropriately address food insecurity will continue long after the pandemic ends, whenever that may be.
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