# The Influence of the COVID 19 Pandemic on Food Insecurity Among Cancer Survivors Across New York State

## TL;DR

The study found that cancer survivors in New York City faced higher food insecurity before and during the pandemic compared to other areas, with factors like race and income playing a role.

## Contribution

This study uniquely examines the impact of the pandemic on food insecurity among cancer survivors in New York State.

## Key findings

- Food insecurity was higher in New York City compared to the rest of the state before and during the pandemic.
- Low income and more co-morbidities were significant factors associated with food insecurity during the pandemic.
- New associations like being out of work and having children in the household were linked to food insecurity during the pandemic.

## Abstract

People surviving cancer represent a particularly vulnerable population who are at a higher risk for food insecurity (FI) due to the adverse short- and long-term effects of cancer treatment. This analysis examines the influence of the COVID-19 pandemic on the prevalence of FI among cancer survivors across New York State (NYS). Data from the 2019 and 2021 NYS Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of FI. Multivariable logistic regression was used to explore socioeconomic determinants of FI. Among cancer survivors, FI varied geographically with a higher prevalence in New York City compared to the rest of the state (ROS) prior to (25.3% vs. 13.8%; p = .0025) and during the pandemic (27.35% vs. 18.52%; p = 0.0206). In the adjusted logistic regression model, pre-pandemic FI was associated with non-White race (OR 2.30 [CI 1.16–4.56]), household income <$15,000 (OR 22.67 [CI 6.39–80.43]) or $15,000 to less than <$25,000 (OR 22.99 [CI 6.85–77.12]), and more co-morbidities (OR 1.39 [CI 1.09–1.77]). During the pandemic, the association of FI with non-White race (OR 1.76 [CI 0.98–3.16]) was attenuated but remained significant for low household income and more co-morbidities. FI was newly associated with being out of work for less than one year (OR 6.36 [CI 1.80–22.54] and having one (OR 4.42 [CI 1.77–11.07]) or two or more children in the household (OR 4.54 [CI 1.78–11.63]). Our findings highlight geographic inequities and key determinants of FI among cancer survivors that are amendable to correction by public health and social policies, for which several were momentarily implemented during the pandemic.