Associations between housing stability and food insecurity among U.S. low-wage workers.

Introduction: Housing instability and food insecurity are two social determinants of health with considerable overlap and complex dynamics among populations experiencing economic instability. This study sought to examine the magnitude and direction of the temporal associations between housing instability and food insecurity among low-wage workers in two U.S. cities.

Methods: This study was a secondary analysis was conducted in 2024 using five years of data (2018-2022) collected from a cohort of low-wage workers in Minneapolis, MN, and Raleigh, NC. Annual measures included a 6-item food insecurity measure, a 3-item housing instability measure, and demographic characteristics. Four Dynamic Panel Models tested the effect of housing instability on food insecurity in the subsequent year and the effect of food insecurity on housing instability in the subsequent year.

Results: At baseline, most participants experienced food insecurity (74.9%) and housing instability (70.8%), both of which declined in each subsequent year before increasing in 2022. Participants who experienced housing instability or food insecurity were more likely to experience the same hardship in the subsequent year. Overall, housing instability was negatively associated with subsequent food insecurity (b [95% CI], -0.082 [-0.136, -0.028]). Similarly, food insecurity had a negative association with subsequent housing instability (-0.125 [-0.189, -0.060]).

Conclusion: Housing instability and food insecurity have a complex and dynamic relationship. Expansion of federal nutrition assistance programs coordinated with other safety net programs, such as eviction prevention or rental assistance, as was implemented during the COVID-19 pandemic, could provide critical protection from these hardships.