Demographic Determinants of Food Insecurity in Older Adults During the COVID-19 Pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic exacerbated food insecurity in the United States, with older adults facing heightened vulnerability due to fixed incomes, chronic illness, and limited mobility. Methods: A cross-sectional online survey was conducted with 4961 urban U.S. adults aged 65 and older. Food insecurity was assessed using the USDA Six-Item Short Form. Paired sample t-tests, chi-square tests, and multivariate logistic regression were used to examine demographic predictors of food insecurity before and during the pandemic. Results: Logistic regression indicated that race and income were significant predictors of food insecurity. African American and Hispanic participants were 92.1% and 126.4%, respectively, more likely to experience food insecurity than White participants (p < 0.001). Compared with those earning less than USD 50,000, participants earning USD 50,000-USD 100,000 and USD 100,000+ were 32.4% and 63.8% less likely to experience food insecurity (p < 0.001). Bivariate analyses showed that food insecurity increased most among African Americans (9.2%) and middle-income participants (USD 50,000-USD 100,000: 11.0%). Education did not remain significant in the adjusted model. Conclusions: Older adults of color and those with lower incomes were disproportionately impacted by food insecurity during the pandemic. The findings highlight the need for targeted, equity-driven policy responses to mitigate food insecurity in older adulthood.