Food Insecurity Associated With Increased Long COVID Risk, Lower Recovery Rates

Food insecurity is associated with increased odds of having current long COVID and reduced likelihood of recovery, according to a survey study of US adults with prior COVID-19 infection published in JAMA Network Open.1

While prior research has focused on the clinical features of long COVID, less attention has been given to its broader social and economic consequences. Evidence suggests that individuals with lower income are at greater risk of developing long COVID and that those affected may face higher risks of unemployment and health care-related financial toxicity.

Although income has been identified as a potential contributing factor to long COVID, the role of other potential social risk factors remains less clear. The researchers highlighted food insecurity as a key area of concern due to its prevalence in the US, with approximately 13.5% of US households affected in 2023, and the reach of the Supplemental Nutrition Assistance Program (SNAP), which had a monthly average of 42.1 million participants that year.2,3

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The researchers conducted a retrospective, cross-sectional survey study to investigate the association between food insecurity and long COVID, as well as the modifying effects of SNAP and unemployment.1

They used 2022 to 2023 data from the National Health Interview Survey (NHIS), an annual, nationally representative, cross-sectional survey conducted by the National Center for Health Statistics (NCHS) that collects demographic, socioeconomic, and health-related information from the civilian, noninstitutionalized US population.4 It measured food insecurity using a 10-item scale, with scores of 0 to 2 indicating high or marginal food security and scores of 3 to 10 indicating low or very low food security.1

The study’s primary outcome was current long COVID, defined as symptoms lasting 3 or more months after initial COVID-19 infection and persisting at the time of the interview. Its secondary outcome was long COVID recovery, defined as a history of long COVID without current symptoms.

The study included individuals aged 18 and older from the NHIS adult sample who reported having COVID-19 at any point and provided responses to questions regarding food insecurity. For secondary analyses of long COVID recovery, the researchers further restricted the sample to respondents who reported experiencing long COVID at any point.

The sample consisted of 21,631 adults, of whom 1807 were food insecure. Among the study population, 12,155 were female, and 5059 were aged 65 or older. In terms of race and ethnicity, 3578 were Hispanic, 1906 were non-Hispanic Black, and 14,456 were non-Hispanic White. Current long COVID was reported by 288 respondents with food insecurity and 1547 without.

Food insecurity was positively associated with current long COVID (adjusted OR [aOR], 1.73; 95% CI, 1.39-2.15). In contrast, it was negatively associated with recovery among adults with prior long COVID (aOR, 0.70; 95% CI, 0.54-0.92).

Subgroup analyses showed that SNAP participation and employment status modified these associations. Food insecurity was associated with current long COVID among individuals not receiving SNAP (aOR, 2.04; 95% CI, 1.58-2.64) and among unemployed individuals (aOR, 2.32; 95% CI, 1.71-3.14). Therefore, SNAP participation (P for interaction = .04) and unemployment (P for interaction = .04) significantly influenced these relationships.

The researchers acknowledged their limitations, including that they cannot infer causality or directionality due to the cross-sectional nature of their study. Still, they expressed confidence in their results.

“These findings suggest that food insecurity may be an important and modifiable risk factor for long COVID and that strengthening access to programs like SNAP, raising awareness, and simplifying enrollment could help reduce the health burden of long COVID,” the authors wrote.

References

1. Lin JC, McCarthy M, Potluri S, Nguyen D, Yan R, Aysola J. Long COVID and food insecurity in US adults, 2022-2023. JAMA Netw Open. Published online September 9, 2025. doi:10.1001/jamanetworkopen.2025.30730
2. Jones JW, Toossi S. The food and nutrition assistance landscape: fiscal year 2023 annual report. Economic Research Service. Published June 12, 2024. Accessed September 9, 2025. https://www.ers.usda.gov/webdocs/publications/109314/eib-274.pdf?v=1831.6
3. Swann CA. Household history, SNAP participation, and food insecurity. Food Policy. 2017;73:1-9. doi:10.1016/j.foodpol.2017.08.006
4. Kimani ME, Sarr M, Cuffee Y, Liu C, Webster NS. Associations of race/ethnicity and food insecurity with COVID-19 infection rates across US counties. JAMA Netw Open. 2021;4(6):e2112852. doi:10.1001/jamanetworkopen.2021.12852