Food Insecurity Associated With Increased Risk of Post-COVID-19 Condition

Food insecurity was found to be a critical and modifiable risk factor for the development of post-COVID-19 condition, also known as long COVID, according to results of a survey study of over 20,000 adults who had previously had COVID-19.

Researchers found that food insecurity also lowered the chances of a patient recovering from long COVID. The findings were published in the Journal of the American Medical Association. Data indicated that participation in food assistance programs can reduce the risk of long COVID, giving pharmacists a large opportunity to raise awareness and strengthen access to such programs.¹

Known to contribute to other chronic conditions, food insecurity is gaining traction as a modifiable risk factor for long COVID. | Image Credit: © Emin - stock.adobe.com

How Does Food Insecurity Relate to Long COVID?

Research into risk factors for long COVID is ongoing. Given its complicated mechanism of action and chronic burden, the condition is a significant public health concern, especially as the emergency phase of the COVID-19 pandemic recedes and the concern grows increasingly out-of-mind for many individuals. Much of this research has focused on epidemiologic and clinical presentations of long COVID; however, there has been less focus on the socioeconomic factors that could precede the condition.^1,2

Socioeconomic status is increasingly recognized as a predictor of long COVID development. Novel research is emerging that suggests unemployment and health care-related financial toxicities are major risks for individuals with long COVID. There is also evidence indicating that those with lower income are at heightened long COVID risk. Although food insecurity has been linked to a generally increased risk of other chronic health conditions, the association of long COVID with food insecurity has yet to be fully fleshed out.^1,3

Given the importance of understanding the association and the widespread nature of food insecurity and federal food assistance programs in the United States, study authors investigated the association of food insecurity with long COVID. They utilized data gathered from 2022 to 2023 in the National Health Interview Survey (NHIS) to analyze patient interactions with unemployment and the Supplemental Nutrition Assistance Program (SNAP)—the largest government-funded food assistance program in the US—and their associations with long COVID.¹

The NHIS is an annual, nationally representative, cross-sectional survey that collects a variety of demographic, socioeconomic, and health-related information. Individuals aged 18 and older from the NHIS adult sample who reported having COVID-19 at any time and responded to questions regarding food insecurity were included in the analysis. The authors primarily sought to examine whether individuals had current long COVID and whether they had a history of and recovered from long COVID. Long COVID was defined as self-reported symptoms sustained for 3 months or longer following an initial diagnosis of COVID-19.¹

Long COVID Is Often Associated Food Insecurity, and Vice Versa

A total of 21,631 adults were included in the study, of which 1807 were food insecure and 19,824 were food secure. Among those with food insecurity, 567 participated in SNAP. A simple regression analysis indicated that food insecurity had a large positive association with current long COVID (odds ratio [OR], 2.46 [95% CI, 2.05–2.96]). The association remained strong following adjustments for covariates in a multiple regression model (adjusted OR, 1.73 [95% CI, 1.39–2.15]).¹

Food insecurity was also negatively associated with recovery from long COVID in both the simple (OR, 0.67 [95% CI, 0.53–0.86]) and multiple regression (aOR, 0.70 [95% CI, 0.54–0.92]) analyses. Notable differences were revealed in the subgroup analyses regarding the association of food insecurity with current long COVID based on individuals’ levels of food assistance and employment status. For example, food insecurity was not associated with current long COVID in those receiving SNAP benefits or in unemployed individuals. Conversely, food insecurity was observed in current long COVID patients not receiving SNAP (aOR, 2.04 [95% CI, 1.58–2.64]) and unemployed individuals (aOR, 2.32 [95% CI, 1.71–3.14]) separately, indicating the major role that food assistance programs play in reducing risk.¹

What Should Pharmacists Know?

The investigators postulated some reasons behind the association. Food insecurity could lead to reduced consumption of essential nutrients, exacerbating and contributing to long COVID. Additionally, long COVID may impair individuals’ ability to work, inducing financial difficulties and contributing to long COVID.

Pharmacists can play an integral role in monitoring patients for food insecurity, especially those who are unemployed or facing financial difficulties. A simple referral to SNAP could be the factor that helps a patient begin a gradual recovery from long COVID or prevent them from developing the condition at all.¹

“Expanding SNAP eligibility, simplifying enrollment, and increasing awareness are critical to addressing food insecurity and its health impacts,” the study authors concluded. “Our findings underscore the importance of closing such gaps for long COVID and add to the mounting evidence for the role of food insecurity in chronic disease prevention and management.”¹

REFERENCES

1. Lin JC, McCarthy M, Potluri S, et al. Long COVID and Food Insecurity in US Adults, 2022-2023. JAMA Netw Open. 2025;8(9):e2530703. doi:10.1001/jamanetworkopen.2025.30730

2. CDC—Long COVID. The public health approach to long COVID. Updated September 3, 2025. Accessed September 16, 2025. https://www.cdc.gov/long-covid/php/scientific-approach/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcovid%2Fphp%2Flong-covid%2Findex.html

3. Datta BK, Coughlin SS, Fazlul I, et al. COVID-19 and health care–related financial toxicity in the United States: Evidence from the 2022 National Health Interview Survey. AJIC. 2024;52(4):392-399. doi:10.1016/j.ajic.2023.11.00