Not only do healthcare workers bear the brunt of caring for patients during the COVID-19 pandemic and have an increased likelihood of contracting the infectious disease, but nearly 7% (6.6%) of them may also face food insecurity, according to a recent study published in Health Affairs.

Mithuna Srinivasan, PhD, principal research scientist at the National Organization for Research (NORC) at the University of Chicago, in Chicago, Illinois, the study’s lead author, told Medscape Medical News that the overall prevalence of food insecurity among healthcare workers from 2013 to 2018 was nearly 7%. Although that was lower than the national prevalence (10.5%), there’s wide variation among healthcare workers, Srinivasan said.

Healthcare support workers were 5.1 times more likely to be food insecure than their colleagues who were diagnosing and treating patients. Health technologists and technicians were 2.5 times more likely. Healthcare support workers serve as nursing, psychiatric, and home health aides and as occupational and physical therapist assistants and aides.

Food insecurity is defined as difficulty accessing an adequate supply of nutritious food. The study authors note that food insecurity is associated with poor health outcomes, including diabetes, heart disease, and depression.

“It is critical that food insecurity issues faced by US healthcare workers be addressed, because the healthcare industry is the largest employer within the United States and will only continue to grow,” said Srinivasan. “In particular, the long-term care sector is projected to grow exponentially over the course of this decade, amid an aging US population and payment policies and incentives that promote community-based care.”

Doctors and nurses can play a role in helping their colleagues who are experiencing food insecurity, said Jennifer Pooler, MPP, senior study director in the food and nutrition practice area at Insight Policy Research and study co-author.

“As leaders in the healthcare community, physicians and nurses can help educate health systems’ leadership and advocate for fair policies and practices that acknowledge and resolve issues that contribute to food insecurity, such as low wages and unstable work schedules,” Pooler said. Insight Policy Research conducts quantitative and qualitative data collection and research related to health and food and nutrition areas.

Lower Income, Higher Rates of Food Insecurity

The US Bureau of Labor Statistics expects that home healthcare services, in which nearly 88% (87.7%) of the employees are women, will be one of the country’s fastest growing occupations. Nearly 35% (34.9%) of these healthcare workers earned less than $15 per hour. A 2019 study found that nearly half of Black and Latina healthcare workers earn less than $15 an hour and that more than 10% don’t have health insurance.

The Health Affairs study found that 25.4% of healthcare support workers received Supplemental Nutrition Assistance Program (SNAP) benefits in the previous year. Only 2.3% of diagnosing and treating practitioners and nearly 7% (6.6%) of technologists and technicians received such benefits. SNAP is a program of the US Department of Agriculture. It is administered by states and supplements families’ food budgets.

The income thresholds for participation in SNAP are low. In Massachusetts, for example, a single resident must have a pre-tax annual income of $25,760 or less. For a family of four to quality, the earnings cap is $53,000. In Kentucky, a single resident must have a pre-tax annual income of $16,744; for a family of four, the cap is $34,450.

According to the study in HealthAffairs, nearly 42% (41.9%) of healthcare support workers had an annual income of less than $35,000. By contrast, almost 6% (5.7%) of diagnosing and treating practitioners and 15.1% of technologists and technicians had a take-home pay of less than $35,000. Eighty-nine percent of diagnosing and treating practitioners earned more than $50,000 each year; just under 42% (41.6%) of healthcare support workers earned that salary level.

Raising the Minimum Wage, Providing Transportation Benefits Can Help

Raising the minimum wage to $15 an hour would reduce poverty rates among healthcare workers by 27% to 50%, the authors of the 2019 article indicated.

Srinivasan said that developing long-term, viable solutions to the food insecurity problem among healthcare workers largely depends on policymakers and health system employers. Employers can help by increasing healthcare worker’s wages and benefits, including nontraditional benefits, such as providing transportation, housing assistance, and child care, she said.

“However, it is important to hear firsthand from [healthcare workers] on what would work — and particularly for addressing this problem on a sustained or long-term basis,” said Srinivasan. “For example, input can be solicited from healthcare workers on potential strategies through anonymous employee pulse surveys to assess which strategies would be desired or useful to employees.”

Although an assessment of the impact of the COVID-19 pandemic on food insecurity among healthcare workers was beyond the scope of the study, Srinivasan observes that food prices have increased, and many healthcare support workers — especially women — have lost their jobs. These factors may have exacerbated food insecurity for healthcare support workers.

The Health Affairs study relied on data from the 2013–2018 National Health Interview Survey, which is conducted by the Centers for Disease Control and Prevention. The survey provides information on a large, representative sample of healthcare workers and relies on a validated measure of food insecurity. It provides data on a variety of sociodemographic and health-related characteristics.

Health Aff. 2021 Sep;40:1449-1456. Abstract

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