Food Insecurity, COVID-19 Anxiety, and Perceived Stress As Correlates of Binge Eating Among Essential Workers of Color

Background and Purpose: Essential workers of color have been at the intersection of risk during the COVID-19 pandemic. Not only were many required to work on the frontlines with increased risk for contracting COVID-19, they also were more likely to have low wages and experience food insecurity compared to non-essential workers. For example, 38% of essential workers in New York reported food insecurity during the COVID-19 pandemic. Though we know that these workers may be more likely to be food-insecure, we know less about the psychosocial correlates that may also be related to this experience. Thus, the purpose of this study was to examine the associations between food insecurity, perceived stress, COVID-19 anxiety, and binge eating.

Methods: Data and Sample. The analytic sample comprised 319 individuals who reported being essential workers during the COVID-19 pandemic. About 50% of participants identified as female, and 92% identified as heterosexual. Nearly 68% of participants identified as Black or African American, 18% identified as Native American or Alaskan Native, 6% identified as Latinx or Hispanic, and 7% identified as Asian or Native Hawaiian. Measures. Food insecurity was our focal exogenous latent factor and was measured using an adapted version of the six-item Household Food Security Scale, with each item specified as an observed indicator ( = 0.91). Endogenous observed indicators included average scores yielded from multi-item scales measuring perceived stress ( = 0.92), COVID-19 anxiety ( = 0.92), and binge eating ( = 0.91). Analysis. We employed structural equation modeling (SEM) to assess direct and indirect associations between endogenous and exogenous variables. Preliminary calculations indicated that the full model was overidentified and powered (1 - β) at 0.97 to detect not-close model fit (i.e., RMSEA of 0.06 or higher; MacCallum et al., 1996).

Results: The final model yielded the following fit indices: χ²(40)=96.49, p<.001; CFI=0.96; TLI=0.94; RMSEA=0.067 (90% confidence intervals: 0.050, 0.084). Results indicated that food insecurity was positively associated with COVID-19 anxiety (β=0.60), perceived stress (β=0.47), and binge eating (β=0.38). COVID-19 anxiety was also positively associated with binge eating (β=0.17); the indirect association between food insecurity and binge eating via COVID-19 anxiety was statistically significant and positive (β=0.10). Multiple group comparison analyses indicated that the measurement and structural parameters were effectively invariant between two subgroups: (a) those indicating four or fewer areas of life-stress impact caused by the COVID-19 pandemic (relatively low impact; n=164), and (b) those with five or more areas of life-stress impact (relatively high impact; n=155).

Conclusions and Implications: Findings from this study reveal essential workers of color experiencing food insecurity may have also been managing COVID-19 anxiety, perceived stress, and binge eating behavior. Indeed, as these workers were taking significant risks during the COVID-19 pandemic, they were also navigating increased stress and anxiety, and challenges regulating their eating behavior. Developing programs to care more appropriately for these workers may include systemic changes to ensure the receipt of equitable wages and mental health care. Future research is also needed to inform food assistance policy.