{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T17:24:45Z","timestamp":1767374685207,"version":"3.48.0"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Long COVID (ie, post\u2013COVID-19 condition) is a substantial public health concern, and its association with health-related social needs, such as food insecurity, remains poorly understood. Identifying modifiable risk factors like food insecurity and interventions like food assistance programs is critical for reducing the health burden of long COVID.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the association of food insecurity with long COVID and to assess the modifying factors of Supplemental Nutrition Assistance Program (SNAP) participation and employment status.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective, cross-sectional survey study used data from the 2022 to 2023 National Health Interview Survey. Respondents aged 18 years and older who reported prior COVID-19 infection and responded to questions on food insecurity and long COVID were included.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Food insecurity, categorized as food secure or food insecure.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was current long COVID, defined as symptoms lasting 3 or more months after initial COVID-19 infection persisting to time of interview. The secondary outcome was long COVID recovery, indicating history of long COVID without current symptoms. Food insecurity was measured using the validated 10-item National Center for Health Statistics food insecurity scale. Odds ratios (ORs) and 95% CIs for the association of food insecurity with long COVID were calculated using simple and multiple logistic regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study enrolled 21\u202f631 participants (1255 female [weighted percentage, 53%]; 5058 aged 65 years or older [weighted percentage, 16%]), including 19\u202f824 with food security and 1807 with food insecurity. In total, 288 respondents with food insecurity (weighted percentage, 15%) reported current long COVID compared with 1547 (weighted percentage, 7%) without food insecurity. Food insecurity was positively associated with current long COVID (adjusted OR, 1.73; 95% CI, 1.39-2.15) and negatively associated with recovery among adults with prior long COVID (adjusted OR, 0.70; 95% CI, 0.54-0.92). SNAP participation (\n P<\/jats:italic>\n for interaction\u2009=\u2009.04) and unemployment (\n P<\/jats:italic>\n for interaction\u2009=\u2009.04) significantly modified these associations.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this survey study of US adults with prior COVID-19 infection, food insecurity was associated with greater odds of long COVID and lower odds of recovery, with SNAP participation and unemployment mitigating these associations. These findings suggest that expanding SNAP eligibility, simplifying enrollment processes, and increasing awareness of food assistance programs may reduce the burden of food insecurity and long COVID and further emphasize the importance of addressing health-related social needs in chronic disease prevention and management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.30730","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T15:00:26Z","timestamp":1757430026000},"page":"e2530730","source":"Crossref","is-referenced-by-count":1,"title":["Long COVID and Food Insecurity in US Adults, 2022-2023"],"prefix":"10.1001","volume":"8","author":[{"given":"John C.","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Penn Medicine Center for Health Equity Advancement, University of Pennsylvania Health System, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madison","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Yale School of Public Health, New Haven, Connecticut"},{"name":"University of Cambridge, Cambridge, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sriya","family":"Potluri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Penn Medicine Center for Health Equity Advancement, University of Pennsylvania Health System, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruiqi","family":"Yan","sequence":"additional","affiliation":[{"name":"Penn Medicine Center for Health Equity Advancement, University of Pennsylvania Health System, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaya","family":"Aysola","sequence":"additional","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia"},{"name":"Penn Medicine Center for Health Equity Advancement, University of Pennsylvania Health System, Philadelphia"},{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"3","key":"zoi250865r2","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: major findings, mechanisms and recommendations.","volume":"21","author":"Davis","year":"2023","journal-title":"Nat Rev Microbiol"},{"issue":"2","key":"zoi250865r4","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.56152","article-title":"Association of post\u2013COVID-19 condition symptoms and employment status.","volume":"6","author":"Perlis","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"4","key":"zoi250865r5","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.ajic.2023.11.004","article-title":"COVID-19 and health care-related financial toxicity in the United States: evidence from the 2022 National Health Interview Survey.","volume":"52","author":"Datta","year":"2024","journal-title":"Am J Infect Control"},{"issue":"8","key":"zoi250865r6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065083","article-title":"Short-term and long-term impacts of COVID-19 on economic vulnerability: a population-based longitudinal study (COVIDENCE UK).","volume":"12","author":"Williamson","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"zoi250865r7","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1186\/s12889-021-10631-0","article-title":"The association between food insecurity and mental health during the COVID-19 pandemic.","volume":"21","author":"Fang","year":"2021","journal-title":"BMC Public Health"},{"issue":"6","key":"zoi250865r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.12852","article-title":"Associations of race\/ethnicity and food insecurity with COVID-19 infection rates across US counties.","volume":"4","author":"Kimani","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"5","key":"zoi250865r9","doi-asserted-by":"publisher","first-page":"776","DOI":"10.2105\/AJPH.2022.306724","article-title":"Food insecurity and delayed or forgone medical care during the COVID-19 pandemic.","volume":"112","author":"Bertoldo","year":"2022","journal-title":"Am J Public Health"},{"issue":"5","key":"zoi250865r12","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1001\/jamainternmed.2020.7048","article-title":"Unemployment insurance, health-related social needs, health care access, and mental health during the COVID-19 pandemic.","volume":"181","author":"Berkowitz","year":"2021","journal-title":"JAMA Intern Med"},{"issue":"1","key":"zoi250865r13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.35884","article-title":"Association between receipt of unemployment insurance and food insecurity among people who lost employment during the COVID-19 pandemic in the United States.","volume":"4","author":"Raifman","year":"2021","journal-title":"JAMA Netw Open"},{"key":"zoi250865r15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.foodpol.2017.08.006","article-title":"Household history, SNAP participation, and food insecurity.","volume":"73","author":"Swann","year":"2017","journal-title":"Food Policy"},{"issue":"18","key":"zoi250865r18","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1056\/NEJMsb2408466","article-title":"Long Covid defined.","volume":"391","author":"Ely","year":"2024","journal-title":"N Engl J Med"},{"issue":"8","key":"zoi250865r20","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.2105\/AJPH.89.8.1231","article-title":"The effectiveness of a short form of the Household Food Security Scale.","volume":"89","author":"Blumberg","year":"1999","journal-title":"Am J Public Health"},{"key":"zoi250865r21","doi-asserted-by":"publisher","DOI":"10.5888\/pcd10.120203","article-title":"Prevalence of multiple chronic conditions among US adults: estimates from the National Health Interview Survey, 2010.","volume":"10","author":"Ward","year":"2013","journal-title":"Prev Chronic Dis"},{"issue":"100","key":"zoi250865r22","first-page":"1","article-title":"Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years.","author":"Freid","year":"2012","journal-title":"NCHS Data Brief"},{"issue":"2","key":"zoi250865r23","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1111\/ajae.12322","article-title":"Unemployment benefits, food insecurity, and supplemental nutrition assistance program spending.","volume":"105","author":"Fu","year":"2023","journal-title":"Am J Agric Econ"},{"issue":"1","key":"zoi250865r25","doi-asserted-by":"publisher","DOI":"10.1136\/bmjmed-2022-000385","article-title":"Effect of covid-19 vaccination on long covid: systematic review.","volume":"2","author":"Byambasuren","year":"2023","journal-title":"BMJ Med"},{"issue":"1","key":"zoi250865r26","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s12888-017-1235-0","article-title":"Seeking help in times of economic hardship: access, experiences of services and unmet need.","volume":"17","author":"Barnes","year":"2017","journal-title":"BMC Psychiatry"},{"issue":"10","key":"zoi250865r27","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.1377\/hlthaff.2017.0545","article-title":"Health care in the suburbs: an analysis of suburban poverty and health care access.","volume":"36","author":"Schnake-Mahl","year":"2017","journal-title":"Health Aff (Millwood)"},{"issue":"4","key":"zoi250865r28","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1001\/jama.2015.8421","article-title":"Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act.","volume":"314","author":"Sommers","year":"2015","journal-title":"JAMA"},{"issue":"2S","key":"zoi250865r29","doi-asserted-by":"publisher","first-page":"521S","DOI":"10.1093\/jn\/129.2.521S","article-title":"Nutrition and health outcomes associated with food insecurity and hunger.","volume":"129","author":"Olson","year":"1999","journal-title":"J Nutr"},{"issue":"10","key":"zoi250865r30","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1016\/S0002-8223(96)00271-4","article-title":"Relationship of hunger and food insecurity to food availability and consumption.","volume":"96","author":"Kendall","year":"1996","journal-title":"J Am Diet Assoc"},{"key":"zoi250865r31","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2022.100224","article-title":"Hunger relief: a natural experiment from additional SNAP benefits during the COVID-19 pandemic.","volume":"10","author":"Bryant","year":"2022","journal-title":"Lancet Reg Health Am"},{"issue":"8","key":"zoi250865r32","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.2511","article-title":"Associations between ending supplemental nutrition assistance program emergency allotments and food insufficiency.","volume":"4","author":"Richterman","year":"2023","journal-title":"JAMA Health Forum"},{"issue":"10","key":"zoi250865r33","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1377\/hlthaff.2023.01566","article-title":"Food insufficiency increased after the expiration of COVID-19 emergency allotments for SNAP benefits in 2023.","volume":"43","author":"Wells","year":"2024","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"zoi250865r34","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1257\/pol.20200561","article-title":"Employed in a SNAP? The impact of work requirements on program participation and labor supply.","volume":"15","author":"Gray","year":"2023","journal-title":"AEJ Econ Policy"},{"issue":"15","key":"zoi250865r35","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1001\/jama.2020.19759","article-title":"The COVID-19 pandemic and the $16 trillion virus.","volume":"324","author":"Cutler","year":"2020","journal-title":"JAMA"},{"issue":"5","key":"zoi250865r36","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.1809","article-title":"The costs of long COVID.","volume":"3","author":"Cutler","year":"2022","journal-title":"JAMA Health Forum"},{"issue":"9","key":"zoi250865r37","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1016\/j.jand.2021.05.018","article-title":"Barriers to accessing healthy food and food assistance during the COVID-19 pandemic and racial justice uprisings: a mixed-methods investigation of emerging adults\u2019 experiences.","volume":"121","author":"Larson","year":"2021","journal-title":"J Acad Nutr Diet"},{"key":"zoi250865r38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pbiomolbio.2023.04.008","article-title":"Identification and diagnosis of long COVID-19: a scoping review.","volume":"182","author":"Srikanth","year":"2023","journal-title":"Prog Biophys Mol Biol"},{"key":"zoi250865r1","unstructured":"Centers for Disease Control and Prevention. Long COVID basics. Updated July 24, 2025. Accessed August 4, 2025. https:\/\/www.cdc.gov\/covid\/long-term-effects\/index.html"},{"key":"zoi250865r3","unstructured":"Centers for Disease Control and Prevention. CDC science and the public health approach to long COVID. Updated July 24, 2025. Accessed August 4, 2025. https:\/\/www.cdc.gov\/covid\/php\/long-covid\/index.html"},{"key":"zoi250865r10","unstructured":"Gregory? CA, Coleman-Jensen? A. Food insecurity, chronic disease, and health among working-age adults. US Department of Agriculture Economic Research Service. Published July 31 2017. Accessed August 4, 2025. https:\/\/www.ers.usda.gov\/publications\/pub-details?pubid=84466"},{"key":"zoi250865r11","doi-asserted-by":"crossref","unstructured":"Rabbitt? MP, Hales? LJ, Burke? MP, Coleman-Jensen? A. Household food security in the United States in 2022. US Department of Agriculture Economic Research Service. Published October 25, 2023. Accessed August 4, 2025. https:\/\/www.ers.usda.gov\/webdocs\/publications\/107703\/err-325.pdf?v=2711.1","DOI":"10.32747\/2023.8134351.ers"},{"key":"zoi250865r14","unstructured":"Jones? JW, Toossi? S. The food and nutrition assistance landscape: fiscal year 2023 annual report. Published June 12, 2024. Accessed August 4, 2025. https:\/\/www.ers.usda.gov\/webdocs\/publications\/109314\/eib-274.pdf?v=1831.6"},{"key":"zoi250865r16","unstructured":"American Association for Public Opinion Research. Survey disclosure checklist. Posted May 13, 2009. Accessed June 30, 2025. https:\/\/aapor.org\/standards-and-ethics\/disclosure-standards\/"},{"key":"zoi250865r17","unstructured":"National Center for Health Statistics. 2023 NHIS questionnaires, datasets, and documentation. Centers for Disease Control and Prevention. Updated November 20, 2024. Accessed August 4, 2025. https:\/\/www.cdc.gov\/nchs\/nhis\/documentation\/2023-nhis.html"},{"key":"zoi250865r19","unstructured":"Bickel? G, Nord? M, Price? C, Hamilton? W, Cook? J. Guide to measuring household food security: measuring food security in the United States. US Department of Agriculture Food and Nutrition Service. Published March 2000. Accessed August 4, 2025. https:\/\/nhis.ipums.org\/nhis\/resources\/FSGuide.pdf"},{"key":"zoi250865r24","unstructured":"Nord? M, Coleman-Jensen? A, Gregory? CA. Prevalence of U.S. food insecurity is related to changes in unemployment, inflation, and the price of food. US Department of Agriculture Economic Research Service. Published June 20, 2014. Accessed August 4, 2025. https:\/\/www.ers.usda.gov\/publications\/pub-details\/?pubid=45216"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2838652\/lin_2025_oi_250865_1766772455.61794.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T16:00:18Z","timestamp":1767369618000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2838652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":38,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.30730","relation":{},"ISSN":["2574-3805"],"issn-type":[{"type":"electronic","value":"2574-3805"}],"subject":[],"published":{"date-parts":[[2025,9,9]]}}}