Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic Key Findings • Despite a 28% increase in food insecurity since the pandemic, minimal changes were observed in rates of food assistance program participation. • SNAP benefits were considered inadequate to meet family needs by more than half of the participating households. • A fifth of SNAP participants reported that they could not use SNAP benefits for online purchases, even though this flexibility was available to all SNAP participants since the pandemic began. • Half of WIC participants would like to use their benefits for online purchases, but they are currently not afforded this flexibility. • Almost half of WIC participants reported not being able to fully redeem their benefits in stores due to lack of availability of WIC approved foods during the pandemic. • Limited hours, inconvenient locations, as well as meals running out before the next pick up day were identified as major challenges for using the school meal programs. • Food pantry beneficiaries found long lines and limits on frequency of visits to the pantry challenging. • Personal convictions about independence and concerns of having too many assets to qualify for benefits were key concerns cited by respondents. These concerns may have limited Arizona households participation in available food assistance programs that are designed to mitigate the negative impacts of food insecurity. Sarah Martinelli, MS, RD, SNS 1 Francesco Acciai, PhD 1 Aggie J. Yellow Horse, PhD 2 Anna Josephson, PhD 3 Punam Ohri-Vachaspati RD, PhD 1 1 College of Health Solutions, Arizona State University 2 School of Social Transformation, Arizona State University 3 Department of Agricultural and Resource Economics, University of Arizona Introduction The coronavirus (COVID-19) pandemic led to disruptions in the food supply and high rates of unemployment and under-employment, both in Arizona and nationally.1,2 These emergencies required food assistance programs to adapt quickly and in unprecedented ways by relaxing eligibility criteria, improvising on delivery modalities, and increasing benefits.3 To examine food assistance program participation during the pandemic, we collected data from a representative sample of 620 Arizona households. The sample was drawn from across Arizona in July-August 2020 using an online survey. This brief provides the summary for participation in key food assistance programs, namely, the Supplementary Nutrition Assistance Program (SNAP), the Special Supplemental Program for Women Infants and Children (WIC), School Food Programs, and the emergency food assistance provided through food pantries. During COVID-19, food insecurity rates increased in Arizona, but food assistance program participation did not change. Food insecurity rates among Arizona households increased by 28% since the start of the pandemic, from 25% to 32%.4 Yet, compared to 12 months prior to the pandemic (March 2019 – March 2020), food assistance program participation remained about the same (Figure 1). In the prior 12 months, 26% of Arizona households in our survey reported participating in at least one food assistance program, compared 27% doing so since the start of the pandemic in March 2020. See the glossary on page 6 for definitions of terms. 1 November 2020 Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic Figure 1. Food Assistance Program Participation among Arizona Households, Before and Since COVID-19 Pandemic (%) Figure 2. Arizona Households’ Participation in Any Food Assistance Program by Household Food Insecurity Status and Household Demographics (%) Note: The period between March 2019 to March 2020 covered the “12 months before the pandemic”. The period from March 2020 onwards refers to ‘since the pandemic’. Vulnerable families participated in food assistance programs at higher rates. Note: The period between March 2019 to March 2020 covered the “12 months before the pandemic”. The period from March 2020 onwards refers to ‘since the pandemic’. Food assistance program participation, both before and since the pandemic, was highest in households classified as persistently food insecure (those who were food insecure both before and since the pandemic), with 59% participating in at least one program prior to the pandemic and 62% doing so since the pandemic (Figure 2). The newly food insecure households (those who became food insecure after the pandemic) experienced the greatest increase in proportion participating in food assistance programs, which increased from 35% to 52%. Compared to all households in the sample, food assistance program participation rates were also higher among households with children, households with lower annual income (at or below $50,000), as well as among households that experienced COVID-19-related job disruptions (e.g., job loss, reduced hours or income, furloughed). SNAP participation did not change. 2 Participation rates remained at 16% overall, with slightly over a quarter of the low-income households participating at both time points. The vast majority of SNAP participants indicated that they found the program easy to use (Figure 3). However, only 46% of SNAP participants thought the benefits were adequate to meet their family’s needs, despite USDA’s issuance of emergency supplements to SNAP households that normally receive less than the maximum benefit. SNAP households that already received the maximum monthly allotment were not eligible for any additional assistance. USDA also allowed all SNAP beneficiaries flexibility to pay for online purchases using SNAP benefits, but nearly one in four (23%) SNAP participants reported that they could not pay for online groceries using their benefits. Similarly, one in five SNAP participants said they November 2020 Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic could not use their full month’s benefit because of COVID-19 related difficulties in shopping or stores running out of food items. Figure 3. Arizona Households’ Experience Using SNAP during COVID-19 (%) “It’s difficult to shop and it’s WIC because you have to go in person no matter what and potentially expose yourself/family to the virus and some stores limit the quantity of items you can buy so you have to make multiple trips to be able to get your full benefits. This is really difficult with small children and no consistent babysitter.” —Survey respondent Note: Includes respondents who strongly agreed or agreed with the statement. WIC participation declined during COVID-19. Recognizing the new challenges that emerged during the pandemic, WIC programs in Arizona utilized a number of USDA waivers granting flexibility to WIC participants, including waiver of physical presence at the clinic and waivers for food substitutions3. Nonetheless, based on our estimates, WIC participation fell from 7% to 5% since COVID-19, and the fall was larger for low-income households (from 12% to 5%). Further, three quarters of WIC-using households reported challenges with limited selection of WICapproved foods in stores, and nearly half (48%) reported not being able to use their full benefits because of COVID-19 related difficulties in shopping and lack of availability of WIC items in stores (Figure 4). Figure 4. Arizona Households’ Experience Using WIC During COVID-19 (%) COVID-19 school closures limited children’s access to USDA’s reimbursable school meals. Schools across Arizona, supported by waivers from the USDA, were able to provide meals during COVID-19 school closures using the summer meal program guidelines including flexibilities on location, timing, meal patterns, meal distribution, and eligibility for free and reduced-price meals.3 In addition, starting in April 2020, the Arizona Department of Education provided a novel benefit called P-EBT (pandemic electronic benefits transfer) to families whose children were eligible for free and reduced-price school meals. In spite of these additional provisions, low-income households with children reported a decrease in school meal participation since the pandemic (from 40% to 31%). As shown in Figure 5, most households that used the school meal program found it helpful (78%), but a substantial portion of families identified challenges with school meal participation during the pandemic, including difficulties with location (39%) and timing of operation (41%) of distribution sites, families running out of meals before the next pick up day (41%), and lack of feasible delivery options (59%). “The Pandemic-EBT was fantastic help with our food as we struggle through this pandemic.” Note: Includes respondents who strongly agreed or agreed with the statement. 3 —Survey respondent November 2020 Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic Figure 5. Arizona Households’ Experience Using School Meal Programs during COVID-19 (%) Note: Includes respondents who strongly agreed or agreed with the statement. Food pantry use increased among households impacted by COVID-19 related job and income loss and those that were newly food insecure. One in four (25%) households that experienced disruptions in employment reported using a food pantry since the pandemic, an increase from 20% pre-pandemic. Compared to the pre-pandemic period, newly food insecure households used food pantry more than twice as frequently (12% vs 32%). The main barriers to using food pantries during the pandemic were limits to how frequently one can visit the pantry (63%) and long lines and wait times (54%). Food pantry hours (35%) and availability of preferred foods (35%) were also identified by respondents as barriers (Figure 6). Despite issues experienced with food pantries, the majority (84%) of households found this program helpful. Figure 6. Arizona Households’ Experience Using Food Pantries during COVID-19 (%) Note: Includes respondents who strongly agreed or agreed with the statement. 4 November 2020 Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic Arizona households expressed concerns and identified barriers for participating in food assistance programs Food assistance programs can be critical for families during emergencies, including COVID-19. However, we did not see an overall increase in program participation that might have been expected given the increase in food insecurity rates. When respondents were asked to share their concerns and barriers for participating in food assistance programs, two stood out (Figure 7). First, 47% of all households and 43% of low-income households expressed that they valued their personal independence and did not want to rely on food assistance programs. Second, 40% of households reported concerns they had too many assets that would prevent them for qualifying. Respondents, especially those from low-income households, listed paperwork and travel to program office as additional barriers. Figure 7. Arizona Households’ Concerns/Barriers for Participating in Food Assistance Programs during COVID-19 (%) Policy Implications • Record high unemployment rates and increased rates of food insecurity call for maintaining and enhancing food assistance program waivers and supports, such as additional benefits, as well as flexibility in program enrollment and delivery. Current regulations that include temporary boosts in income, such as unemployment insurance, when calculating program eligibility need to be reevaluated, as they can result in vulnerable households temporarily losing benefits essential for mitigating the negative impacts of increased food insecurity during crises. • Enhancing SNAP benefits for all beneficiaries will ensure unmet needs of food insecure households are addressed. SNAP participants’ ability to shop online could be enhanced by allowing for SNAP benefits to pay for grocery delivery options. • Ensuring WIC participants are aware of flexibility related to in-person clinic visits and substitution of WIC approved items at the store can help increase participation and redemption rates. Options for online shopping using WIC benefits would improve access during emergencies. • Further innovation is needed in program delivery for school meals to meet the needs of parents re-entering workforce while their children are still not attending school on a regular basis. • Reducing administrative barriers for program enrollment and for receipt of benefits are critical for mitigating the negative impacts of increased food insecurity during COVID-19. Methods Note: Includes respondents who strongly agreed or agreed with the statement. 5 In July-August 2020, a sample of 620 adult Arizona residents responded to an online survey of households contacted through a survey research firm (Qualtrics). Survey respondents were selected to be representative of Arizona population, with an over-sampling of respondents from low-income households. The respondents in the sample reside in 75 different towns, from 15 out of the 16 counties in AZ. Most respondents lived in Maricopa county (60%), followed by Pima (17%), and Pinal (6%) counties. Respondents were 18-86 years old, with the average age being 47. Half (49%) of the respondents were from low-income households (i.e., with an annual income in 2019 lower than $50,000); 54% were non-Hispanic white and 34% were Hispanic; 39% had a college degree; 17% were foreign-born. Participants were asked to answer questions on a variety of topics including food security, food access, food assistance program participation, as well as November 2020 Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic households and individual demographic characteristics. All analyses were adjusted for sampling weights so that results can be generalized to all Arizona households. The period from March 2019 to March 10, 2020 was referred to as prior to the pandemic while the period after March 11, 2020 aims at capturing what has changed since the pandemic. A series of briefs from this survey are available at asufoodpolicy.org and nfactresearch.org. Acknowledgments This project was supported by a COVID-19 seed grant from the College of Health Solutions, Arizona State University. About NFACT This research is conducted as part of The National Food Access and COVID Research Team (NFACT). NFACT is a national collaboration of researchers committed to rigorous, comparative, and timely food access research during the time of COVID-19. We do this through collaborative, open access research that prioritizes communication to key decision-makers while building our scientific understanding of food system behaviors and policies. To learn more visit nfactresearch.org. Citations 1. US Department of Labor. dol.gov/ui/data.pdf. Accessed on 9/22/2020. 2. The Hamilton Project. hamiltonproject.org/blog/the_ covid_19_crisis_has_already_left_too_many_children_ hungry_in_america. Accessed on 9/22/2020. 3. USDA Food and Nutrition Services. (September 22, 2020). Arizona: COVID-19 Waivers & Flexibilities. Retrieved from fns.usda.gov/disaster/pandemic/covid-19/arizona. 4. Acciai F, Yellow Horse AJ, Martinelli S, Josephson A, Evans T, Ohri-Vachaspati P. Impacts of COVID-19 on Food Security in Arizona. College of Health Solutions, Arizona State University, November 2020. 5. USDA Economic Research Services. (September 9, 2020). Survey Tools. Food Security in the US. Retrieved from: ers.usda.gov/topics/food-nutrition-assistance/food-securityin-the-us/survey-tools/#six Glossary Low-income households: Households with annual income less than $50,000 per year. USDA: U.S. Department of Agriculture, oversees food assistance program benefits including SNAP, WIC, school meals and others. SNAP: Supplemental Nutrition Assistance Program (formally known as Food Stamps). An income-based program that provides financial benefits to supplement food budgets of low-income families. WIC: Special Supplemental Nutrition Program for Women, Infants, and Children provides supplemental foods, health care referrals, and nutrition education for low-income pregnant and postpartum women, and to infants and children up to age five. P-EBT: Pandemic-Electronic Benefits Transfer provides assistance to households with children who are eligible for free or reduced-price school meals during COVID-19 school closures. Food insecure households: Food insecurity was measured using the USDA’s validated six-item household food security survey module.5 Respondents who answered affirmatively to 2 or more of the food insecurity questions were considered food insecure5. Respondents who were food insecure at both in the 12 months prior to the pandemic (March 2019 – March 2020) and since the pandemic (since March 2020) were classified as persistently food insecure. Those who were food secure but became food insecure since the pandemic were classified as newly food insecure. The food secure category includes households that were food secure since COVID, regardless of their food security status prior to the pandemic. Suggested Citation Martinelli S, Acciai F, Yellow Horse AJ, Josephson A, Ohri-Vachaspati P. “Food Assistance Program Participation among Arizona Households during the COVID-19 Pandemic.” College of Health Solutions, Arizona State University, November 2020. 6 November 2020