The Association between Food Insecurity and Making Hunger-Coping Trade-Offs during the COVID-19 Pandemic: The Role of Sources of Food and Easiness in Food Access.

Many individuals make financial, health and food related trade-offs to cope with the challenges of food insecurity and to meet their household needs for healthy, affordable food. A survey ( = 652) was conducted in nine rural counties in South Carolina, USA, during the COVID-19 pandemic from August 2020 to July 2021. We examine if level of food insecurity predicts hunger-coping trade-offs, and whether this relationship is moderated by easiness in food access and dependence on different food source types. Nearly one-third of the respondents experienced food insecurity. Making trade-offs between paying for food and other household expenses was common among the rural residents as on average they made nearly one type of trade-off in the past three months. The number of trade-offs was the highest among highly food insecure respondents (mean = 2.64), followed by moderately food insecure respondents (mean = 1.66); low food insecure respondents had the lowest number of trade-offs (mean = 0.39). The moderating effects of easiness in food access and dependence on food sources varied by level of food insecurity. The results show that individuals at different levels of food insecurity use different strategies to fulfill their food needs and social programs are more often utilized than personal food sources. We conclude with implications for addressing food insecurity in order to reduce the possibility of making trade-offs.