A statewide survey conducted by Montana State University researchers during the COVID-19 pandemic determined that food security — or having consistent access to enough food for an active, healthy life — has decreased substantially among Montanans. At the same time, anxiety and other feelings of mental distress are on the rise.

The survey results, released in December under the title “The Impact of COVID-19 on the Health of Montanans,” include the responses of 1,944 participants between April and September 2020. The research received grant support from MSU’s Center for American Indian and Rural Health Equity, or CAIRHE.

“This survey was the first of its kind in Montana to report about the immediate impacts of COVID-19 on food security,” said lead researcher Carmen Byker Shanks, a CAIRHE investigator and associate professor in MSU’s Department of Health and Human Development. “In addition, we investigated a variety of health variables, since the causes and consequences of food insecurity are multifaceted. To build solutions to food insecurity in our state, we must understand the entire scope of the issue.”

Byker Shanks leads a separate CAIRHE project that aims to increase the availability of healthy foods at two rural Montana food pantries while promoting nutritious diets to decrease health risks. When the pandemic reduced her ability to work with her food pantry partners last year, she pivoted a portion of her research to include the statewide survey. The project is supported by a three-year, $464,943 grant from the National Institutes of Health.

Byker Shanks’ co-investigators on the survey project are Michelle Grocke, assistant professor in the Department of Health and Human Development and an MSU Extension specialist; Justin Shanks, former faculty at the MSU Library; Eliza Webber, CAIRHE research project manager; and graduate research assistant Kimberly Scanlon.

“This research casts light on an often overlooked consequence of COVID-19, which is greater food insecurity and anxiety among many sectors of our rural population that are already facing health disparities,” said Dr. Alexandra Adams, director of CAIRHE and a nutritional scientist. “It should be an important tool for those who are working to make sure underserved populations aren’t left behind as the pandemic continues.”

During the early months of 2020, the research team developed the online survey to assess the impact of COVID-19 on Montanans’ food security, health behaviors and health outcomes, then distributed it statewide through email and social media beginning in late April.

Among the survey’s most significant findings is the reported increase in food insecurity. Prior to the pandemic, 11% of the survey respondents were food-insecure, while 18% reported food insecurity during the pandemic.

“Recommendations to stock up on food and limit trips to the grocery store aren’t possible for those who can’t afford to purchase large amounts of food, or who live in communities without access to a consistent food supply,” Byker Shanks said. “COVID-19 requires considerable and rapid behavioral shifts for everyone, including food management skills to cook more, plan ahead and reduce waste. Not everyone has the resources to navigate our new situation.”

Not surprisingly, with food hoarding rampant in the early weeks of the pandemic, respondents reported a decline in food availability, particularly in remote communities, Byker Shanks said. About 77% of respondents indicated that some of the foods they needed were unavailable. Nearly half of the respondents reported buying more food out of fear or anxiety.

Beyond the pandemic’s particular effect on food security in Montana, the survey also explored the broader impact on the well-being of respondents. For example, 34% reported financial hardship due to COVID-19, and 37% said they had engaged in negative health behaviors, such as greater alcohol consumption and more screen time, since the start of the pandemic.

In a six-question assessment of psychological distress, respondents indicated an increase in all six measures since the pandemic began. For example, thinking back to the period before the pandemic, 2.4% of respondents answered “all of the time” or “most of the time” in response to the question “How often did you feel nervous?” That number jumped to 21.5% for the time after COVID-19 struck Montana.

“Navigating a variety of information in the media was stressful to Montanans because it was unclear what was accurate,” Justin Shanks said. “The public needs to be equipped with tangible strategies to access, analyze and share media in the contemporary digital era that’s defined by an ever-increasing pace of access and quantity of information from multiple sources.”

But the news isn’t all bad, Byker Shanks said. A majority of respondents, 54%, also reported positive health behavior changes since the start of the pandemic, such as more exercise and greater connection with family and friends. At the community level, the survey highlighted a greater sharing of resources and more flexible federal food assistance for those in need.

Last August, with early results of the Montana survey in mind, Byker Shanks published an editorial in the American Journal of Public Health titled “The COVID-19 Pandemic: A Watershed Moment to Strengthen Food Security Across the U.S. Food System.” In it, Byker Shanks and her three co-authors from institutions in Arizona and Nebraska said the pandemic provides “an opportunity to develop policy, systems and environmental strategies to enhance food security, reduce inefficiencies and decrease inequities, now and into the future.”

Also prompted in part by the survey, Byker Shanks and her colleagues published a position paper in Translational Behavioral Medicine titled “Scaling Up Measurement to Confront Food Insecurity in the USA” that outlines strategies to bolster measurement of food security.

In their report on the Montana survey findings, Byker Shanks and her MSU co-investigators make similar recommendations for state and local policymakers. Those recommendations include leveraging policy and programmatic support to promote food security; reorienting food systems to ensure adequate food for all; formalizing strategies for resource sharing and the use of federal aid; making mental health resources more readily available; communicating to Montanans through a variety of methods; and creating support systems to encourage positive habits.

“This moment in time highlights a food insecurity crisis that’s existed for decades,” Byker Shanks said. “We have a responsibility to solve an inexcusable problem in a society where enough food and resources are available, but we don’t distribute them equally to everyone.”

To learn more about the survey, visit montana.edu/cairhe/projects/byker-shanks/COVID-19-food-security.html.