Lillie Monroe-Lord^1,, Azam Ardakani¹, Xuejing Duan², Elmira Asongwed¹, Tia Jeffery¹, Phronie Jackson¹

The coronavirus disease 2019 (COVID-19) pandemic has led to significant shifts in dietary behaviors worldwide, influenced by socioeconomic factors such as income and education. This study examines the impact of these factors on dietary changes in urban middle-aged and older adults in the United States during the pandemic. A cross-sectional survey was conducted with 10,050 participants aged 40–100 years who were stratified by income and education levels. Dietary habits were assessed using the 25-item Dietary Screening Tool (DST), with scores being calculated pre- and post-pandemic. Nutritional risk was evaluated based on the DST scores, and binary logistic regression models were used to assess associations between socioeconomic factors and changes in food consumption. During the pandemic, lower-income individuals were more likely to reduce their consumption of nutrient-dense foods, including fruits, vegetables, and lean proteins, while processed meat intake showed mixed trends across income levels. Interestingly, individuals with higher education levels demonstrated increased nutritional vulnerability, potentially due to stress-related changes and disrupted access to preferred foods. Educational level was a stronger predictor of nutritional risk than income level, with higher education being unexpectedly associated with greater vulnerability to dietary disruption. These findings highlight the need for public health interventions that address nutritional challenges across all socioeconomic levels during crises, rather than focusing solely on income or educational disparities. By improving food access, promoting affordable healthy options, and addressing stress-related eating, future policies can better support equitable dietary resilience. This study’s insights can inform strategies for mitigating nutritional risk and promoting dietary stability in future public health emergencies.

COVID-19 pandemic, dietary change, socioeconomic disparities, nutritional vulnerability, public health nutrition, income and education level