Factors determining household-level food insecurity during COVID-19 epidemic: a case of Wuhan, China

  • Yu Zhang School of Geography and Ocean Science, Nanjing University, Nanjing, China
  • Kui Yang School of Geography and Ocean Science, Nanjing University, Nanjing, China
  • Song Hou School of Economics and Business Administration, Central China Normal University
  • Taiyang Zhong School of Geography and Ocean Science, Nanjing University, Nanjing, China
  • Jonathan Crush Balsillie School of International Affairs, Canada; Wilfrid Laurier University, Canada
Keywords: food insecurity, food access, HFIAS, COVID-19, negative binomial regression


Background: In coping with the coronavirus disease 2019 (COVID-19) epidemic, cities adopted social isolation and lockdown measures; however, little is known about the impacts of these restrictions on household food security.

Objective: This study provides a timely assessment of household food insecurity (HFI) in the Chinese city of Wuhan during the COVID-19 epidemic period and also investigates its determinant factors.

Design: We collected valid data on food insecurity from 653 households in Wuhan via an online questionnaire in March 2020. The Household Food Insecurity Access Scale Score (HFIASS) was used to measure HFI, and a multiple linear regression model was used to determine the HFIASS.

Results: The mean HFIASS in Wuhan was 9.42 (standard deviation: 5.82), with more than 50% of the households had an HFIASS < 9. Compared with normal conditions, lockdown measures had a huge negative impact on household food security. The results revealed that socio-demographic characteristics remained the underlying determinants of HFIASS during the epidemic. Households in Wuhan with local Hukou (city household registration) and self-owned property had a lower risk of food insecurity.

Discussion and conclusion: After the restriction of conventional food access channels, intermediary food purchase methods such as group purchasing, shopping with the help of neighborhood committees, property management agents, and volunteers became the most important or the only channel for residents to access food. There were similarities in the use of these intermediary channels. Based on the probability that the epidemic will continue and the probability of similar public health-related outbreaks in the future, the study calls for a more resilient and responsive sustainable food supply system by harnessing the capacity of communities, e-commerce and rapid logistics.


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  1. Novel Coronavirus Epidemic Prevention and Control Headquarters in Wuhan. Notice of Wuhan novel coronavirus infected pneumonitis epidemic prevention and control headquarters (No. 1). Available from: http://www.gov.cn/xinwen/2020-01/23/content_5471751.htm [cited 21 May 2020].
  2. Health Times. Where are the more than 5 million people who left Wuhan? These three places have the most! Available from: http://www.jksb.com.cn/html/2020/jjxxgzbd_0127/158668.html [cited 21 May 2020].
  3. Zhao A, Li ZY, Ke YL, Huo SS, Ma YD, Zhang YM, et al. Dietary diversity among Chinese residents during the COVID-19 outbreak and its associated factors. Nutrients 2020; 12(6): 1699. doi: 10.3390/nu12061699
  4. Hobbs JE. Food supply chains during the COVID-19 pandemic. Can J Agric Econ 2020; 68(2): 171–6. doi: 10.1111/cjag.12237
  5. The Economic Observer. After the lockdown of Wuhan, citizens scrambled for supplies. Available from: https://new.qq.com/omn/20200123/20200123A0HVZQ00.html?pc [cited 21 May 2020].
  6. FAO. Rome Declaration on World Food Security and World Food Summit Plan of Action, Rome 1996. Available from: http://www.fao.org/3/w3613e/w3613e00.htm [cited 14 May 2020].
  7. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household Food Security in the United States in 2018. Available from: https://www.ers.usda.gov/webdocs/publications/94849/err-270.pdf?v=955.5 [cited 01 November 2020].
  8. Simon GA. Food security: definition, four dimensions, history. Available from: http://www.fao.org/fileadmin/templates/ERP/uni/F4D.pdf [cited 17 May 2020].
  9. Seivwright AN, Callis Z, Flatau P. Food insecurity and socioeconomic disadvantage in Australia. Int J Environ Res Public Health 2020; 17(2): 559. doi: 10.3390/ijerph17020559
  10. Tarasuk V, Fafard St-Germain AA, Mitchell A. Geographic and socio-demographic predictors of household food insecurity in Canada, 2011–12. BMC Public Health 2019; 19(1): 12. doi: 10.1186/s12889-018-6344-2
  11. Cordero-Ahiman OV, Vanegas JL, Beltran-Romero P, Quinde-Lituma ME. Determinants of food insecurity in rural households: the case of the Paute River Basin of Azuay Province, Ecuador. Sustainability 2020; 12(3): 946. doi: 10.3390/su12030946
  12. Naja F, Hwalla N, Fossian T, Zebian D, Nasreddine L. Validity and reliability of the Arabic version of the household food insecurity access scale in rural Lebanon. Public Health Nutr 2015; 18(2): 251–8. doi: 10.1017/S1368980014000317
  13. Hadley C, Lindstrom D, Tessema F, Belachew T. Gender bias in the food insecurity experience of Ethiopian adolescents. Soc Sci Med 2008; 66(2): 427–38. doi: 10.1016/j.socscimed.2007.08.025
  14. Nyangasa MA, Buck C, Kelm S, Sheikh M, Hebestreit A. Exploring food access and sociodemographic correlates of food consumption and food insecurity in Zanzibari households. Int J Environ Res Public Health 2019; 16(9): 1557. doi: 10.3390/ijerph16091557
  15. Swann CA. Household history, SNAP participation, and food insecurity. Food Policy 2017; 73: 1–9. doi: 10.1016/j.foodpol.2017.08.006
  16. Misselhorn AA. What drives food insecurity in southern Africa? a meta-analysis of household economy studies. Global Environ Change 2005; 15(1): 33–43. doi: 10.1016/j.gloenvcha.2004.11.003
  17. Webb P, Coates J, Frongillo EA, Rogers BL, Swindale A, Bilinsky P. Measuring household food insecurity: why it’s so important and yet so difficult to do. J Nutr 2006; 136(5): 1404S–8S. doi: 10.1093/jn/136.5.1404S
  18. D’Souza A, Jolliffe D. Conflict, food price shocks, and food insecurity: the experience of Afghan households. Food Policy 2013; 42: 32–47. doi: 10.1016/j.foodpol.2013.06.007
  19. Ratcliffe C, McKernan SM, Zhang S. How much does the supplemental nutrition assistance program reduce food insecurity? Am J Agric Econ 2011; 93(4): 1082–98. doi: 10.1093/ajae/aar026
  20. Hsiang S, Allen D, Annan-Phan S, Bell K, Bolliger I, Chong T, et al. The effect of large-scale anti-contagion policies on the COVID-19 pandemic. Nature 2020; 584(7820): 262–7. doi: 10.1038/s41586-020-2404-8
  21. WHO. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 [cited 2 July 2020].
  22. Wuhan Bureau of Statistics. Statistical Bulletin of Wuhan’s National Economic and Social Development in 2019. Available from: http://tjj.wuhan.gov.cn/tjfw/tjgb/202004/t20200429_1191417.shtml [cited 4 July 2020].
  23. The Government of Wuhan. Wuhan overview: natural and geographical. Available from: http://www.wuhan.gov.cn/zjwh/whgk/ [cited 2 July 2020].
  24. Wu F, Zhao, S, Yu B, Chen, YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature 2020; 579(7798): 265–9. doi: 10.1038/s41586-020-2008-3
  25. Novel Coronavirus Epidemic Prevention and Control Headquarters in Wuhan. COVID-19 epidemic prevention and control interim measures in Wuhan. Available from: http://www.wuhan.gov.cn/zwgk/tzgg/202003/t20200316_972483.shtml [cited 4 July 2020].
  26. Novel Coronavirus Epidemic Prevention and Control Headquarters in Wuhan. Notice of Wuhan Novel coronavirus infected pneumonitis epidemic prevention and control headquarters (No. 12). Available from: http://www.gov.cn/xinwen/2020-02/11/content_5477104.htm [cited 2 July 2020].
  27. Wuhan Municipal Health Commission. Covid-19 epidemic situation in Wuhan (24 March 2020). Available from: http://wjw.wuhan.gov.cn/ztzl_28/fk/tzgg/202004/t20200430_1198541.shtml [cited 3 July 2020].
  28. Coates J, Swindale A, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for measurement of household food access: indicator guide (v. 3). Washington, DC: FHI 360/FANTA; 2007.
  29. Mohammadi F, Omidvar N, Houshiar-Rad A, Khoshfetrat MR, Abdollahi M, Mehrabi Y. Validity of an adapted Household Food Insecurity Access Scale in urban households in Iran. Public Health Nutr 2012; 15(1): 149–57. doi: 10.1017/S1368980011001376
  30. Knueppel D, Demment M, Kaiser L. Validation of the Household Food Insecurity Access Scale in rural Tanzania. Public Health Nutr 2010; 13(3): 360–7. doi: 10.1017/S1368980009991121
  31. Kim K, Kim MK, Shin YJ, Lee SS. Factors related to household food insecurity in the Republic of Korea. Public Health Nutr 2011; 14(6): 1080–7. doi: 10.1017/S1368980010003733
  32. Afridi F, Li SX, Ren YF. Social identity and inequality: the impact of China’s hukou system. J Public Econ 2015; 123: 17–29. doi: 10.1016/j.jpubeco.2014.12.011
  33. Zhong TY, Si ZZ, Crush J, Xu ZY, Huang XJ, Scott S, et al. The impact of proximity to wet markets and supermarkets on household dietary diversity in Nanjing City, China. Sustainability 2018; 10(5): 1465. doi: 10.3390/su10051465
  34. Tusiime HA, Renard R, Smets L. Food aid and household food security in a conflict situation: empirical evidence from Northern Uganda. Food Policy 2013; 43: 14–22. doi: 10.1016/j.foodpol.2013.07.005
  35. Navarro CAJ, Gironella GMP, Ignacio MSE. Association of household food security status with mother/caregiver-child pair’s nutritional status using HFIAS and FCS. Philipp J Sci 2018; 143(3): 493–501.
  36. Galanakis CM. The food systems in the era of the coronavirus (COVID-19) pandemic crisis. Foods 2020; 9(4): 523. doi: 10.3390/foods9040523
  37. Zhong TY, Si ZZ. The state of Household Food Security in Nanjing, China (HUNGRY CITIES REPORT NO. 9). Available from: https://hungrycities.net/wp-content/uploads/2018/04/HCP9.pdf [cited 6 July 2020].
  38. Editorial, Food in a time of COVID-19. Nat Plants 2020; 6(5): 429. doi: 10.1038/s41477-020-0682-7
  39. Changjiang Daily, Changjiang Net. Supermarket is not open to the public, how to buy life supplies? See how these districts do. Available from: http://www.cjrbapp.cjn.cn/p/161699.html [cited 6 July 2020].
  40. Investment in Wuhan. The 5th Wuhan online food shopping strategy is coming! Purchase platform to add 8 more. Available from: https://mp.weixin.qq.com/s/efJPeyAIOrsnv_Kl0Iuqwg [cited 6 July 2020].
  41. Block P, Hoffman M, Raabe IJ, Dowd JB, Rahal C, Kashyap R, et al. Social network-based distancing strategies to flatten the COVID-19 curve in a post-lockdown world. Nat Hum Behav 2020; 4(6): 588–96. doi: 10.1038/s41562-020-0898-6
  42. Investment in Wuhan. Wuhan community group purchase food prices on the high level and few categories? Relevant parties responded to the six questions. Available from: https://mp.weixin.qq.com/s/7pbM9mM2CkpU9LNLx3T8Pw [cited 6 July 2020].
  43. Wolfson JA, Leung CW. Food insecurity and COVID-19: disparities in early effects for US adults. Nutrients 2020; 12(6): 1648. doi: 10.3390/nu12061648
  44. Wuhan Public Security Bureau. Starting from Oct 1, Wuhan will allow non-residents to enter their homes with points. Available from: http://gaj.wuhan.gov.cn/jmzx/jqfb/202001/t20200108_653923.html [cited 8 July 2020].
  45. Wuhan Civil Affairs Bureau. Notice of Wuhan COVID-19 prevention and control command on further ensuring the livelihood of people in need affected by the epidemic. Available from: http://mzj.wuhan.gov.cn/zwgk_918/fdzdgk/ggfw/shjz/202005/t20200512_1312791.shtml [cited 8 July 2020].
  46. Glass RJ, Glass LM, Beyeler WE, Min HJ. Targeted social distancing design for pandemic influenza. Emerg Infect Dis 2006; 12(11): 1671–81. doi: 10.3201/eid1211.060255
  47. Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, et al. The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg 2020; 78: 185–93. doi: 10.1016/j.ijsu.2020.04.018
  48. Wechat Pie (Weixin Pai). 2019 WeChat data report. Available from: https://mp.weixin.qq.com/s/vmhoiRzpBs7-JK_x2a7gZw [cited 11 November 2020].
How to Cite
Zhang Y., Yang K., Hou S., Zhong T., & Crush J. (2021). Factors determining household-level food insecurity during COVID-19 epidemic: a case of Wuhan, China. Food & Nutrition Research, 65. https://doi.org/10.29219/fnr.v65.5501
Original Articles