The focus on social determinants of health (SDOH) and their impact on health outcomes is evident in U.S. federal actions by Centers for Medicare & Medicaid Services and Office of National Coordinator for Health Information Technology. The disproportionate impact of COVID-19 on minorities and communities of color heightened awareness of health inequities and the need for more robust SDOH data collection. Four Clinical and Translational Science Award (CTSA) hubs comprising the Texas Regional CTSA Consortium (TRCC) undertook an inventory to understand what contextual-level SDOH datasets are offered centrally and which individual-level SDOH are collected in structured fields in each electronic health record (EHR) system potentially for all patients.

Hub teams identified American Community Survey (ACS) datasets available via their enterprise data warehouses for research. Each hub’s EHR analyst team identified structured fields available in their EHR for SDOH using a collection instrument based on a 2021 PCORnet survey and conducted an SDOH field completion rate analysis.

One hub offered ACS datasets centrally. All hubs collected eleven SDOH elements in structured EHR fields. Two collected Homeless and Veteran statuses. Completeness at four hubs was 80%–98%: Ethnicity, Race; < 10%: Education, Financial Strain, Food Insecurity, Housing Security/Stability, Interpersonal Violence, Social Isolation, Stress, Transportation.

Completeness levels for SDOH data in EHR at TRCC hubs varied and were low for most measures. Multiple system-level discussions may be necessary to increase standardized SDOH EHR-based data collection and harmonization to drive effective value-based care, health disparities research, translational interventions, and evidence-based policy.

Food pantries and the Supplemental Nutrition Assistance Program (SNAP) are widely available resources for individuals facing food insecurity, yet the dietary quality of individuals using both programmes is not well characterised. We describe the dietary intake of individuals in North Texas who use both food pantries and SNAP to identify nutritional gaps and opportunities to improve food assistance programmes.

We analysed baseline data from a randomised controlled trial examining food security and dietary intake. At baseline, we administered the validated, 26-item Dietary Screener Questionnaire (DSQ). We calculated descriptive statistics for dietary intake variables and compared with the 2020–2025 Dietary Guidelines for Americans recommended intake values.

Two large food pantries in Dallas County, TX.

Eligible participants were English or Spanish speaking adults receiving SNAP benefits who had used the food pantry within the last 4 months.

We analysed baseline DSQ data from 320 participants (mean age 47 years; 90% female; 45% Black or African American; 37% Hispanic or Latino). Despite receiving SNAP benefits and food pantry assistance, most participants did not meet the minimum recommended intake values for fruits (88.4%), vegetables (97.4%), fibre (90·7%), whole grains (99·7%), dairy products (98·4%) and Ca (83·4%). Furthermore, 73·2% of participants exceeded the maximum recommended intake for added sugar. Still, the gap between median daily intake and recommended daily intake could be partially bridged with food obtained through current food assistance programmes.

Multilevel, coordinated approaches within both SNAP and food pantry networks are needed to improve diet quality in individuals receiving food assistance.

The COVID-19 pandemic initially doubled the rates of food insecurity across the USA and tripled rates among households with children. Despite the association among food insecurity, chronic disease and psychological distress, narratives depicting the experiences of already food insecure populations are notably underrepresented in the literature. The current study assessed the impact of COVID-19 on clients of a food pantry who were also enrolled in the Supplemental Nutrition Assistance Program (SNAP).

A qualitative study probing the effects of the pandemic on daily living, food needs, food buying and food insecurity. Interview transcripts were analysed using a combined deductive and inductive approach.

Interviews were conducted via telephone between May and June of 2020.

Equal numbers of English- and Spanish-speaking clients (n 40 total).

Three main findings emerged: (1) the pandemic increased economic distress, such as from job loss or increased utility bills due to sustained home occupancy and (2) the pandemic increased food needs, food prices and food shortages. In combination with economic stressors, this led to greater food insecurity; (3) increased economic stress and food insecurity contributed to increased psychological stress, such as from fear of infection, isolation and children being confined at home.

Despite federal legislation and state and local programmes to alleviate food insecurity, COVID-19 exacerbated economic hardship, food insecurity and psychological distress among urban SNAP and food pantry clients. Additional research is needed to identify the most effective policies and programmes to ameliorate the short- and long-term health and economic inequities exacerbated by the pandemic.