Food insecurity in the Deep South: a qualitative study exploring the lived experience of food insecure adults

This qualitative study explored the lived experience of food insecure adults in one region of Alabama, to better understand how structural, economic, and psychosocial factors shape daily food access and health. Semi-structured interviews were conducted with 52 adults receiving care by a medical provider who had been referred to a partnering food pantry after being identified as food insecure. Data were analyzed using thematic analysis guided by the Social Ecological Model. Participants described persistent financial strain which often forced tradeoffs between food and household necessities. Many also faced geographic and logistical barriers including residence in food deserts, limited transportation, and difficulty accessing food assistance programs. Food assistance served as important sources of support, but participants often described these resources as inconsistent, difficult to access, or insufficient to meet household needs. Food insecurity was further shaped by cyclical periods of scarcity tied to benefit schedules and that limited access to healthy foods complicated the management of chronic health conditions. To cope with persistent resource constraints, individuals employed a number of strategies to ensure children or other family members had enough to eat. Findings underscore the complex interplay of structural inequities, limited resources, and health burdens that shape food insecurity in the Deep South. This study provides contextual insights that complement quantitative research and highlights the need for interventions that address logistical barriers, improve the consistency and quality of food assistance, and incorporate the psychological and temporal dimensions of food insecurity.