Abstract
The COVID-19 pandemic has dramatically altered people's lives in multiple aspects, including grocery shopping behaviors. Yet, the changing trend of grocery shopping frequencies during the COVID-19 and its associations with food deserts remain unclear. We aimed to (1) examine variations of grocery shopping frequencies at county level in the USA during the COVID-19 pandemic from March 2020 to December 2021; (2) investigate associations between grocery shopping frequencies and food deserts during the COVID-19 pandemic; and (3) explore heterogeneity in grocery shopping frequencies-food desert associations across urban and rural areas. The county-level grocery shopping frequencies were derived from a grocery pattern dataset obtained from SafeGraph. We divided the 22-month period into 5 stages and employed the growth curve modeling to estimate the trajectories of grocery shopping frequencies and the associations between grocery shopping frequencies and food deserts in each stage, separately. Results revealed that grocery shopping frequencies experienced a "W-shaped" pattern from March 2020 to December 2021. Counties with the least percent of food deserts had slower decrease in grocery shopping frequencies at the initial stage and recovered more rapidly at later stages. Counties with the highest percent of food deserts were subject to deprivation amplification as a result of the pandemic. We also found differences existed in the grocery shopping frequencies-food desert associations between metropolitan counties and rural counties. Our findings suggest the impacts of COVID-19 on grocery shopping frequencies varied across different time periods, shedding light on designing different strategies to reduce the risk of contagion while shopping inside of grocery stores. Further, our findings highlight an urgent need to help people living in food deserts (especially in rural counties) to procure healthy foods safely during health emergencies like COVID-19 pandemic which disrupt mobility and social behaviors.