A month after COVID-19 effectively shuttered the U.S. economy, scientists at the Fralin Biomedical Research Institute at VTC saw an opportunity to learn how the perception of scarcity during the pandemic was influencing our health choices.

Research consistently shows that higher delay discounting, a preference for smaller rewards delivered sooner over larger rewards delivered later, is a trait associated with a range of unhealthy behaviors, such as high-calorie food purchases, lower vegetable consumption, less frequent exercise, and addictive disorders.

As a result, that neurocognitive trait is seen as a potential target to treat and prevent lifestyle-related diseases and addictions.

Most research linking scarcity and delay discounting, however, has been hypothetical and conducted in laboratory settings. The lived experience of resource scarcity brought on by the pandemic, along with the uncertainty of those early months, gave researchers an opening to validate previous research by examining decision-making by people who had experienced changes in their employment or income. 

Their findings are in the September issue of Behavioural Processes.

“The economic impact of COVID-19 provided a natural experiment to examine scarcity, since a large number of people were experiencing these impacts at the same time,” said Jeff Stein, corresponding author of the study and assistant professor at the Fralin Biomedical Research Institute.

The study’s first author, Haylee Downey, is a doctoral student in the Translational Biology, Medicine, and Health Graduate Program.

"I was a contact tracer during the pandemic before I started graduate school, so I saw the pandemic from both an applied and research perspective," Downey said. "Analyzing the data a couple of years after lockdowns was a reminder of how terrible that time period was, and the many different ways that the pandemic impacted people."

Haylee Downey, a student in the Translational Biology, Medicine and Health program who is part of the Stein Lab, was the first author on the paper. "I was a contact tracer during the pandemic before I started graduate school, so I saw the pandemic from both an applied and research perspective," she said. Photo by Clayton Metz for Virginia Tech.

Haylee Downey
Haylee Downey, a student in the Translational Biology, Medicine, and Health Graduate Program who is part of the Stein Lab, was the first author on the paper. "I was a contact tracer during the pandemic before I started graduate school, so I saw the pandemic from both an applied and research perspective," she said. Photo by Clayton Metz for Virginia Tech.

The study was funded by an internal pilot grant from the Fralin Biomedical Research Institute Center for Health Behaviors Research. Stein, George Davis, and Elena Serrano, who are also on the faculty of the Department of Human Nutrition, Foods, and Exercise in the College of Agriculture and Life Sciences, were investigating behavioral interventions in food purchasing for people receiving Supplemental Nutrition Assistance Program benefits.

Because of the pandemic, they pivoted to examine how people faced with financial scarcity may be biased toward immediate gratification. 

What they did

In April 2020, Virginia Tech researchers recruited 1,159 people using Amazon Mechanical Turk. The crowdsourcing site allows “requesters,” usually businesses and researchers, to recruit workers to complete tasks online. Participants could not have had a previous diagnosis of COVID-19 and they had to live in and complete the survey from the United States, according to Stein, who is also an associate director of the Fralin Biomedical Research Institute’s Center for Health Behaviors Research.

Participants also had to have reported income, based on household size, within 200 percent of the federal poverty line. In 2020, for example, that translated to an income of $52,400 or less for someone in a four-person household. 

Those who met the guidelines completed various tasks to assess delay and probability discounting, which involved the valuation of a hypothetical $100 and a $100 grocery gift card. Study participants were asked whether they had experienced negative financial consequences because of the pandemic, and if so, the severity of those consequences. Researchers also asked about perceived stress, food insecurity, and participation in public assistance programs, before and after the start of the pandemic.

What they found

The findings provided additional support for research showing that scarcity, the feeling of not having enough, could amplify delay discounting and trigger unhealthy behaviors.

Those who experienced severe financial consequences related to COVID-19 were more likely to devalue both money and a grocery gift card compared with those who did not. Individuals with no financial consequences were willing to wait, on average, up to 74 days to receive $100 in cash or a grocery store gift card, rather than take $50 now. However, those experiencing severe financial consequences were far less willing to wait — 25 days for cash and 43 days for the grocery gift card. 

Probability discounting, a measure of risk-taking, was similar for all participants, regardless of how COVID-19 affected them financially. Probability discounting is consistently related to problem gambling.

Greater food insecurity during the pandemic, or the lack of consistent access to enough food for every person in a household to be active and healthy, predicted a higher tendency to devalue a grocery card but not money. 

“This is probably an adaptive response,” Stein said. “If you’re experiencing scarcity, who cares about getting more money in six months or a year if you need to keep food on the table now? There are circumstances in which delay discounting is adaptive — you don’t have the luxury to wait.”

How this helps

The findings can inform future interventions by shedding light on the complexity of how people weigh immediate rewards against future benefits when experiencing food insecurity.

“When the outcomes are money or food gift cards, the shift in future-oriented focus, or the shift toward discounting, may be adaptive,” Stein said. “If it’s a generalized shift, that would also drive things that aren’t adaptive, like increased smoking or increased alcohol intake.” Research indicates that smoking and alcohol use went up during the pandemic. 

That may be in part because of an increase in delay discounting, Stein said. “If people are too focused on the present, that could present a challenge when it comes to changing or maintaining health behaviors whose benefits are in the future.” Helping people place a higher value on future outcomes is a promising method for changing health behaviors.

This points to a need for therapies that help people value the future, even when faced with uncertainty, Stein said. “We have an ongoing interest in looking at interventions that, even when challenged by scarcity, can hold up under those stressors.” 

Co-authors on the work include the following:

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