Food Hardship during the COVID-19 Pandemic and Great Recession

Food Insecurity across Age Groups in the United States during the COVID-19 Pandemic

Food insecurity increased during the COVID-19 pandemic, but the impact varied across different age groups during the prolonged public health emergency. This study sought to describe national food insecurity prevalence by adult age group at multiple stages of the pandemic and explore differences by demographic characteristics. Data were from the nationally representative US Census Bureau's Household Pulse Survey from April 2020 to May 2023 (N = 4,153,462). Locally weighted scatterplot smoothing (LOESS) regression analysis identified change points in food insecurity trends, segmenting the timeline into three periods: (1) April 2020-March 2021, (2) April 2021-May 2022, and (3) June 2022-May 2023. Logistic regression models examined associations between age, time period, and self-reported household food insecurity; covariates included demographics, socioeconomic status, household structure, and food support program usage. Overall, 9.3% of respondents experienced food insecurity, ranging from 3.5% among those aged ≥75 to 12.2% for ages 35-44 years. Significant interaction between age group and time period indicated inconsistency in the age-food insecurity association during the pandemic (p < 0.001). From Period 1 to 3, the proportion of food-insecure adults aged ≥65 rose from 9.2% to 13.9%. Across all age groups, higher odds of food insecurity were found among Black, Hispanic/Latino, or Other/Multiracial respondents; those with less than a Bachelor's degree; those with incomes below USD 35,000; those unemployed for reasons other than retirement; and non-homeowners (p < 0.001). The results show that trends and characteristics associated with food insecurity varied across age groups and time periods. Continuous monitoring of food insecurity during emergencies is critical to identify vulnerable populations and timely interventions.

Racial-Ethnic Gaps in Pandemic-Related Economic Hardship: Age Differences Among Older Adults

OBJECTIVES

Racial-ethnic disparities in experiences of economic hardship during the pandemic are well documented in the population overall and among older adults. Existing research shows that this economic hardship was much less common at older than younger ages. Little is known about the intersection of racial-ethnic and age disparities in pandemic-related hardship in later life. This research report investigated racial-ethnic gaps in economic hardship by age group among older adults.

METHODS

Data were from the 2018 and 2020 U.S. Health and Retirement Study (HRS) including the 2020 coronavirus disease 2019 module. We estimated Heckman-corrected linear probability models to examine differences in experiences of pandemic-related economic hardship in the 2020 HRS by race-ethnicity (non-Hispanic White, non-Hispanic Black, U.S.-born Hispanic, foreign-born Hispanic) across age groups (55-64, 65-74, 75+). In the multivariable analysis, we controlled for sociodemographic characteristics, participation in social programs, pre-existing health conditions and behaviors, and economic resources from the 2018 HRS.

RESULTS

Experiences of economic hardship declined with age within each racial-ethnic group. Racial-ethnic gaps in hardship remained at older ages without any controls. However, when all controls were added, racial-ethnic gaps in economic hardship were eliminated for those ages 75+. Individual characteristics prior to the pandemic explained racial-ethnic differences in hardship for the oldest adults (75+) but did not explain gaps for those ages 55-74.

DISCUSSION

Results point to structural factors generating new racial-ethnic gaps in pandemic-related economic hardship among those approaching retirement (ages 55-74) that did not affect the oldest adults (ages 75+).

Age-related differences in the association between financial hardship and weight change during the COVID-19 pandemic

Objective

To examine the association of financial hardship with weight changes in the US during the COVID-19 pandemic.

Methods

We used data from the COVID-19's Unequal Racial Burden survey, a nationally representative, cross-sectional, online survey of diverse adults living in the US, 12/2020-2/2021. This study included 1000 Asian, Black, Latino (half Spanish-speaking), and White adults and 500 American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and multiracial adults (5500 total). Age-specific (18-39, 40-59, ≥60) associations between financial hardship domains and weight change were estimated using multinomial logistic regression, adjusted for demographic and health characteristics.

Results

Financial hardship during the COVID-19 pandemic was prevalent across all age groups (18-39: 76.2 %; 40-59: 75.6 %; ≥60: 50.6 %). Among adults aged 18-39 and ≥ 60 years old, food insecurity was significantly associated with weight loss (18-39: aOR = 1.42, 95 % CI = 1.04, 1.95; ≥60: aOR = 3.67, 95 % CI = 1.50, 8.98). Among all age groups, unmet healthcare expenses was also associated with weight loss (18-39: aOR = 1.31, 95 % CI = 1.01, 1.70; 40-59: aOR = 1.49, 95 % CI = 1.06, 2.08; ≥60: aOR = 1.73, 95 % CI = 1.03, 2.91). Among adults aged 18-39 and ≥ 60 years old, lost income was significantly associated with weight gain (18-39: aOR = 1.36, 95 % CI = 1.09-1.69; ≥60: aOR = 1.46, 95 % CI = 1.04, 2.06), and among adults 40-59 years old, experiencing increased debt was significantly associated with weight gain (aOR = 1.50, 95 % CI = 1.13, 1.99).

Conclusions

For those aged 18-39 and ≥ 60 years old experiencing financial hardship during the COVID-19 pandemic was associated with both weight loss and weight gain. Less correlation was observed among adults aged 40-59.

Time-Trends in Food Insecurity Among US-Born and Foreign-Born Hispanic Adults by Language Use: An Analysis of National Health and Nutrition Examination Survey Data, 1999-2018

BACKGROUND

Historically, food insecurity prevalence has been higher in Hispanic households than in non-Hispanic White households. Food insecurity prevalence among Hispanic adults, US-born and foreign-born, may vary by language use.

OBJECTIVE

To explore whether or not the relationship between language use and food insecurity varied over time (1999-2018) among US-born and foreign-born Hispanic adults.

DESIGN

Trends analysis and multivariable logistic regression modeling using pooled cross-sectional data.

PARTICIPANTS AND SETTING

Fifteen thousand sixty-two Hispanic adults participating in the United States National Health and Nutrition Examination Survey (1999-2018).

MAIN OUTCOME MEASURES

Food insecurity prevalence, assessed with the US Household Food Security Survey Module.

STATISTICAL ANALYSIS

Unadjusted food insecurity trends from 1999 to 2018 by language use (mostly English, both languages equally, or mostly Spanish) among US-born and foreign-born Hispanic adults were analyzed using piecewise-linear regression of log prevalence rates. Multivariable logistic regression models adjusted for sociodemographic characteristics and with an interaction term between language use and time were used to determine if odds of food insecurity among US-born and foreign-born Hispanic adults varied by language use between 1999 and 2018.

RESULTS

Hispanic adults' food insecurity prevalence followed an upward linear trend from 1999 to 2018; this was significant for US-born mostly English-speakers (P < 0.001), US-born mostly Spanish-speakers (P = 0.013), and foreign-born mostly Spanish-speakers (P < 0.001). In fully adjusted logistic regression models, foreign-born Hispanic adults who spoke both languages equally (odds ratio 1.8, 95% CI 1.2 to 2.6) and those who spoke mostly Spanish (odds ratio 1.9, 95% CI 1.4 to 2.8) had significantly higher food insecurity odds, compared with mostly English-speakers. No variations in associations across time were observed between language use and food insecurity (interaction P value > 0.1).

CONCLUSIONS

Hispanic adults' unadjusted food insecurity trends from 1999 to 2018 varied by language use. When adjusted for sociodemographic characteristics and compared with mostly English-speakers, food insecurity odds were significantly higher only among foreign-born Hispanic adults who spoke either both languages equally or mostly Spanish. Food assistance programs should linguistically adapt their services for Hispanic adults.

Understanding the health benefits and technological properties of β-glucan for the development of easy-to-swallow gels to guarantee food security among seniors

The world's population is growing rapidly and the number of elderly people with undernutrition and malnutrition is increasing. Common health problems among seniors are cardiovascular, inflammatory, gastrointestinal, and cognitive disorders, cancer, diabetes, psychological and dental problems. The food industry is trying to meet the demands of an aging society, but these efforts are not sufficient. New strategies are needed, and they demand foods development with modified textures that are easy to swallow, such as gels suitable for seniors. Depending on the specific needs of the elderly, bioactive compounds with health benefits should be included in food systems. Novel foods may play an important role in the prevention, maintenance, and treatment of age-related diseases. One of the most studied bioactive compound is β-glucan, a polysaccharide with approved health claims confirmed by clinical trials, such as "β-glucan contributes to the maintenance of normal blood cholesterol levels" and "the consumption of β-glucan from oats or barley contributes to the reduction of postprandial glucose spikes." In this review, the health benefits, and technological properties of β-glucan for the development of senior-friendly ready-to-swallow gels were described. In addition, some patents and studies conducted in connection with the development of the gel systems were collected.

Measuring Food Security in the United States for More Than 25 years: History, Methods, Findings, and Opportunities

This article sets the stage for the "25 Years of Food Security Measurement: Answered Questions and Further Research" conference, with support from the Economic Research Service of the US Department of Agriculture, by providing some history of federal food security measurement, summarizing notable findings, and reviewing selected special topics in analysis methods. The federal government uses food security surveys to monitor national progress toward reducing food insecurity and to evaluate federal nutrition assistance programs. For the monitoring purpose, there is a tension between focus (on a single authoritative measurement approach) and breadth (encompassing multiple tools or instruments suitable for diverse populations, contexts, and applications). For the program evaluation purpose, challenges include coordination with study designs capable of real causal estimation in the face of strong self-selection effects and tailored reference periods in survey questions that match the timing of program participation. Some analysis methods treat the food security survey items as distinct experiences of hardship, whereas others treat the food security survey items as windows on an underlying latent variable, a food insecurity score. The severity of food-related hardship may be assessed quantitatively by the number of distinct hardships reported, by the estimated value of a latent food insecurity score, or by the frequency of occurrence for sentinel hardships. Ongoing work investigates statistical approaches that are sufficiently simple for policy application and yet sufficiently flexible to accurately match the empirical survey evidence.

Household food insecurity during the COVID-19 pandemic is associated with anxiety and depression among US- and foreign-born adults: Findings from a nationwide survey

The COVID-19 pandemic led to significant disruptions to household food security with as many as 10.5 % of US households experiencing food insecurity during 2020. Food insecurity is associated with psychological distress including depression and anxiety. However, to the best of our knowledge, no study has analyzed the association between COVID-19 food insecurity and poor mental health outcomes by place of birth. The Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases national survey assessed the physical and psychosocial effects of social and physical distancing during the COVID-19 pandemic among a diverse population of US- and foreign-born adults. Multivariable logistic regression was used to assess the relationship between place of birth and food security status and anxiety (N = 4817) and depression (N = 4848) among US- and foreign-born individuals. Stratified models subsequently analyzed the associations between food security and poor mental health among US- and foreign-born populations separately. Model controls included sociodemographic and socioeconomic factors. Low and very low household food security were associated with greater odds of both anxiety (low: odds ratio (OR) [95 % confidence interval (CI)] = 2.07 [1.42-3.03]; very low: OR [95 % CI] = 3.35 [2.15-5.21]) and depression (low: OR [95 % CI] = 1.92 [1.33-2.78]; very low: OR [95 % CI] = 2.36 [1.52-3.65]). However, this relationship was attenuated among foreign-born individuals compared to US-born individuals in the stratified models. All models found a dose-response relationship between increasing levels of food insecurity and anxiety and depressive symptoms. Further research is needed to explore the factors that attenuated the relationship between food insecurity and poor mental health among foreign-born individuals.

Study of the Structural Changes and Internal Activator Transport Behavior after Activation of Aluminum-Based Flameless Ration Heaters: Experimental and Molecular Dynamics Simulations

Aluminum-based flameless ration heaters (AFRHs) are heating elements in food packaging. Water is used to activate AFRHs. The material properties of each region of AFRHs were determined by X-ray diffraction, scanning electron microscopy, and hydrogen and heat generation. The results show that the internal cross-section shows stratification with hydrogen and heat production capacities of 105.2 ± 9.7 mL/g and 1435.0 ± 30.3 J/g for the outer layer, 27.1 ± 4.4 mL/g and 80.4 ± 3.1 J/g for the inner layer, and 1.1 ± 0.01 mL/g and 1.2 ± 0.05 J/g for the middle layer, respectively. According to the correspondence between aluminum and hydrogen in the aluminum-water reaction relationship, the reaction efficiency of the outer layer and the inner layer is as low as 64 and 80%, which is an indication of low reaction efficiency. To analyze the reasons for low reaction efficiency, a pore channel model of 3.5 nm tricalcium aluminate (C3A) was developed using molecular dynamics (MD) to reveal the adsorption behavior of the activator in the pore channel. The results show that the activator is subject to solid surface adsorption in the pore channel with a low diffusion coefficient. Oxygen atoms on the surface adsorb hydrogen atoms to form hydrogen bonds and sodium ions to form ionic bonds with calcium ions. This increases the retention time of the activator on the surface. The MD results explain the low reaction efficiency of AFRHs at the microscopic scale. Moreover, it provides ideas and a basis for the optimization of AFRHs.

Impact of COVID-19's Economic Burden on Alcohol-Related Problems: An Indirect Effect of Depression, Stress, and Anxiety

The COVID-19 pandemic resulted in global monumental upheaval. Many people were displaced from their jobs and sources of income. COVID-19 was also linked to increased mental health difficulties and increased alcohol consumption and problems. The current study aims to identify the indirect effect of depression, stress, and anxiety on the relations between the economic burden of COVID-19 and alcohol problems. Participants (N = 344) were recruited via Amazon's Mechanical Turk (MTurk). Participants completed a questionnaire about substance use, mood, and the economic burden of COVID-19. Eligible participants were 18 years or older, consumed alcohol or cannabis within the past week, and verified through Amazon. Results indicated significant indirect effects of depression, stress, and anxiety on the association between the economic burden of COVID-19 and alcohol problems regardless of use. Findings revealed large effect sizes, suggesting that mental health symptomatology may have a large impact on the association between COVID-19's economic burden and alcohol-related problems. Findings suggest mental health difficulties indirectly effect the association between COVID-19's economic burden and alcohol-related problems. Intervention efforts targeting mental health may be beneficial in reducing alcohol problems among individuals experiencing distress due to large-scale public health impact, such as the COVID-19 pandemic.

Predictors of food insecurity among older adults before and during COVID-19 in the United States

Background

The COVID-19 pandemic has strained the health and wellbeing of older adult populations through increased morbidity, mortality, and social exclusion. However, the impact of COVID-19 on the health of older adults through food security has received relatively little attention, despite the strong impact of diet quality on the health and longevity of older adults.

Objective

The objective of this study was to identify sociodemographic and socioeconomic predictors of self-reported food insecurity before and early in the COVID-19 pandemic among community-dwelling older adults in the United States.

Methods

Using longitudinal data from the Health and Retirement Study, a nationally representative sample of middle-aged and older adults in the United States, we examined the associations between sociodemographic and socioeconomic predictors of self-reported food insecurity between 2018 (N = 2,413) and June 2020 (N = 2,216) using population-weighted multivariate logistic regression models.

Results

The prevalence of food insecurity doubled among participants from 2018 (4.83%) to June 2020 (9.54%). In 2018, non-Hispanic Black and rural residents were more likely to report food insecurity, while individuals with higher education and greater wealth were less likely to report food insecurity in adjusted models. In June 2020, those who were relatively younger, not working due to a disability, and renting were more likely to report food insecurity. Those with an increased number of functional limitations, a recent onset of a work-limiting disability, and those who were no longer homeowners experienced an elevated longitudinal risk for food insecurity.

Conclusion

Future research should examine effective policies and interventions to address the disproportionate impacts of COVID-19 on populations at a heightened risk of experiencing food insecurity.

Impacts of Covid-19 School Closures on School Food Service Revenue: Analysis of Public Local Education Agencies in Maryland

BACKGROUND

The public health policies and school closures in response to the Covid-19 pandemic have created disruptions in school meal programs. Research is needed to understand the changes in school food service revenue before and during the initial Covid-19-related school shutdowns.

METHODS

A longitudinal cohort study examining federal and state reimbursements as well as sales revenues for all public local education agencies (LEAs) in Maryland from school years (SY) 2018-2019 and 2019-2020 was conducted. Monthly changes in federal and state reimbursements for Child Nutrition Programs, including the National School Lunch Program (NSLP), School Breakfast Program (SBP), Summer Food Service Program (SFSP), and Child and Adult Care Food Program (CACFP) were examined.

RESULTS

In the SY 2018-2019, the total revenues from federal and state reimbursements for SBP, NSLP, SFSP, and at-risk CACFP were $272.9 million; in comparison, for the SY 2019-2020, the total revenues were $241.8 million (11.4% reduction from SY 2018-2019). On average, the school shutdown (during March to June 2020) was associated with a $450,385 (p-value < .01) reduction in federal and state reimbursements per LEA-month (41% reduction).

CONCLUSIONS

The school shutdown during the Covid-19 pandemic was associated with a statistically significant reduction in school food service revenues across Maryland's public LEAs.

Did mental and emotional health of SNAP families' children improve during the COVID-19 pandemic?

The onset of the COVID-19 pandemic disproportionately affected low-income households in the United States. As part of the government's response to the pandemic, households with children participating in the Supplemental Nutrition Assistance Program (SNAP) benefited from several temporary provisions. This study examines whether the mental/emotional well-being of children in SNAP families was influenced by the SNAP temporary provisions, overall and across subpopulations by race/ethnicity and school meal programs (SMP) participation status of children. Cross-sectional data from the 2016-2020 National Survey of Children Health (NSCH) were used to study the occurrence of mental, emotional, developmental, or behavioral (MEDB) health of children (6-17 years) in SNAP families. Difference-in-Differences (DID) analyses were conducted to assess the association between MEDB health of children in SNAP families and the implementation of the SNAP provisions. Overall, finding show that between 2016 and 2020, children in SNAP families were more likely to face adverse MEDB conditions than children in non-SNAP families (p < 0.05). DID analyses indicate that children's MEDB health was not statistically affected following the first year of SNAP temporary provisions (p > 0.1). Additionally, no differential results were found by race/ethnicity of children or SMP participation (p > 0.1). Results are robust to the use of different well-being measures. These results suggest that SNAP provisions may have been associated with the reduction of the adverse effects of the pandemic on children's well-being.

Older People in Emergencies; Addressing Food Insecurity, Health Status and Quality of Life: Evaluating the "365+ Days of Care" Program

During emergencies, older adults stand among the most vulnerable, facing long-lasting food insecurity and overall health issues. The "365+ Days of Care" food aid program addressed food insecurity and poor quality of life among vulnerable older adults following a devastating wildfire in Greece. Our aim was to evaluate the program's efficiency, using a process evaluation framework and a partial cost-utility analysis. In total, n = 133 wildfire-hit residents (≥65 years) received daily tailored, pre-cooked meals and/or weekly food packages. The study outcomes were assessed from baseline to 12 months later. Focus groups and interviews (n = 30), researcher observations, and questionnaires were used to assess the beneficiaries' perception of the initiative. Within the 12-month follow-up period, food insecurity and malnutrition risk decreased, whereas Mediterranean diet adherence; quality of life; and physical, social, and mental health were improved (p < 0.05). A one-point increase in food insecurity was positively associated with improved quality of life, general health, limitation in activities, body pain, vitality, and pain/discomfort (p's < 0.05), and it was marginally associated with mobility, anxiety/depression, and self-evaluated health status (p's < 0.1). Quantitative and qualitative data characterized it as successful, acceptable, beneficial, and of high quality. The partial cost-utility ratio was one QALY gained per EUR 22.608. The utilization of well-designed food aid programs during emergencies can alleviate food insecurity and improve quality of life in older adults.

The COVID-19 pandemic and food security in low- and middle-income countries: a review

We review findings from the emerging microeconomic literature on observed changes in food insecurity associated with the COVID-19 pandemic. To do so, we focus our review on studies in low- and middle-income countries that include household survey data measuring food insecurity collected both before and after the onset of the COVID-19 pandemic. We first focus on several studies-seven from countries in Sub-Saharan Africa and one from India-that estimate immediate changes in food insecurity associated with the COVID-19 pandemic. Next, we review subsequent analysis studying longer term changes in food insecurity associated with the COVID-19 pandemic. This review, therefore, complements existing macroeconomic projections of food insecurity based on expected changes in income and prices.

Meeting Older Adults' Food Needs During the COVID-19 Pandemic: Lessons And Challenges from Washington State

The COVID-19 pandemic threatened the ability of nutrition providers to address food insufficiency among older adults. Findings from Household Pulse Survey data and interviews with 23 service leaders in Washington state during the summer of 2020 point to key organizational practices that should inform future emergency food assistance planning. Organizations deeply connected to and trusted by racially and ethnically diverse, unhoused, and low-income older adults are critical to addressing disparities in food insufficiency. Stable and flexible increases in funding would allow these organizations to maintain the effective and culturally-relevant service adaptations they implemented in the first months of the pandemic.

Economic Impact Payments and Household Food Insufficiency during COVID-19: The Case of Late Recipients

During the COVID-19 pandemic, the U.S. government distributed Economic Impact Payments (EIPs) to ease the economic hardships of American households. Using the Household Pulse Survey, we study the association of first-round EIPs with household-level food insufficiency in a sample of late recipients of EIPs. Studying the late recipients is important for two reasons, first, about 12 million eligible individuals did not automatically receive EIPs, and second, the late receipt of EIPs and the low-income status of late recipients allow us to tease out the relationship between EIPs and food insufficiency. We find that EIPs were associated with a 9.2 percentage points decrease in the likelihood of food insufficiency. However, households kept relying on free food acquisition to fight food hardship. Our results suggest that government efforts to provide more timely stimulus payments could be very impactful and significantly impact household food insufficiency.

COVID-19 and Indigenous health in the Brazilian Amazon

We test whether the COVID-19 pandemic has an ethnicity-differentiated (Indigenous vs non-Indigenous) effect on infant health in the Brazilian Amazon. Using vital statistics data we find that Indigenous infants born during the pandemic are 0.5% more likely to have very low birth weights. Access to health care contributes to health gaps. Thirteen percent of mothers travel to deliver their babies. For traveling mothers, having an Indigenous baby during the pandemic increases the probability of very low birth weight by 3%. Indigenous mothers are 7.5% less likely to receive adequate prenatal care. Mothers that travel long distances to deliver their babies and give birth during the pandemic are 35% less likely to receive proper prenatal care. We also find evidence that the pandemic shifts medical resources from rural to urban areas, which disproportionately benefits non-Indigenous mothers. These results highlight the need for policies to reduce health inequalities in the Amazon.

Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic

BACKGROUND

Food insecurity is a critical public health problem in the United States that has been associated with poor diet quality. Cooking dinner more frequently is associated with better diet quality.

OBJECTIVE

This study aimed to examine how food insecurity and dinner cooking frequency are associated with diet quality during the initial months of the coronavirus disease 2019 pandemic.

DESIGN

This cross-sectional study analyzed data from a national web-based survey (June 23 to July 1, 2020).

PARTICIPANTS/SETTING

Participants were 1,739 low-income (<250% of the federal poverty level) adults in the United States.

MAIN OUTCOME MEASURES

The outcome was diet quality, measured by the Prime Diet Quality Score (PDQS-30D). The PDQS-30D is a food frequency questionnaire-based, 22-component diet quality index.

STATISTICAL ANALYSES PERFORMED

Food security status (high, marginal, low, or very low) and frequency of cooking dinner (7, 5 to 6, 3 to 4, or 0 to 2 times/week) were evaluated in relation to PDQS-30D scores (possible range = zero to 126) in age- and sex and gender-, and fully adjusted linear regression models. Postestimation margins were used to predict mean PDQS-30D score by food security status and dinner cooking frequency. The interaction between food security status and frequency of cooking dinner was also tested.

RESULTS

Overall, the mean PDQS-30D score was 51.9 ± 11 points (possible range = zero to 126). The prevalence of food insecurity (low/very low) was 43%, 37% of the sample cooked 7 times/week and 15% cooked 0 to 2 times/week. Lower food security and less frequent cooking dinner were both associated with lower diet quality. Very low food security was associated with a 3.2-point lower PDQS-30D score (95% CI -4.6 to -1.8) compared with those with high food security. Cooking dinner 0 to 2 times/week was associated with a 4.4-point lower PDQS-30D score (95% CI -6.0 to -2.8) compared with cooking 7 times/week. The relationship between food insecurity and diet quality did not differ based on cooking dinner frequency.

CONCLUSIONS

During the initial months of the coronavirus disease 2019 pandemic food insecurity and less frequently cooking dinner at home were both associated with lower diet quality among low-income Americans. More research is needed to identify and address barriers to low-income households' ability to access, afford and prepare enough nutritious food for a healthy diet.

SNAP and WIC Participation During Childhood and Food Security in Adulthood, 1984-2019

Objectives. To examine the effects of childhood participation in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on adult food security in the United States. Methods. We used data from the 1984 to 2019 waves of the Panel Study of Income Dynamics to follow a balanced panel of 1406 individuals from birth through ages 20 to 36 years. We measured food insecurity from 1999 to 2003 and 2015 to 2019 among those who resided in low-income households during childhood. Results. Twenty-eight percent of individuals who resided in low-income households during childhood exhibited improved food security status from childhood to adulthood. Those who participated in SNAP and WIC during childhood had 4.16-fold higher odds (95% confidence interval [CI] = 1.91, 9.03) of being more food secure than those who were eligible for but did not receive SNAP or WIC, and those who participated in SNAP alone had 3.28-fold higher odds (95% CI = 1.56, 6.88). Conclusions. Participation in social safety net programs such as SNAP and WIC during childhood helps to improve food security across the life course. Our findings add evidence regarding the long-term benefits of participation in SNAP and WIC during childhood. (Am J Public Health. 2022;112(10):1498-1506. https://doi.org/10.2105/AJPH.2022.306967).

Food Insecurity–Related Interventions and Mental Health Among US Adults During the COVID-19 Pandemic, April 2020 through August 2021

Objectives:

Financial hardships, job losses, and social isolation during the COVID-19 pandemic have increased food insecurity. We examined associations between food insecurity–related interventions and mental health among US adults aged ≥18 years from April 2020 through August 2021.

Methods:

We pooled data from the Household Pulse Survey from April 2020 through August 2021 (N = 2 253 567 adults). To estimate associations between mental health and food insecurity, we examined the following interventions: the Supplemental Nutrition Assistance Program (SNAP), Economic Impact Payments (stimulus funds), unemployment insurance, and free meals. We calculated psychological distress index (PDI) scores (Cronbach α = 0.91) through principal components analysis using 4 mental health variables: depression, anxiety, worry, and lack of interest (with a standardized mean score [SD] = 100 [20]). We conducted multivariable linear regression to estimate the interactive effects of the intervention and food insecurity on psychological distress, controlling for sociodemographic characteristics.

Results:

During the study period, adults with food insecurity had higher mean PDI scores than adults without food insecurity. Food insecurity was associated with increased PDI scores after controlling for sociodemographic characteristics. In stratified models, negative associations between food insecurity and mental health (as shown by reductions in PDI scores) were mitigated by SNAP (−4.5), stimulus fund (−4.1), unemployment insurance (−4.4), and free meal (−4.4) interventions. The mitigation effects of interventions on PDI were greater for non-Hispanic White adults than for non-Hispanic Black or Asian adults.

Conclusions:

Future research on food insecurity and mental health should include investigations on programs and policies that could be of most benefit to racial and ethnic minority groups.

Food spending in the United States during the first year of the COVID-19 pandemic

The COVID-19 pandemic brought about a significant increase in the unemployment rate and a decline in consumer income. At the same time, the public health responses to the pandemic, such as lockdowns and business closures, disrupted the food supply chain. These pandemic-driven changes could lead to a shift in food spending behaviors and potentially exacerbate the food insecurity situation. Leveraging the nationally representative dataset from the 2017-2020 consumer expenditure surveys, we employ a two-part model to assess the changes in weekly household spending on total food, food-at-home (FAH), and food-away-from-home (FAFH) between the pre-pandemic and pandemic period in the United States. Our finding shows a predicted marginal decline in FAFH expenditure by 33.7% but an increase in FAH spending by 6.9% during the pandemic. The increase in FAH spending could not fully offset the decrease in FAFH spending, leading to a decline in total food spending by 12.6%. The results could provide a basis for future studies on food insecurity, nutrient intake, and healthy consumption during the pandemic.

Understanding the impacts of COVID-19 on the determinants of food insecurity: A state-specific examination

This paper examines risk factors influencing food insecurity during the first year of the COVID-19 pandemic in a state in the U.S. heavily impacted by it and offers recommendations for multi-sector intervention. The U.S. Census Bureau Household Pulse Survey was analyzed to evaluate the impacts of COVID-19 on food security in Massachusetts from April 2020 through March 2021 using a study sample of 57,678 participants. Food security was defined as a categorical variable (food security, marginal food security, low food security, very low food security) and binary variable (food security and food insecurity). Known or suspected factors that contribute to it, such as childcare, education, employment, housing, and transportation were examined in multivariate logistic regression models. Data imputation methods accounted for missing data. Sociodemographic characteristics, including lower education level and living in a household with children, were determinants of food insecurity. Another factor that influenced food insecurity was economic hardships, such as unemployment, being laid off due to COVID-19, not working due to concerns about contracting or spreading COVID-19, or not having enough money to buy food. A third factor influencing food insecurity was food environment, such as lack of geographic access to healthy foods. Some of these factors have been exacerbated by the pandemic and will continue to impact food security. These should be addressed through a comprehensive approach with public health efforts considering all levels of the social ecological model and the context created by the pandemic.

Consumer behavior during the COVID-19 pandemic: An analysis of food purchasing and management behaviors in U.S. households through the lens of food system resilience

The COVID-19 pandemic has stimulated considerable interest in the resilience of the U.S. food system. Less attention has been paid to the resiliency characteristics of the final link in the food system - individual households. We use national survey data from July 2020 to understand the food acquisition, preparation, and management strategies that households implemented in response to the pandemic. We find a substantial increase in the amount of food prepared and consumed at home which scales with respondents' time availability, perceived risks of dining out, and pandemic-induced income disruption. We then identify several household responses to support this increase in home food consumption that are in line with practices suggested to enhance resiliency at other links in the food supply chain, including increased cold storage capacity and enhanced in-house capability via improved cooking and food management skills. We discuss how responses such as improved food skills can reduce the propagation of shocks through the supply chain by allowing greater flexibility and less waste, while actions such as increased home cold storage capacity could undermine system resilience by exacerbating bullwhip effects, i.e., amplifying consumer demand shocks that are propagated to upstream food supply chain actors.

The Prevalence of Hardship by Race and Ethnicity in the USA, 1992-2019

Racial and ethnic inequality continues to be the subject of considerable public interest. We shed light on this issue by examining racial disparities in the prevalence of several types of hardship, such as trouble paying bills and housing problems, in the USA over the 1992-2019 period. Using data from several panels of the Survey of Income and Program Participation, we find that hardships were considerably higher-sometimes double, depending on the measure-among blacks and Hispanics than whites and Asians. Nevertheless, these disparities generally narrowed over time. We find that the decline in these disparities-as indicated by a summary hardship index-exceeded that of the official income poverty ratio. We also find that while Asians were more likely to be poor than whites, they were not more likely to experience hardship. Notably, we also see variation in the experiences of different types of hardship. Specifically, there was little decline in the racial disparity of two of the hardships that tend to be responsive to short-term fluctuations in income-bill-paying and health hardship, as well as fear of crime-but substantial declines in disparities with most other measures. Overall, our findings indicate significant racial differences in the experience of hardship, though with a narrowing of many gaps over time.

The dietary impact of the COVID-19 pandemic

The COVID-19 pandemic led to significant changes in people's budgets, the opportunity cost of their time, and where they can purchase and consume food. We use novel data on food and non-alcoholic drink purchases from stores, takeaways, restaurants and other outlets to estimate the impact of the pandemic on the diets of a large, representative panel of British households. We find that a substantial and persistent increase in calories consumed at home more than offset reductions in calories eaten out. Households increased total calories relative to pre-pandemic by 280 per adult per day from March to July 2020, and by 150 from July to the end of 2020. Although quantity increased, there was little change in diet quality over the pandemic. All socioeconomic groups increased their calorie intake, with the largest rises for the highest SES households and the smallest for retired ones. We estimate that the changes could increase the proportion of adults who are overweight by at least five percentage points, two years after the pandemic onset.

The Long-Run Prevalence of Food Insufficiency among Older Americans

The prevalence of food insufficiency among seniors in any given year is well-documented, but the prevalence of this hardship over a longer time period in later life is unknown. Using panel data from the Health and Retirement Study, I find that about 8% of seniors report food insufficiency over a two-year recall window, while 22% experience it at some point over the two decades of their sixties and seventies. Food insufficiency is not concentrated among a small group of persistently disadvantaged elderly, but is instead a surprisingly common feature of the later life course.

Hunger relief: A natural experiment from additional SNAP benefits during the COVID-19 pandemic

Background

COVID-19 has directly affected millions of people. Others have been indirectly affected; for example, there has been a startling increase in hunger brought about by the pandemic. Many countries have sought to relieve this problem through public policy. This research examines the effectiveness of enhanced Supplemental Nutrition Assistance Program (SNAP) benefits in the U.S. to alleviate hunger.

Methods

Using a biweekly cross-sectional survey and corresponding population weights from the U.S. Census Bureau, we estimate the effects of enhanced SNAP benefits on hunger in the U.S. as measured by food insufficiency. We use a Bayesian structural time series analysis to predict counterfactual values of food insufficiency. We supplement these findings by examining the effect of enhanced SNAP benefits on observed visits to a food pantry network in a midsized U.S. city.

Findings

Our primary finding estimates that nationwide a total 850,000 (95% credible interval 0·24–1·46 million) instances of food insufficiency were prevented per week by the 15 percent increase in SNAP benefits enacted in January 2021. Secondarily, we find similar effects associated with SNAP benefit increases and local food pantry visits. Specifically, enhanced SNAP benefits resulted in fewer visits to the food pantry network than were predicted in the counterfactual model.

Interpretation

These results not only indicate that the policies enacted to mitigate hunger caused by the COVID-19 pandemic helped, but also quantifies how much these benefits helped on a national scale. As a result, policymakers can use this data to benchmark future policy actions at scale.

Funding

None.

Food Insecurity and Delayed or Forgone Medical Care During the COVID-19 Pandemic

Objectives. To describe food insecurity in the United States in December 2020 and examine associations with underuse of medical care during the COVID-19 pandemic. Methods. We fielded a nationally representative Web-based survey in December 2020 (n = 8318). Multivariable logistic regression models and predicted probabilities were used to evaluate factors associated with food insecurity and compare the likelihood of delaying or forgoing medical care because of cost concerns by food security status. Results. In December 2020, 18.8% of US adults surveyed reported experiencing food insecurity. Elevated odds of food insecurity were observed among non-Hispanic Black, Hispanic, and low-income respondents. Experiencing food insecurity was significantly associated with a greater likelihood of forgoing any type of medical care as a result of cost concerns. Conclusions. Food insecurity during the COVID-19 pandemic disproportionately affected non-White and low-income individuals. Experiencing food insecurity was a significant risk factor for delaying or forgoing medical care, an association that could have cumulative short- and long-term health effects. Public Health Implications. Comprehensive policies that target the most at-risk groups are needed to address the high rates of food insecurity in the United States and mitigate its adverse health effects. (Am J Public Health. 2022;112(5):776-785. https://doi.org/10.2105/AJPH.2022.306724).

Food insufficiency and Twitter emotions during a pandemic

The COVID-19 pandemic initially caused worldwide concerns about food insecurity. Tweets analyzed in real-time may help food assistance providers target food supplies to where they are most urgently needed. In this exploratory study, we use natural language processing to extract sentiments and emotions expressed in food security-related tweets early in the pandemic in U.S. states. The emotion joy dominated in these tweets nationally, but only anger, disgust, and fear were also statistically correlated with contemporaneous food insufficiency rates reported in the Household Pulse Survey; more nuanced and statistically stronger correlations are detected within states, including a negative correlation with joy.

Understanding Micro-pantries as an Emergency Food Source During the COVID-19 Pandemic

OBJECTIVE

To explore the role of micro-pantries in addressing food insecurity during the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

Qualitative interviews with 20 micro-pantry users and 10 stakeholders during April and May, 2020.

SETTING

Six US states.

PARTICIPANTS

Users, aged ≥ 18 years, had obtained food from a micro-pantry in the past 2 weeks; stakeholders, aged ≥ 18 years, played a role in organizing micro-pantries at the community, regional, or national levels.

PHENOMENA OF INTEREST

Impact of COVID-19 on food insecurity and use of micro-pantries to mitigate it; benefits of, suggested improvements to, and adoption and administration of micro-pantries.

ANALYSIS

We transcribed the data verbatim and performed deductive qualitative content analysis.

RESULTS

Micro-pantry users had increased their use of both micro-pantries and regular food pantries during the pandemic. Micro-pantries helped stretch resources. Users appreciated the anonymity and choice; the mutual aid aspects reduced stigma. Stakeholders described micro-pantries as providing a direct way for neighbors to help neighbors during the pandemic. They described a decentralized and informal system of administration.

CONCLUSIONS AND IMPLICATIONS

Findings suggest that micro-pantries provided a supplemental food source that supported the resilience of communities during the COVID-19 pandemic.

Food insecurity among active duty soldiers and their families during the coronavirus disease 2019 pandemic

OBJECTIVE

We examined the determinants of food insecurity among active duty Army households that transitioned into food insecurity during the coronavirus disease 2019 (COVID-19) pandemic.

DESIGN

We compared Army households that recently transitioned into marginal food insecurity with those households that remained highly food secure (n 2832) to better understand how these households differ in their resilience to food insecurity during economic downturns using data from a military installation in the USA in 2020.

SETTING

A US military installation in the USA.

PARTICIPANTS

Active duty US Army soldiers.

RESULTS

Prior to the pandemic, the prevalence of marginal food insecurity among Army households was similar to that reported for households in the general population. Marginal food insecurity among Army households increased over 1·5-fold - from 19 % to 33 % - with the onset of the pandemic. Relative to Army households with consistently high food security, the Army households that transitioned into marginal food insecurity after the onset of the pandemic were more likely to report concerns about financial insecurity and the job security of their family members.

CONCLUSIONS

Army households, like their civilian counterparts, are vulnerable to food insecurity because of instability in their income during periods of economic uncertainty. Periods of economic uncertainty are more common for Army households because of the frequent relocations associated with military service which could lead to predictable periodic spikes in their food insecurity.

Effect of COVID-19 on food security, hunger, and food crisis

COVID-19 affected the world’s socioeconomic and food security more than other infectious diseases. In many countries, food industries’ workers were moderated because of the COVID-19 pandemic, which caused food factories to reduce or slow down their production. Airline closures, national and international restrictions, and lockdowns have severely disrupted the food supply chain. These, along with structural weaknesses in the world food system such as production, distribution, access, and stability in the food chain, have exposed more people to the food crisis and acute hunger in the world. Therefore it is necessary to use proper planning by governmental organizations and charities in the field of food supply in critical situations.

Food Security, Financial Resources, and Mental Health: Evidence during the COVID-19 Pandemic

COVID-19 has negatively impacted many households’ financial well-being, food security, and mental health status. This paper investigates the role financial resources play in understanding the relationship between food security and mental health among U.S. households using data from a survey in June 2020. Results show job loss and savings draw down to pay for household bills had a significant relationship with both lower food security and greater numbers of poor mental health days during the pandemic.

The Impact of the COVID-19 Pandemic on Consumers’ Preferences for Wood Furniture: An Accounting Perspective

The COVID-19 pandemic has had a major impact on forest product markets and the forest product industry, and has also seriously affected the sales of forest products. This research aimed to analyze people’s preference for wood furniture and make policy recommendations. We examined the impact of the pandemic on consumers’ preferences for wood furniture from the perspective of accounting. Taking the accounting data of wood furniture enterprises as the research object, through the translog revenue function, and using the relationship between revenue and consumption in economics, we found that the COVID-19 pandemic has reduced consumers’ preferences for wood furniture, but the decline in preference is smaller for wood furniture produced by extra-large furniture manufacturers. This study contributes to the literature and in view of our research results and the severity of the COVID-19 pandemic, we provide policy suggestions for the related governmental agencies and wood furniture manufacturers, in this special environment, that can reduce the negative impact of a pandemic on the wood furniture industry.

Urban Networks, Micro-agriculture, and Community Food Security

The white paper first outlines the state of inequity in food security/sovereignty in our area of focus, taking into account historical context as well as emerging and ongoing effects of the COVID-19 pandemic and community and policy responses to it. We then discuss a food acquisition intervention, structured as a longitudinal, collaborative research, and service-learning effort known as Everybody Eats. The white paper provides detailed discussion of competing understandings of agriculture, horticulture, and the social problem of food insecurity; the preliminary data that has led to a current collaborative effort to enhance the skillset of people previously not understood as food producers and provisioners, but only as end-user consumers; and the new iteration of the project wherein specific sets of expertise from diverse disciplines are deployed both to offer a more robust intervention, and bring new methodologies to bear in assessing the ecology of a local foodshed. We propose mobilizing existing resources and expertise of the Land Grant/Cooperative Extension system to act as a regional hub for facilitating full community food security (caloric and nutritional adequacy) and food sovereignty (participatory decision-making regarding living spaces and culturally appropriate foodways). Finally, we illustrate how a nexus of faculty, working from a service-learning advocacy perspective and embedded in a participatory action framework, provides a mechanism for bringing together and sustaining a community of intellectually diverse researchers and stakeholders.

Food insecurity associated with higher COVID-19 infection in households with older adults

OBJECTIVES

As a well-documented social determinant of health, food insecurity may be associated with COVID-19 infection in households with older adults. We examined whether older adults were vulnerable to COVID-19 infection during the early pandemic if they were food insecure versus food secure.

STUDY DESIGN

A cross-sectional study using a nationally representative population-based survey of US older adults.

METHODS

We used a random subsample of Health and Retirement Study (HRS) drawn in June 2020 (N = 3212). We compared the odds of reporting COVID-19 infection in a household, COVID-19 infection and mortality among acquaintances, and respondent's perceived fair or poor health across household food insecurity status resulted from financial or non-financial barriers. Baseline health and socioeconomic circumstances were adjusted in the models.

RESULTS

Results showed a higher COVID-19 infection rate among food-insecure households than among their food-secure counterparts during the pandemic. Food insecurity due to non-financial obstacles was associated with greater likelihood of COVID-19 infection both within respondents' households (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.03-2.90) and among their acquaintances (aOR = 1.32, 95% CI: 1.05-1.65). Food insecurity caused by both non-financial and financial constraints was associated with twice the likelihood of knowing someone who died from COVID-19 than their food-secure counterparts (aOR = 2.14, 95% CI: 1.27-3.61).

CONCLUSIONS

Food insecurity driven by non-financial constraints played an important role in the ongoing pandemic among US older adults. Policies addressing COVID-19 need to recognize the vulnerability of food-insecure older adults beyond lack of monetary resources.

How did Covid-19 impact US household foods? an analysis six months in

Using a nationwide survey of primary grocery shoppers conducted in August 2020, we examine household food spending when the economy had partially reopened and consumers had different spending opportunities in comparison to when the Covid-19 lockdown began. We estimate the impact of Covid-19 on household spending using interval and Order Probit regressions. Income levels, age, access to grocery stores and farmers markets, household demographic information, along with other independent variables are controlled in the model. Findings show that middle-class households (with income below $50,000, or with income between $50,000 and $99,999) are less likely to increase their grocery expenditures during the pandemic. Households with children or elderlies that usually require higher food quality and nutrition intakes had a higher probability of increasing their spending during Covid-19 than before. Furthermore, consumers' spending behaviors were also significantly affected by their safe handing levels and the Covid-19 severity and food accessibility in their residences.

Current and Future Food Insufficiency During Covid-19: Examining Disparities by Race/Ethnicity and Recent Work Loss

The Covid-19 pandemic, which began in early 2020, has eroded the previous decade’s reductions in food insecurity. Pandemic-related food insufficiency has been concentrated among Black and Hispanic households and those who have experienced a recent work loss. Households with children are particularly vulnerable. Using the first twenty-one weeks of the US Census Bureau’s Household Pulse Survey data from April 2020 through December of 2020, we examine the association between recent work losses and food insufficiency and document the extent to which the impact varies by race/ethnicity. Work loss is predictive of current and future food insufficiency, with the association most acutely experienced by Blacks and Hispanics and households with children. There is evidence of racial/ethnic disparities in current and future food insufficiency. The results provide insight into how the pandemic has widened racial/ethnic gaps in the experience of food insufficiency despite recent policy interventions.

Prevalence and changes in food-related hardships by socioeconomic and demographic groups during the COVID-19 pandemic in the UK: A longitudinal panel study

Background

Food insecurity concerns have featured prominently in the UK response to the COVID-19 pandemic. We assess changes in the prevalence of food-related hardships in the UK population from April to July 2020.

Method

We analysed longitudinal data on food-related hardships for 11,104 respondents from the April-July 2020 waves of the Understanding Society COVID-19 web survey with linked data from the 2017-9 wave of the annual Understanding Society survey. Outcome variables were reports of being hungry but not eating and of being unable to eat healthy and nutritious food in the last week, which were adapted from the Food Insecurity Experience Scale. We used unadjusted estimates to examine changes in population prevalence and logistic regression to assess the association between employment transitions and both outcomes at the individual level.

Findings

The prevalence of reporting an inability to eat healthy or nutritious food rose from 3•2% in April to 16•3% in July 2020. The largest increases in being unable to eat healthy or nutritious food were among Asian respondents, the self-employed, and 35-44-year-olds. The prevalence of being hungry but not eating rose from 3•3% in April to 5•1% in July, with the largest increases observed among unemployed individuals below age 65. Those moving from employment to unemployment had higher odds of being hungry but not eating in the last week relative to furloughed individuals (OR = 2•2; p < 0•05; 95% CI: 1•1 to 4•2) and to the persistently employed (OR = 3•5; p < 0•001; 95% CI: 1•8 to 6•9), adjusting for age, highest qualification in 2017-19, net household income in 2017-19 (equivalized), gender, race/ethnicity, number children at home (aged 0-4, 5-15, and 16-18), cohabitation status, and government office region. Respondents moving from employment to unemployment also had higher odds of reporting an inability to eat healthy and nutritious food relative to furloughed individuals (OR = 1•9; p < 0•05; 95% CI: 1•4 to 3•2) and to the persistently employed (OR = 2•0; p < 0•01; 95% CI: 1•2 to 3•4). No statistically significant differences were found between furloughed individuals and the persistently employed in their probability of reporting either outcome.

Interpretation

Food-related hardships increased substantially in the UK between April and July 2020, largely driven by reports of an inability to eat healthy and nutritious food. The Coronavirus Job Retention Scheme and Self-Employment Income Support Scheme appeared to have conferred some protection, but more could have been done to mitigate the problems we describe in obtaining affordable food.

Funding

DS is funded by the Wellcome Trust investigator award. JK and DS are funded by the European Research Council n. 313590 – HRES. VT is funded by the European Research Council n. 694145- IFAMID.

Perceived Neighborhood-Level Drivers of Food Insecurity Among Aging Women in the United States: A Qualitative Study

BACKGROUND

Aging populations in the United States exhibit high rates of food insecurity and chronic illness. Few studies have explored the neighborhood-level drivers of food insecurity among such populations, and how they intersect with experiences of aging.

OBJECTIVE

The aim of this study was to explore how aging women experience food insecurity in the United States, and the neighborhood-level factors that influence these experiences.

DESIGN

Semistructured qualitative interviews were conducted to elicit participants' perceptions of how their neighborhood influenced their experiences with food security and aging.

PARTICIPANTS/SETTING

Thirty-eight food-insecure women aged 50 years and older were purposively sampled from the Northern California, Georgia, and North Carolina sites of the Women's Interagency Human Immunodeficiency Virus Study. Interviews were conducted between November 2017 and July 2018 at the three Women's Interagency Human Immunodeficiency Virus Study sites.

STATISTICAL ANALYSIS

Three researchers thematically analyzed the data using an inductive-deductive approach.

RESULTS

Participants described neighborhood-level drivers of food insecurity that centered around three themes: accessibility of food from traditional food stores, the role of food aid institutions, and the intersection of aging with the food environment. Participants explained that food insecurity was related to limited access to food stores largely due to long distances and poor public transportation in Georgia and North Carolina, and high food prices in Northern California. Most participants described being dependent on food aid programs, but found this difficult due to poor quality food and long wait times. Aging-related issues emerged as a cross-cutting theme, with fatigue, poor strength, and chronic illness amplifying barriers to accessing food.

CONCLUSIONS

Findings from this study reveal the structural barriers that aging women face in accessing healthy food within their neighborhoods, and how experiences with aging and chronic illnesses exacerbate these barriers. Although future programs should address common neighborhood-level barriers such as the accessibility and affordability of healthy foods, they should also be tailored to aging women and the local context.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review

BACKGROUND

The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.

OBJECTIVE

This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias.

METHODS

A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.

RESULTS

A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted.

CONCLUSIONS

Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

COVID-19 lockdowns and demographically-relevant Google Trends: A cross-national analysis

The spread of COVID-19 and resulting local and national lockdowns have a host of potential consequences for demographic trends. While impacts on mortality and, to some extent, short-term migration flows are beginning to be documented, it is too early to measure actual consequences for family demography. To gain insight into potential future consequences of the lockdown for family demography, we use cross-national Google Trends search data to explore whether trends in searches for words related to fertility, relationship formation, and relationship dissolution changed following lockdowns compared to average, pre-lockdown levels in Europe and the United States. Because lockdowns were not widely anticipated or simultaneous in timing or intensity, we exploit variability over time and between countries (and U.S. states). We use a panel event-study design and difference-in-differences methods, and account for seasonal trends and average country-level (or state-level) differences in searches. We find statistically significant impacts of lockdown timing on changes in searches for terms such as wedding and those related to condom use, emergency contraception, pregnancy tests, and abortion, but little evidence of changes in searches related to fertility. Impacts for union formation and dissolution tended to only be statistically significant at the start of a lockdown with a return to average-levels about 2 to 3 months after lockdown initiation, particularly in Europe. Compared to Europe, returns to average search levels were less evident for the U.S., even 2 to 3 months after lockdowns were introduced. This may be due to the fact, in the U.S., health and social policy responses were less demarcated than in Europe, such that economic uncertainty was likely of larger magnitude. Such pandemic-related economic uncertainty may therefore have the potential to slightly increase already existing polarization in family formation behaviours in the U.S. Alongside contributing to the wider literature on economic uncertainty and family behaviors, this paper also proposes strategies for efficient use of Google Trends data, such as making relative comparisons and testing sensitivity to outliers, and provides a template and cautions for their use in demographic research when actual demographic trends data are not yet available.

Labor Issues in the Food Supply Chain Amid the COVID-19 Pandemic

The impacts of COVID-19 on labor in the food supply chain and on workers' decisions to accept essential jobs are discussed. We then analyze surveys administered to low-skilled domestic workers before and during the pandemic to assess respondents' attitudes toward food production, guest workers, immigration policy, and the government's response to COVID-19. Results suggest the outbreak resulted in respondents, on average, shifting their view toward food being a national security issue and a higher degree of empathy for H-2A workers. Regression analysis shows that gender, current agricultural workers, and information on COVID-19 and agricultural field workers influenced respondents' answers.

Food Insecurity during COVID-19

For a decade, Feeding America's Map the Meal Gap (MMG) has provided sub-state-level estimates of food insecurity for both the full population and for children. Along with being extensively used by food banks, it is widely used by state and local governments to help plan responses to food insecurity in their communities. In this paper, we describe the methods underpinning MMG, detail the approach Feeding America has used to make projections about the geography of food insecurity in 2020, and how food insecurity rates may have changed due to COVID-19 since 2018. We project an increase of 17 million Americans who are food insecure in 2020 but this aggregate increase masks substantial geographic variation found in MMG.

What the COVID-19 Pandemic Reveals about Racial Differences in Child Welfare and Child Well-Being: An Introduction to the Special Issue

This paper introduces the special issue on race, child welfare, and child well-being. In doing so, I summarize the evidence of racial/ethnic disparities in child well-being after the onset of the COVID-19 pandemic. Recent findings demonstrate that, compared to white children, black and Latino children are more likely to have experienced poverty and food insufficiency, to have had parents lose their jobs, and to be exposed to distance learning and school closures during the pandemic. I argue that though COVID-19 has indeed worsened racial/ethnic disparities in child well-being, it has also served to place a spotlight on the American welfare state's historical mistreatment of low-income families and black and Latino families in particular. Consider that around three-fourths of black and Latino children facing food insufficiency during the pandemic also experienced food insufficiency prior to the onset of the pandemic. Moving forward, analyses of racial/ethnic disparities in child well-being during the pandemic, I argue, must not only consider the economic shock and high unemployment rates of 2020, but the failure of the American welfare state to adequately support jobless parents, and black and Latino parents in particular, long before the COVID-19 pandemic arrived.