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Kibe LW, Bosah A, Schrode KM, Kuo Y, Shaheen M, Adinkra E, Sanchez H, Bazargan M. Assessing Food Access, Exercise, and Dietary History among Older African American Parishioners During the COVID-19 Pandemic (C-FED Study): Design, Opportunities, Challenges, and Lessons Learned. J Racial Ethn Health Disparities 2024; 11:1857-1868. [PMID: 37336866 PMCID: PMC11110797 DOI: 10.1007/s40615-023-01657-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Unhealthy diets and inadequate exercise are associated with chronic health conditions and excess mortality. Older African Americans do not meet dietary and exercise guidelines, and this may have worsened during the COVID-19 pandemic due to individual and environmental factors, including food insecurity. Studies evaluating these dynamics are essential for developing interventions. This narrative details a study protocol and data collection experiences during the pandemic. METHODS Participants > 55 years African American old completed detailed food frequency, exercise, and food access questionnaires between October 2020 and July 2021. Observations of the study administrators (authors of this manuscript) for the duration of the study are presented. Details on the study design and reflections on the opportunities, challenges, and lessons learned are summarized. Future manuscripts will report data analysis of study findings. RESULTS A total of 123 older African American adults participated in the study, and 118 (70% female) completed all three questionnaires. More than 50% of the participants had at least two primary chronic conditions. About 85% were fully vaccinated against COVID-19. Applying community-based participatory approaches, leveraging partnerships, and exercising flexibility approaches were pivotal to successfully implementing the study protocol. CONCLUSIONS Despite challenges related to the COVID-19 pandemic, detailed data on older African American adults' diet and exercise habits were obtained. Our study design and experiences will benefit future researchers. More importantly, results from our study will inform interventions and policies aimed at minimizing consequences associated with poor diet and exercise habits during the pandemic among this vulnerable population.
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Affiliation(s)
- Lucy W Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA.
| | - Adaobi Bosah
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA
| | - Katrina M Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Yufu Kuo
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Edward Adinkra
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Humberto Sanchez
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science, 1731 E. 120Th St., Los Angeles, CA, 90059, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, 90059, USA
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Inoue M, Masa R, Prieto L, Baruah D, Kellermeyer K, Booker E, Sweeney G. Prevalence and Correlates of Food Insecurity Among Older Adults in the United States. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:738-755. [PMID: 38739384 DOI: 10.1080/01634372.2024.2339975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
This study analyzed the 2021 National Health Interview Survey (NHIS) to assess food insecurity among adults aged 65 and older. Among 8,877 older adults, 4 percent (N=287) reported low or very low food security levels. Those who identified as Black or African American and Hispanic or Latino were more likely to experience food insecurity compared to White individuals. The study found that merely surpassing the poverty threshold might not be sufficient to protect against food insecurity. It also underscored socioemotional support's protective role in older adults' food security. Social workers must recognize various factors influencing food security among older adults.
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Affiliation(s)
- Megumi Inoue
- Department of Social Work, George Mason University, Virginia, USA
| | - Rainier Masa
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lucas Prieto
- Department of Social Work, George Mason University, Virginia, USA
| | - Dicky Baruah
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Emma Booker
- Department of Social Work, George Mason University, Virginia, USA
| | - Grace Sweeney
- Department of Social Work, George Mason University, Virginia, USA
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Perrins SP, Vermes E, Cincotta K, Xu Y, Godoy-Garraza L, Chen MS, Addison R, Douglas B, Yatco A, Idaikkadar N, Willis LA. Understanding forms of childhood adversities and associations with adult health outcomes: A regression tree analysis. CHILD ABUSE & NEGLECT 2024; 153:106844. [PMID: 38761717 DOI: 10.1016/j.chiabu.2024.106844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/18/2024] [Accepted: 05/03/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Empirical studies have demonstrated associations between ten original adverse childhood experiences (ACEs) and multiple health outcomes. Identifying expanded ACEs can capture the burden of other childhood adversities that may have important health implications. OBJECTIVE We sought to identify childhood adversities that warrant consideration as expanded ACEs. We hypothesized that experiencing expanded and original ACEs would be associated with poorer adult health outcomes compared to experiencing original ACEs alone. PARTICIPANTS The 11,545 respondents of the National Longitudinal Surveys (NLS) and Child and Young Adult Survey were 48.9 % female, 22.7 % Black, 15.8 % Hispanic, 36.1 % White, 1.7 % Asian/Native Hawaiian/Pacific Islander/Native American/Native Alaskan, and 7.5 % Other. METHODS This study used regression trees and generalized linear models to identify if/which expanded ACEs interacted with original ACEs in association with six health outcomes. RESULTS Four expanded ACEs-basic needs instability, lack of parental love and affection, community stressors, and mother's experience with physical abuse during childhood -significantly interacted with general health, depressive symptom severity, anxiety symptom severity, and violent crime victimization in adulthood (all p-values <0.005). Basic needs instability and/or lack of parental love and affection emerged as correlates across multiple outcomes. Experiencing lack of parental love and affection and original ACEs was associated with greater anxiety symptoms (p = 0.022). CONCLUSIONS This is the first study to use supervised machine learning to investigate interaction effects among original ACEs and expanded ACEs. Two expanded ACEs emerged as predictors for three adult health outcomes and warrant further consideration in ACEs assessments.
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Affiliation(s)
| | - Ellen Vermes
- ICF, 1902 ICF Reston Plaza, Reston, VA 20190, USA
| | | | - Ye Xu
- ICF, 1902 ICF Reston Plaza, Reston, VA 20190, USA
| | | | - May S Chen
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, 4770 Buford Highway NE, Mailstop S106-10, Atlanta, GA 30341-3717, USA
| | - Ronnesha Addison
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway NE, Mailstop S106-8, Atlanta, GA 30341-3717, USA
| | - Brooke Douglas
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, 4770 Buford Highway NE, Mailstop S106-10, Atlanta, GA 30341-3717, USA
| | - Allison Yatco
- Oak Ridge Institute for Science and Education, 100 ORAU Way, Oak Ridge, TN 37830, USA
| | - Nimi Idaikkadar
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway NE, Mailstop S106-8, Atlanta, GA 30341-3717, USA
| | - Leigh A Willis
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention, 4770 Buford Highway NE, Mailstop S106-10, Atlanta, GA 30341-3717, USA
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Johnson SL, Rieder AD, Rasmussen JM, Mansoor M, Quick KN, Proeschold-Bell RJ, Boone WJ, Puffer ES. A Pilot Study of the Coping Together Virtual Family Intervention: Exploring Changes in Family Functioning and Individual Well-Being. Res Child Adolesc Psychopathol 2024; 52:1-16. [PMID: 38498230 DOI: 10.1007/s10802-024-01183-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/20/2024]
Abstract
In this pilot study, we tested a virtual family strengthening and mental health promotion intervention, Coping Together (CT), during the COVID-19 pandemic. We explored changes at the family and individual levels, as well as mechanisms of change. Participants included 18 families (24 caregivers, 24 youth) with children aged 7 to 18 years. Community health workers delivered the 8-session CT intervention using videoconferencing software. We used qualitative semi-structured interviews with 14 of the families to explore changes and mechanisms of change using a thematic content analysis approach. We also administered pre-post surveys with the 18 families to explore the direction of changes, using only descriptive statistics in this small sample. Qualitative findings supported positive changes across family and individual level outcomes including family functioning, relationship quality, and individual psychosocial well-being. Results also confirmed several hypothesized mechanisms of change with improved communication providing the foundation for increased hope and improved problem solving and coping. Pre-post survey results were mixed, showing positive, but very small, changes in family closeness, caregiver-child communication, and levels of hope; almost no change was observed on measures of caregiver and child mental health. Families reported few problems at baseline quantitatively despite qualitative descriptions of pre-intervention difficulties. Results provide preliminary support for benefits of CT with the most consistent improvements seen across family relationships. Findings were mixed related to individual-level mental health benefits. Results have implications for revising content on mental health coping strategies and suggest the need to revise the quantitative measurement strategy for this non-clinical sample.
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Affiliation(s)
- Savannah L Johnson
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
- Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
| | - Amber D Rieder
- Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | - Justin M Rasmussen
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
- Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | - Mahgul Mansoor
- Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | - Kaitlin N Quick
- Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | | | | | - Eve S Puffer
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
- Duke Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
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Watts JP, Anderson JA, Milton A, Babagbemi KT, Weissman IA, Miles RC, Flores EJ, Martin MD, Narayan AK. The Association Between Food Security and Mammography Screening: Cross-Sectional Survey Results From the National Health Interview Survey. J Am Coll Radiol 2024:S1546-1440(24)00507-6. [PMID: 38838797 DOI: 10.1016/j.jacr.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE There are limited data about food insecurity within the cancer screening setting. To inform the potential need for food insecurity interventions, our study evaluated the association between food security and mammographic screening among eligible participants. METHODS Female respondents aged 40 to 74 years in the 2019 National Health Interview Survey without history of breast cancer were included. Food insecurity was assessed using the Six-Item Food Security Scale developed by the National Center for Health Statistics. The proportion of patients who reported mammographic screening within the last year was estimated, stratified by food security. Multiple variable logistic regression analyses evaluated the association between food security and mammography screening, adjusted for potential confounders. All analyses were performed accounting for complex survey design features. RESULTS In all, 8,956 weighted survey respondents met inclusion criteria; 90.1% were classified as having high or marginal food security, of whom 56.6% reported screening; 6.1% were classified with low food security, of whom 42.1% reported screening; and 3.8% were classified with very low food security, of whom 43.1% reported screening. In our unadjusted analyses, participants with low food security (P < .001) and very low food security (P < .001) were less likely to report screening within the last year. In our adjusted analyses, participants with food insecurity (P = .009) were less likely to report screening. DISCUSSION In a nationally representative cross-sectional survey, participants with food insecurity were less likely to report mammography screening. Radiology practices should consider screening patients for food insecurity and social determinants of health. Evidence-based food insecurity interventions may increase adherence to mammography screening.
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Affiliation(s)
- Jerome Phillip Watts
- Howard University College of Medicine, Washington, DC; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
| | - Jade Arielle Anderson
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin; and Member, ACR PFCC Outreach Committee
| | - Arissa Milton
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kemi Tokunbo Babagbemi
- Department of Radiology, New York Presbyterian Hospital Weill Cornell Medical Center, New York, New York; Member, ACR PFCC Outreach Committee; Fellow, ACR
| | - Ian Allan Weissman
- Department of Radiology, Milwaukee Veterans Affairs Medical Center, Milwaukee, Wisconsin; Chair, ACR PFCC Outreach Committee; Member, Council Steering Committee; Chair, ACR Veterans Affairs Committee; and Fellow, ACR
| | | | - Efrén Jesus Flores
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Associate Editor, JACR; and JACR Editorial Board
| | | | - Anand Kumar Narayan
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin; Vice Chair, ACR PFCC Outreach Committee; Treasurer, Wisconsin Radiological Society; JACR Editorial Board
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Patte KA, Duncan MJ, Amores A, Belita E, Kocsis R, Riazi NA, Laxer R, Leatherdale ST. Inequities in dietary intake and eating behaviours among adolescents in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:507-520. [PMID: 38381304 PMCID: PMC11133286 DOI: 10.17269/s41997-024-00854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents. METHODS We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES). RESULTS Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/"prefer not to say" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES. CONCLUSION Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities.
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Affiliation(s)
- Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada.
| | - Markus J Duncan
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Angelica Amores
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Emily Belita
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Rita Kocsis
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Negin A Riazi
- Student Health & Wellbeing, University of British Columbia, Vancouver, BC, Canada
| | | | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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7
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Spence EH, Niles MT, Bertmann F, Mares T, Belarmino EH. Higher rates of food insecurity and stress experienced by food systems workers during the first year of the COVID-19 pandemic. Front Nutr 2024; 11:1274656. [PMID: 38774263 PMCID: PMC11106489 DOI: 10.3389/fnut.2024.1274656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/09/2024] [Indexed: 05/24/2024] Open
Abstract
Introduction The present study examined the prevalence of food insecurity and perceived stress among food system workers relative to other members of the population during the first year of the COVID-19 pandemic. It also explored perspectives on the role of food system workers during the pandemic and their experiences working during this time. Methods Data were collected via an online survey in spring 2021. The sample was comprised of 441 residents of Vermont, United States, including 41 food system workers. Results Regression models identified higher rates of food insecurity and perceived stress among food system workers during the first year of the pandemic. However, these relationships were not maintained when the models were adjusted for income and job disruption, suggesting that the associations were primarily due to the economic vulnerability of food system workers. Most respondents indicated concern for the health and well-being of food system workers, felt that food system workers were undervalued, and agreed that the well-being of food system workers should be prioritized. However, opinions were split regarding whether it was worth the health risk to require farms and food processing plants to stay open to maintain the food supply. Half of food system workers believed that their work had compromised their well-being during the pandemic, although several also identified their jobs as pathways for accessing food. Discussion The findings provide valuable information for decision-makers seeking to increase the resilience of the food supply and the food system workforce.
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Affiliation(s)
- Emma H. Spence
- Food Systems Program, University of Vermont, Burlington, VT, United States
| | - Meredith T. Niles
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, United States
- Gund Institute for Environment, University of Vermont, Burlington, VT, United States
| | - Farryl Bertmann
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, United States
| | - Teresa Mares
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Anthropology, University of Vermont, Burlington, VT, United States
| | - Emily H. Belarmino
- Food Systems Program, University of Vermont, Burlington, VT, United States
- Department of Nutrition and Food Sciences, University of Vermont, Burlington, VT, United States
- Gund Institute for Environment, University of Vermont, Burlington, VT, United States
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de Aquino Guerreiro N, Manfrinato CV, Lourenço BH, Franco MDCP, Stedefeldt E, Tomita LY. Insufficient Answer During the Public Health Emergency: A Lesson from the Persistence of Food Insecurity in Low-Income Communities. Ecol Food Nutr 2024; 63:177-190. [PMID: 38454757 DOI: 10.1080/03670244.2024.2326925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Cohort study in deprived communities to investigate the persistence of food insecurity (FI) during the COVID-19 was conducted. Sample were derived from a list of mobile phone numbers provided by community leaders and local nonprofit organizations. Temporal trends and prevalence ratios of FI persistence, categorized as "never," "occasional FI," "consistent FI," were calculated. A total of 302 households completed three assessments, the majority nonwhite women. During the follow-up, families covered by social assistance increased; however, their income decreased (p < 0.05). 33% were "consistent," and 46% "occasional" FI. Permanent difficulties accessing gas canisters, hygiene products, and hand sanitizers were observed.
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Affiliation(s)
| | | | | | | | - Elke Stedefeldt
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Luciana Yuki Tomita
- Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil
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Wang ML, Gago CM. Shifts in Child Health Behaviors and Obesity After COVID-19. JAMA Pediatr 2024; 178:427-428. [PMID: 38436952 DOI: 10.1001/jamapediatrics.2024.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
This Viewpoint examines recent COVID-19–related behavioral shifts in children’s diet, physical activity, sleep, and screen time from a health equity perspective and provides upstream interventions to support overall child health.
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Affiliation(s)
- Monica L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cristina M Gago
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
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10
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Bui T, Melnick EM, Tong D, Acciai F, Yedidia MJ, Ohri-Vachaspati P. Emergency Free School Meal Distribution During the COVID-19 Pandemic in High-Poverty Urban Settings. J Acad Nutr Diet 2024; 124:636-643. [PMID: 37935347 PMCID: PMC11032230 DOI: 10.1016/j.jand.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 09/02/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic triggered nationwide school closures in March 2020, putting millions of children in the United States who were reliant on subsidized school meals at risk of experiencing hunger. In response, the US Department of Agriculture mobilized the Summer Food Service Program and Seamless Summer Option program to provide emergency free school meals. There is a need to investigate the effectiveness of these programs in covering underresourced communities during the pandemic. OBJECTIVE This study assessed associations between meal distribution and census tract demographics (ie, poverty level, race/ethnicity, and deprivation level based on social deprivation index score). DESIGN An observational study using longitudinal meal distribution data collected over an 18-month period following school closures (March 2020 to August 2021). PARTICIPANTS AND SETTING Monthly meal distribution data were collected for community sites serving 142 census tracts within 4 urban New Jersey cities predominantly populated by people with low incomes and from racial and ethnic minority groups. MAIN OUTCOME MEASURES Main outcome measures were the number of meals served monthly by Summer Food Service Program and Seamless Summer Option meal sites. STATISTICAL ANALYSES PERFORMED A 2-part multivariable regression approach was used to analyze the data. RESULTS In the first step, logistic regression models showed that high-deprivation tracts were more likely to serve meals during the observed period (odds ratio 3.43, 95% CI 1.001 to 11.77; P = 0.0499). In the second step, among tracts that served any meals during the observed period, mixed effects negative binomial regression models showed that high-poverty and high-deprivation tracts served comparatively more meals (incidence rate ratio [IRR] 2.83, 95% CI 2.29 to 3.51; P < 0.001 and IRR 1.94, 95% CI 1.65 to 2.28; P < 0.001, respectively). CONCLUSIONS Findings show that meal distribution during the pandemic was higher within census tracts with higher poverty and deprivation levels, indicating that underresourced communities with higher need had more free meals available during this unprecedented public health emergency.
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Affiliation(s)
- Theresa Bui
- College of Medicine, University of Arizona, Phoenix, Arizona
| | - Emily M Melnick
- College of Health Solutions, Arizona State University, Phoenix, Arizona.
| | - Daoqin Tong
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, Arizona
| | - Francesco Acciai
- College of Health Solutions, Arizona State University, Phoenix, Arizona
| | - Michael J Yedidia
- Center for State Health Policy, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey
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Chai L. Food insecurity and its association with multiple health outcomes among Indigenous peoples in Canada: the buffering role of culture-based resources. ETHNICITY & HEALTH 2024; 29:371-394. [PMID: 38297918 DOI: 10.1080/13557858.2024.2311419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Despite growing interest in the health disparities associated with food insecurity, research focusing on Indigenous peoples has been limited, especially in studies using nationally representative samples. This study investigates the association between food insecurity and various health outcomes - self-rated general and mental health, chronic health conditions, suicidal ideation, and obesity - among Indigenous peoples in Canada. It also explores the potential moderating effects of culture-based resources, which include cultural identity affect, cultural group belonging, cultural engagement, and cultural exploration. DESIGN The study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations individuals living off-reserve, Métis, and Inuit across Canada (N = 15,533). Logistic regression models were used to analyze the data. RESULTS Food insecurity was negatively associated with all examined health outcomes. Culture-based resources demonstrated a mixture of anticipated and unexpected effects on these relationships. Consistent with the stress process model, cultural group belonging mitigated the negative impact of food insecurity on all health outcomes. A similar pattern was observed for cultural engagement. However, contrary to expectations from the stress-buffering perspective, little evidence was found to support the moderating effects of cultural identity affect and cultural exploration. CONCLUSION The results underscore the detrimental effects of food insecurity on the health of Indigenous peoples in Canada and suggest that culture-based resources, particularly cultural group belonging, play a crucial role in mitigating health disparities.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Canada
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12
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Bofa A, Zewotir T. Key predictors of food security and nutrition in Africa: a spatio-temporal model-based study. BMC Public Health 2024; 24:885. [PMID: 38519902 PMCID: PMC11220996 DOI: 10.1186/s12889-024-18368-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024] Open
Abstract
There is voluminous literature on Food Security in Africa. This study explicitly considers the spatio-temporal factors in addition to the usual FAO-based metrics in modeling and understanding the dynamics of food security and nutrition across the African continent. To better understand the complex trajectory and burden of food insecurity and nutrition in Africa, it is crucial to consider space-time factors when modeling and interpreting food security. The spatio-temporal anova model was found to be superior(employing statistical criteria) to the other three models from the spatio-temporal interaction domain models. The results of the study suggest that dietary supply adequacy, food stability, and consumption status are positively associated with severe food security, while average food supply and environmental factors have negative effects on Food Security and Nutrition. The findings also indicate that severe food insecurity and malnutrition are spatially and temporally correlated across the African continent. Spatio-temporal modeling and spatial mapping are essential components of a comprehensive practice to reduce the burden of severe food insecurity. likewise, any planning and intervention to improve the average food supply and environment to promote sustainable development should be regional instead of one size fit all.
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Affiliation(s)
- Adusei Bofa
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Westville campus, Durban, South Africa.
| | - Temesgen Zewotir
- School of Mathematics, Statistics, and Computer Science, University of KwaZulu Natal, Westville campus, Oliver Tambo Building, Durban, South Africa
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Mui Y, Adam A, Santo R, Bassarab K, Wolfson JA, Palmer A. Characterizing Food Policy Councils' Network Partnerships and COVID-19 Responses. Nutrients 2024; 16:915. [PMID: 38612949 PMCID: PMC11013245 DOI: 10.3390/nu16070915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
The COVID-19 pandemic pushed millions of Americans into food insecurity. Food policy councils (FPCs) across the country played a vital role in organizing coordinated food responses across multiple sectors. We used a social network analysis (SNA) approach to investigate: (1) the network of partnering organizations and agencies within FPCs; (2) how the characteristics of FPCs' network partnerships (i.e., degree, coreness, and density) related to programmatic, policy, and advocacy actions in response to the pandemic; and (3) how FPCs' use of a racial or social equity framework shifted their network partnerships and responses. Local government agencies and food supply chain actors were core in FPCs' network partnerships, while public utilities, correctional facilities, social justice groups, and others were non-core partners. Network density was more likely to be associated with any action by FPCs, and it was especially pronounced for advocacy actions taken by FPCs; trends were similar among FPCs that reported using a racial or social equity framework. The findings begin to uncover core actors in FPCs' partnerships and opportunities to establish new partnerships, particularly with social justice groups. The results also suggest that network density (interconnectedness) may be more important than other network characteristics when responding to food-related needs.
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Affiliation(s)
- Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.A.); (J.A.W.)
| | - Atif Adam
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.A.); (J.A.W.)
| | - Raychel Santo
- Johns Hopkins Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.S.); (K.B.); (A.P.)
| | - Karen Bassarab
- Johns Hopkins Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.S.); (K.B.); (A.P.)
| | - Julia A. Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (A.A.); (J.A.W.)
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anne Palmer
- Johns Hopkins Center for a Livable Future, Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (R.S.); (K.B.); (A.P.)
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Carter A, Broad G, Reeves V. Recapturing Communicative Erasure: Black Women Farmers' Lived Experience, Political Voice and Cultural Knowledge as Critical Health Communication Praxis. HEALTH COMMUNICATION 2024:1-12. [PMID: 38494650 DOI: 10.1080/10410236.2024.2328919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
In this paper, we conduct a case study analysis of the National Women in Agriculture Association (NWIAA), an international, Black women-led farm assistance organization founded in 2008 and based in Oklahoma City, Oklahoma. Drawing on the Culture-Centered Approach (CCA) and grounded in interviews and observational fieldwork, we center the perspectives of NWIAA chapter leaders (n = 16) to examine how they describe motivations for farming, challenge power inequities, engage with intersectional barriers, and develop locally situated solutions across agricultural and community health contexts. The analysis argues that Black women farmer's historical lived experiences, political voice, and shared deep-rooted agricultural knowledge provide an innovative and emancipatory praxis for rethinking health communication intervention approaches that address food system-generated disparities. This study contributes important takeaways for health communication practitioners, policymakers, and advocates addressing food inequities. It extends the CCA as a first step in developing community-driven, context-specific food insecurity health communication interventions within marginalized communities across the United States and beyond.
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Affiliation(s)
- Andrew Carter
- Department of Public Health and Recreation, San Jose State University
| | - Garrett Broad
- Ric Edelman College of Communication and Creative Arts, Rowan University
| | - Vanessa Reeves
- Department of Public Health and Recreation, San Jose State University
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15
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Odoms-Young A, Brown AGM, Agurs-Collins T, Glanz K. Food Insecurity, Neighborhood Food Environment, and Health Disparities: State of the Science, Research Gaps and Opportunities. Am J Clin Nutr 2024; 119:850-861. [PMID: 38160801 DOI: 10.1016/j.ajcnut.2023.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024] Open
Abstract
Food insecurity and the lack of access to affordable, nutritious food are associated with poor dietary quality and an increased risk of diet-related diseases, including cardiovascular disease, diabetes, and certain types of cancer. Those of lower socioeconomic status and racial and ethnic minority groups experience higher rates of food insecurity, are more likely to live in under-resourced food environments, and continue to bear the greatest burden of diet-related chronic diseases in the United States. Despite the growing body of literature in this area, there are still significant gaps in our understanding of the various pathways that link food insecurity and neighborhood food environments to racial/ethnic and socioeconomic disparities in health and the most effective intervention strategies to address these disparities. To better understand the science in this area, the National Institutes of Health, in collaboration with the Centers for Disease Control (CDC) and Prevention and the United States Department of Agriculture (USDA), convened a virtual 3-d workshop 21-23 September 2021: Food Insecurity, Neighborhood Food Environment, and Nutrition Health Disparities: State of the Science. The workshop brought together a diverse group of researchers, practitioners, policymakers, and federal partners with expertise in nutrition, the food environment, health and social policy, and behavioral and social sciences. The workshop had the following 3 research objectives: 1) summarize the state of the science and knowledge gaps related to food insecurity, neighborhood food environments, and nutrition health disparities, 2) identify research opportunities and strategies to address research gaps, and 3) examine evidence-based interventions and implementation approaches to address food insecurity and neighborhood food environments to promote health equity. This article summarizes workshop proceedings and describes research gaps and future opportunities that emerged from discussions.
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Affiliation(s)
- Angela Odoms-Young
- Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | - Alison G M Brown
- National Heart Lung and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States.
| | - Tanya Agurs-Collins
- National Cancer Institute, Division of Cancer Control and Population Sciences, Bethesda, MD, United States
| | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, PA, United States
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16
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Araújo MVRD, Pereira-Borges RC. Racism, health and pandemic: a narrative review of the relationship between black population and COVID-19 events in 2020. CIENCIA & SAUDE COLETIVA 2024; 29:e11072023. [PMID: 38451653 DOI: 10.1590/1413-81232024293.11072023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/20/2023] [Indexed: 03/08/2024] Open
Abstract
This study aimed to analyze how scientific publications described and interpreted findings about the relationship between the Black population and events linked to COVID-19 in 2020. Narrative review with systematic search, in which a survey was conducted on articles published in 2020 in the Scopus, Medline/PubMed, and Web of Science databases. Initially, 665 articles were found, and after reading and applying the eligible criteria, the final number of 45 articles was reached. Epidemiological, observational studies, secondary data and developed in the United States predominated. Four groupings and respective findings emerged from the synthesis of information extracted: Main events in the Black population - high number of deaths and mortality rate; Direct relationships - poor health, housing, and work conditions; Intermediate relationships - low income and anti-Black prejudice; Comprehensive relationships - structural racism and social determinants of health. The identification of racial health disparities is an important finding about the dynamics of the pandemic among the Black population. However, multicausal explanations were limited. It is necessary to mobilize critical theoretical resources from ethnic and health studies to qualify research in order to support global actions to combat the SARS-CoV-2 epidemic in this group.
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Affiliation(s)
- Marcos Vinícius Ribeiro de Araújo
- Instituto Multidisciplinar de Reabilitação e Saúde, Universidade Federal da Bahia. R. Padre Feijó 312, casas 47 e 49, Canela. 40.110-170 Salvador BA Brasil.
| | - Ruan Carlos Pereira-Borges
- Programa de Residência Multiprofissional Hospital Metropolitano Odilon Behrens, Secretaria Municipal de Saúde de Belo Horizonte. Belo Horizonte MG Brasil
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17
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Johnson KA, Owens C, Edelson HC, Yonker M, Robinson-Mosley S, Park J, Cook M. Food insecurity in pediatric HIV: understanding a critical challenge in the United States. AIDS Care 2024:1-9. [PMID: 38387444 DOI: 10.1080/09540121.2023.2287734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/20/2023] [Indexed: 02/24/2024]
Abstract
Advancing the well-being of individuals living with HIV necessitates attention to social determinants of health, including food insecurity. Through a clinical and community-based needs assessment, we aimed to gain insight into experiences of food insecurity among patients receiving care at a large pediatric HIV outpatient clinic in the Southeastern United States. We adopted a multimodal assessment approach involving a literature review, community profiling, key informant interviews, focus group discussions with staff, patients and parents and a community stakeholder advisory meeting. Our needs assessment demonstrates that food insecurity is an important aspect of the lived experience of children, adolescents and young adults living with HIV. Clinical staff agreed that food insecurity screening should be incorporated into the patient care workflow but ideally only in concert with providing resources that meet their needs. We formulated a recommendation matrix for addressing food insecurity based on priority importance and feasibility. Collaborative relationships between healthcare practitioners and leaders, community-based organizations and local and federal funding sources are vital for enhancing patients' access to sustainable, reliable solutions to this fundamental determinant of health. Our approach provides a tested model for other clinics seeking to identify and alleviate food insecurity among patients.
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Affiliation(s)
- Khaliah A Johnson
- Department of Pediatrics, Division of Pediatric Palliative Care, Emory University, Atlanta, GA, USA
- The Ponce de Leon Center, Grady Medical Center, Atlanta, GA, USA
| | - Caroline Owens
- Department of Anthropology, Emory University, Atlanta, GA, USA
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | - Hannah Claire Edelson
- Department of Emergency Medicine, Oliver View- UCLA Medical Center, Los Angeles, CA, USA
| | - Magdalene Yonker
- The Ponce de Leon Center, Grady Medical Center, Atlanta, GA, USA
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | | | - Jenny Park
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Miranda Cook
- Laney Graduate School, Emory University, Atlanta, GA, USA
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18
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Duncan MJ, Belita E, Amores A, Riazi NA, Carsley S, Vanderloo LM, Carson V, Chaput JP, Faulkner G, Leatherdale ST, Patte KA. Changes in breakfast and water consumption among adolescents in Canada: examining the impact of COVID-19 in worsening inequity. BMC Nutr 2024; 10:27. [PMID: 38317176 PMCID: PMC10840267 DOI: 10.1186/s40795-024-00831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND To assess whether changes in breakfast and water consumption during the first full school year after the emergence of the COVID-19 pandemic varied based on sex/gender, race/ethnicity, and socioeconomic status among Canadian adolescents. METHODS Prospective annual survey data collected pre- (October 2019-March 2020) and post-COVID-19 onset (November 2020-June 2021) the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. The sample consisted of 8,128 students; mean (SD) age = 14.2 (1.3) years from a convenience sample of 41 Canadian secondary schools. At both timepoints self-reported breakfast and water consumption were dichotomized as daily or not. Multivariable logistic generalized estimating equations with school clustering were used to estimate differences in maintenance/adoption of daily consumption post-COVID-19 based on demographic factors, while controlling for pre-COVID-19 behaviour. RESULTS Adjusted odds ratios (AOR) with 95% confidence intervals are reported. Females (AOR = 0.71 [0.63, 0.79]) and lower socioeconomic status individuals (AORLowest:Highest=0.41 [0.16, 1.00]) were less likely to maintain/adopt daily breakfast consumption than male and higher socioeconomic status peers in the 2020-2021 school year. Black identifying individuals were less likely than all other racial/ethnic identities to maintain/adopt plain water consumption every day of the week (AOR = 0.33 [0.15, 0.75], p < 0.001). No significant interaction effects were detected. CONCLUSIONS Results support the hypothesis that changes in nutritional behaviours were not equal across demographic groups. Female, lower socioeconomic status, and Black adolescents reported greater declines in healthy nutritional behaviours. Public health interventions to improve adherence to daily breakfast and water consumption should target these segments of the population. TRIAL REGISTRATION Not a trial.
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Affiliation(s)
- Markus J Duncan
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada.
| | - Emily Belita
- School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Angelica Amores
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Negin A Riazi
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Sarah Carsley
- Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Room 500, Toronto, ON, M5T 3M7, Canada
| | - Leigh M Vanderloo
- ParticipACTION, 77 Bloor St. W., Suite 1205, Toronto, ON, M5S 1M2, Canada
- School of Occupational Therapy, Western University, 1201 Western Rd., London, ON, N6G 1H1, Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 8840 114 St., Edmonton, AB, T6G 2H9, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children?s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada
- Department of Pediatrics, University of Ottawa, 75 Laurier Ave. East, Ottawa, ON, K1N 6N5, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station, 2259 Lower Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
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19
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Liu J, Yi SS, Russo RG, Horowitz CR, Zhang D, Rajbhandari-Thapa J, Su D, Shi L, Li Y. Trends and disparities in prevalence of cardiometabolic diseases by food security status in the United States. Nutr J 2024; 23:4. [PMID: 38172928 PMCID: PMC10763098 DOI: 10.1186/s12937-023-00910-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Previous studies have demonstrated the association between food security and cardiometabolic diseases (CMDs), yet none have investigated trends in prevalence of CMDs by food security status in the United States (US). METHODS Serial cross-sectional analysis of the US nationally representative data from National Health and Nutrition Examination Survey (1999-2018) was conducted among adults aged 20 years or older. Food security status was defined by the US Household Food Security Survey Module (full, marginal, low, and very low food security). We estimated the age-adjusted prevalence of CMDs including obesity, hypertension, diabetes, and coronary heart disease by food security status. Racial and ethnic disparities in age-adjusted prevalence of CMDs by food security status were also assessed. RESULTS A total of 49,738 participants were included in this analysis (weighted mean age 47.3 years; 51.3% women). From 1999 to 2018, the age-adjusted prevalence of CMDs was lower in full food secure group as compared with other groups. For example, trends in hypertension decreased from 49.7% (47.5-51.8%) to 45.9% (43.8-48.0%) (P-trend = 0.002) among the full and from 54.2% (49.9-58.5%) to 49.7% (46.8-52.6%) (P-trend = 0.02) among the marginal but remained stable among the low at 49.7% (47.9-51.6%) and among the very low at 51.1% (48.9-53.3%) (P-interaction = 0.02). Prevalence of diabetes increased from 8.85% (8.15-9.60%) to 12.2% (11.1-13.5%) among the full (P-trend < 0.001), from 16.5% (13.2-20.4%) to 20.9% (18.6-23.5%) (P-trend = 0.045) among the marginal and from 14.6% (11.1-19.0%) to 20.9% (18.8-23.3%) (P-trend = 0.001) among the low but remained stable at 18.8% (17.0-20.9) among the very low (P-trend = 0.35) (P-interaction = 0.03). Racial and ethnic differences in prevalence of CMD by food security status were observed. For example, among individuals with full food secure status, the prevalence of diabetes was 9.08% (95% CI, 8.60-9.59%) for non-Hispanic whites, 17.3% (95% CI, 16.4-18.2%) for non-Hispanic blacks, 16.1% (95% CI, 15.0-17.4%) for Hispanics and 14.9% (95% CI, 13.3-16.7%) for others. CONCLUSIONS AND RELEVANCE Prevalence of CMDs was greatest among those experiencing food insecurity, and food insecurity disproportionately affected racial/ethnic minorities. Disparities in CMD prevalence by food security status persisted or worsened, especially among racial/ethnic minorities.
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Affiliation(s)
- Junxiu Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA.
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Rienna G Russo
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Carol R Horowitz
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Donglan Zhang
- Department of Foundations of Medicine, NYU Grossman Long Island School of Medicine, Mineola, NY, USA
| | - Janani Rajbhandari-Thapa
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lu Shi
- Department of Public Health Science, College of Behavioral, Social and Health Science, Clemson University, Clemson, SC, USA
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA.
- School of Public Health, Shanghai Jiao Tong University School of Medicine, 227 S. Chongqing Rd, Shanghai, 200025, China.
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20
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Cuenca MH, Proaño GV, McDermid JM, Badreldin El Shikieri A, Steeves EA, Carrillo-Alvarez E, Fracassi P, Garelick DS, Brewer J, Kazimierczuk FK, Steiber A. Advancing Nutrition and Dietetics Research in Global Food and Nutrition Security: A Roundtable Meeting Report. J Acad Nutr Diet 2024; 124:102-122. [PMID: 37858674 DOI: 10.1016/j.jand.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
Food and nutrition security remains a relevant issue globally, impacting nutritional status and other health outcomes. This is further complicated by various environmental factors that impact stable access to, availability of, and utilization of nutritious foods. Nutrition and dietetics practitioners play an important role in the identification and treatment of food and nutrition security and are also well positioned to advance research that can support food and nutrition security solutions. To address this important issue, the Academy of Nutrition and Dietetics' Council on Research convened a Global Food and Nutrition Security Research Task Force (Task Force). To leverage existing information and expertise in this area and identify the need for future evidence, the Task Force hosted a virtual roundtable with key internal and external stakeholders. This 2-day event included discussions on research gaps, potential entry points for nutrition and dietetics practitioners, and important equity considerations in the area of food and nutrition security research. The identified research gaps included the need for standardized terminology for consistent data collection, the need for validated screening and assessment tools that can be used across settings and also assess diet quality, additional translational and implementation science research, multi-sectoral and multi-pronged approaches, interdisciplinary collaboration with community partners, incorporation of research into policy development, and additional evidence on food systems approaches to target food and nutrition security. To more clearly identify the entry points for practitioners, five examples from various countries were included to identify food and nutrition security issues and how nutrition and dietetics practitioners can be involved in research to address food and nutrition security. The Task Force would like this information to inform a research agenda and be leveraged by the larger scientific community to drive future funding and research opportunities for food and nutrition professionals on this topic.
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21
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Pulvera R, Jackson K, Gosliner W, Hamad R, Fernald LCH. The association of safety-net program participation with government perceptions, welfare stigma, and discrimination. HEALTH AFFAIRS SCHOLAR 2024; 2:qxad084. [PMID: 38756395 PMCID: PMC10986270 DOI: 10.1093/haschl/qxad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 05/18/2024]
Abstract
Safety-net programs in the United States offered critical support to counter food insecurity and poverty during the first year of the COVID-19 pandemic. The Supplemental Nutrition Assistance Program (SNAP) and the Earned Income Tax Credit (EITC) are both means-tested programs with significant benefits. Take-up of SNAP and EITC is lower in California than nationwide and reasons for this difference are unclear. We examined associations of participation in SNAP and receipt of the EITC and perceptions of the US government, 2 types of welfare stigma (program stigma and social stigma), and perceived discrimination. We interviewed a sample of 497 caregivers of young children from families with low income in California during the COVID-19 pandemic (August 2020-May 2021). We found that participation in SNAP (odds ratio [OR] = 1.24 [1.05, 1.47]) and receiving the EITC (OR = 1.39 [1.05, 1.84]) were both associated with greater reported perceptions of social stigma, but not with perceptions of government, program stigma, or discrimination. Among food-insecure respondents, we found that participation in SNAP was additionally associated with program stigma and discrimination. These findings suggest that perceived social stigma may be a reason that people with low income may not participate in programs for which they are eligible.
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Affiliation(s)
- Richard Pulvera
- University of California Agriculture and Natural Resources, Nutrition Policy Institute,Oakland, CA 94607, United States
| | - Kaitlyn Jackson
- T.H. Chan School of Public Health, Harvard University,Boston, MA 02115, United States
| | - Wendi Gosliner
- University of California Agriculture and Natural Resources, Nutrition Policy Institute,Oakland, CA 94607, United States
| | - Rita Hamad
- T.H. Chan School of Public Health, Harvard University,Boston, MA 02115, United States
| | - Lia C H Fernald
- School of Public Health, University of California Berkeley,Berkeley, CA 94704, United States
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22
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Teixeira da Silva D, Valente PK, Lin W, Hightow-Weidman L, Mayer K, Biello K, Bauermeister J. Psychosocial and structural stressors and engagement in medical care among young sexual minority men across racial identities. Behav Med 2023:1-9. [PMID: 38126713 DOI: 10.1080/08964289.2023.2277931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023]
Abstract
Psychosocial and structural stressors and low engagement in medical care likely contribute to the disproportionate burden of chronic disease among sexual minority men (SMM) across the life course. However, how these stressors impact engagement in medical care among young SMM (YSMM) across racial identities remains understudied. The association of psychosocial and structural stressors with forgoing care among YSMM across racial identities was examined using race-stratified adjusted logistic regression of cross-sectional data. Among 737 HIV-negative SMM aged 16-24 years, nearly all (93%) experienced discrimination in their daily lives. Non-Hispanic/Latinx Black participants reported significantly higher levels of discrimination, exposure to community violence, and food insecurity. Medical mistrust and mental health were not significantly different across racial groups. In the full sample model, education, food insecurity, and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx White sample, medical mistrust and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx Black sample, discrimination was associated with forgoing care. Among the Hispanic/Latinx sample, food insecurity was associated with forgoing care. Psychosocial and structural stressors were common in this YSMM cohort, and significantly different across racial/ethnic identities. Race-stratified analysis revealed differences in the association of stressors with forgoing care among YSMM across racial identities, not appreciated in the analysis limited to the total study population. Our findings may support efforts to address health inequity and improve engagement in medical care among SMM.
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Affiliation(s)
| | - Pablo K Valente
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Willey Lin
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kenneth Mayer
- The Fenway Institute at Fenway Health, Boston, MA, USA
| | - Katie Biello
- The Fenway Institute at Fenway Health, Boston, MA, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - José Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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23
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Fusaro V, Mattingly MJ. Racial and Ethnic Disparities in Food Insufficiency in Families with Children During the COVID-19 Pandemic: the Role of Risk and Protective Factors. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01881-2. [PMID: 38112918 DOI: 10.1007/s40615-023-01881-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/16/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Black and Hispanic households are at elevated risk of food insecurity and insufficiency-correlates of adverse outcomes in areas such as health and mental health-relative to White households in the USA. The COVID-19 pandemic and its economic shock threatened to further exacerbate these issues. Research has identified a number of risk and protective factors for food insecurity and insufficiency. These could relate to racial and ethnic disparities in two ways-through aggregate differences in the distribution of characteristics such as educational attainment and employment or through differences in the degree of risk or protection associated with a factor. We examined the relationship between four factors-household head age, educational attainment, single mother household composition, and employment-and disparities in food insufficiency between White, Black, and Hispanic households with children during the COVID-19 pandemic to consider these pathways. METHODS We analyzed data from the Census Bureau's Household Pulse Survey using bivariate statistics, multivariable regression, and decomposition methods to understand differences in the prevalence and consequences of underlying risk and protective factors for food insufficiency in households with children. RESULTS Consistent with prior literature, we documented higher rates of food insufficiency among Black and Hispanic households compared to White households. Differences in the distributions of education and employment accounted for a substantial fraction of the disparities in risk. Both the distribution and degree of risk associated with single mother household composition also related to disparities, but these differences were muted after accounting for economic resources. Much, though not all, of the relationship between the distributions of education and disparate risk of food insufficiency were also captured by differences in economic resources. CONCLUSION This study provides insight into the structure underlying racial and ethnic disparities in food insufficiency during the COVID-19 pandemic, highlighting the importance of human capital, income, and assets.
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Affiliation(s)
- Vincent Fusaro
- Boston College School of Social Work, Chestnut Hill, MA, USA.
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24
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Jacobs M, McDade TR, Chaparro MV, Corea M. Sick, Hungry, and Vulnerable: Federal Stimulus and Food Security on Marginalized Populations During the COVID-19 Pandemic. J Racial Ethn Health Disparities 2023; 10:2685-2703. [PMID: 36378487 PMCID: PMC9666987 DOI: 10.1007/s40615-022-01447-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/21/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
In addition to the threat of serious illness, COVID-19 and subsequent restrictions had devastating economic consequences for many US citizens. This study examines the evolution of food security over the first months of the COVID-19 pandemic testing whether the initial economic stimulus payment improved the nutritional well-being of vulnerable populations. We use data from phase 1 of the Census Bureau's Household Pulse Survey among a nationally representative sample of adults and the 2017-2018 Current Population Survey Food Security Supplement. Using an ordered logistic regression, we assess differences in the incidence and severity of food security across demographic, income, geographic, and employment status cohorts and assess the effects of the first economic stimulus payment. Our results show that marginalized groups faced greater food insecurity and had food-related outcomes worsen over time. Blacks, Hispanics, and individuals living in rural areas became less food secure as the pandemic progressed. However, receipt of a stimulus payment appears to have improved conditions. Rising food prices and persistent high unemployment have the potential to exacerbate food insecurity among marginalized and at-risk groups.
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Affiliation(s)
- Molly Jacobs
- Department of Health Services Research, Management and Policy, University of Florida, 3118 HPNP, 1225 Center Drive, Gainesville, FL, 32603, USA.
| | - Timothy R McDade
- Department of Political Science, Duke University, Durham, NC, USA
| | | | - Michelle Corea
- Department of Political Science, University of North Carolina, Chapel Hill, NC, USA
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25
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Shriver LH, Eagleton SG, Hosseinzadeh M, Buehler C, Wideman L, Leerkes EM. Associations among eating behaviors, food security status, and dietary intake during pregnancy. Appetite 2023; 191:107062. [PMID: 37742786 PMCID: PMC10957504 DOI: 10.1016/j.appet.2023.107062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/26/2023]
Abstract
Dietary intake of certain food groups and/or nutrients during pregnancy has been associated with maternal and infant pregnancy-related outcomes. Few studies have examined how behavioral and environmental factors interact to influence prenatal diet. We examined associations between eating behaviors (dietary restraint, emotional eating, external eating) and food security status regarding dietary intake of selected nutrients/food groups during pregnancy. Participants (N = 299; 29% Non-Hispanic Black; 16% ≤ high school education; 21% food insecure) completed validated questionnaires to assess estimated daily intake of food groups/nutrients during pregnancy [e.g., added sugars from sugar-sweetened beverages (SSBs), % of energy from fat, fruit and vegetable (FV) intake] via National Cancer Institute Dietary Screener Questionnaires); eating behaviors (Dutch Eating Behavior Questionnaire); and food security status (6-item USDA Food security Module). Separate hierarchical multiple regressions for each dietary outcome were conducted controlling for maternal age, education, income-to-needs, race/ethnicity, pre-pregnancy BMI, and gestational diabetes. A significant interaction was found between dietary restraint and food security status on added sugar intake from SSBs (β = -0.15, p = 0.02). The negative association between restraint and added sugar from SSBs was stronger among food insecure participants (β = -0.47, p < 0.001 vs. β = -0.15, p = 0.03). Higher external eating (β = 0.21, p < 0.01) and lower restraint (β = -0.13, p = 0.03) were associated with higher % of energy from fat and living in a food insecure household (β = -0.15, p = 0.01) was associated with lower FV intake. Understanding dietary intake during pregnancy requires consideration of the broader context in which eating behaviors occur.
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Affiliation(s)
- Lenka H Shriver
- Nutrition, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Sally G Eagleton
- Clinical and Translational Science Institute, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Mali Hosseinzadeh
- Nutrition, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Cheryl Buehler
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Laurie Wideman
- Kinesiology, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Esther M Leerkes
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
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26
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Chebli P, Đoàn LN, Thompson RL, Chin M, Sabounchi N, Foster V, Huang TTK, Trinh-Shevrin C, Kwon SC, Yi SS. Identifying opportunities for collective action around community nutrition programming through participatory systems science. Cancer Causes Control 2023; 34:1043-1058. [PMID: 37481755 PMCID: PMC10979368 DOI: 10.1007/s10552-023-01751-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To apply principles of group model building (GMB), a participatory systems science approach, to identify barriers and opportunities for collective impact around nutrition programming to reduce cancer risk for immigrant communities in an urban environment. METHODS We convened four in-person workshops applying GMB with nine community partners to generate causal loop diagrams (CLDs)-a visual representation of hypothesized causal relationships between variables and feedback structures within a system. GMB workshops prompted participants to collaboratively identify programmatic goals and challenges related to (1) community gardening, (2) nutrition education, (3) food assistance programs, and (4) community-supported agriculture. Participants then attended a plenary session to integrate findings from all workshops and identify cross-cutting ideas for collective action. RESULTS Several multilevel barriers to nutrition programming emerged: (1) food policies center the diets and practices of White Americans and inhibit culturally tailored food guidelines and funding for culturally appropriate nutrition education; (2) the lack of culturally tailored nutrition education in communities is a missed opportunity for fostering pride in immigrant food culture and sustainment of traditional food practices; and (3) the limited availability of traditional ethnic produce in food assistance programs serving historically marginalized immigrant communities increases food waste and worsens food insecurity. CONCLUSION Emergent themes coalesced around the need to embed cultural tailoring into all levels of the food system, while also considering other characteristics of communities being reached (e.g., language needs). These efforts require coordinated actions related to food policy and advocacy, to better institutionalize these practices within the nutrition space.
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Affiliation(s)
- Perla Chebli
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA.
| | - Lan N Đoàn
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Rachel L Thompson
- Center for Systems and Community Design, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Matthew Chin
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Nasim Sabounchi
- Center for Systems and Community Design, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Victoria Foster
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Terry T K Huang
- Center for Systems and Community Design, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Chau Trinh-Shevrin
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Simona C Kwon
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Stella S Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
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27
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Cacioppo AM, Winslow V, Abramsohn EM, Jagai JS, Makelarski JA, Waxman E, Wroblewski K, Tessler Lindau S. Food Insecurity and Experiences of Discrimination Among Caregivers of Hospitalized Children. Pediatrics 2023; 152:e2023061750. [PMID: 37986582 PMCID: PMC10657777 DOI: 10.1542/peds.2023-061750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pediatric hospitals are adopting strategies to address food insecurity (FI), a stigmatizing condition, among families with children. We hypothesized that parents and other caregivers ("caregivers") from households with FI or marginal food security (MFS) are more likely to experience discrimination during their child's hospitalization. METHODS We analyzed data from 319 caregivers of children admitted to an urban, academic children's hospital and randomly assigned to the control arm of the double-blind randomized controlled CommunityRx-Hunger trial (November 2020 to June 2022, NCT R01MD012630). Household food security in the 30 days before admission and discrimination during hospitalization were measured with the US Household Food Security Survey and the Discrimination in Medical Settings Scale, respectively. We used logistic regression to model the relationship between food security status and discrimination, adjusting for gender, race, ethnicity, income, and partner status. RESULTS Most participants were African American or Black (81.5%), female (94.7%), and the parent of the hospitalized child (93.7%). FI and MFS were prevalent (25.1% and 15.1%, respectively). Experiences of discrimination during a child's hospitalization were prevalent (51.9%). Caregivers with FI had higher odds than caregivers with food security of experiencing discrimination (adjusted odds ratio = 2.0, 95% confidence interval 1.1-3.6, P = .03); MFS was not significantly associated with discrimination (P = .25). Compared with food secure caregivers, those with FI had higher odds of 5 of 7 experiences of discrimination assessed. CONCLUSIONS Among parents and other caregivers, household FI is associated with experiences of discrimination during a child's hospitalization.
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Affiliation(s)
| | | | | | | | | | - Elaine Waxman
- The Urban Institute, Washington, District of Columbia
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28
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Lu I, Suss R, Lanza DV, Cohen S, Yusuf Y, Yi SS. A qualitative study to inform the development of a subsidized community-supported agriculture program for Chinese Americans in Brooklyn, New York, U.S. Prev Med Rep 2023; 36:102480. [PMID: 37920594 PMCID: PMC10618813 DOI: 10.1016/j.pmedr.2023.102480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023] Open
Abstract
The objective of this study was to inform the development of a subsidized, culturally adapted Community-Supported Agriculture (CSA) program for the Chinese American (CA) community in Brooklyn, New York (NY), USA. We conducted interviews with CA adults to understand their eating and shopping behaviors, interests in CSAs, and recommendations for educational content to inform the development of a subsidized and culturally adapted CSA. We then conducted thematic analysis of those interviews and identified major themes. CA adult participants shared interest in a CSA primarily to support their own health, interact socially with farmers and other participants, and gain access to fresh, culturally appropriate produce. Major concerns for participation, especially among older adults, included language barriers, transportation, and mobility. The unique needs and motivations of CAs should be centered in the development of alternative food access interventions for this population. CA adult participants living in Brooklyn, NY may be interested in a subsidized culturally adapted CSA that includes health information about the produce and provides in-language support. Engaging communities in the development of a health program may be important to ensure accessibility and acceptability for CA populations.
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Affiliation(s)
- Isabel Lu
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States
| | - Rachel Suss
- Department Population Health, NYU Grossman School of Medicine, New York University Langone Health, United States
| | - Dalila Victoria Lanza
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, United States
| | - Sarah Cohen
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, United States
| | - Yousra Yusuf
- Department Population Health, NYU Grossman School of Medicine, New York University Langone Health, United States
| | - Stella S. Yi
- Department Population Health, NYU Grossman School of Medicine, New York University Langone Health, United States
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29
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Antwi J, Olawuyi Y, Bain S, Samuel K. Changes in food purchase, consumption and handling during COVID-19 pandemic among single person households. PLoS One 2023; 18:e0294361. [PMID: 38019731 PMCID: PMC10686418 DOI: 10.1371/journal.pone.0294361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE As a new type of consumer subject in the market that was formerly dominated by multiple person families, single households are driving the change in the buying structure. Food purchase activities have undergone significant changes since the outbreak of the COVID-19. The objective of this study was to assess and compare variations in food consumption, purchase and handling during the COVID-19 pandemic between single person households (SPH) and multiple person households. METHOD A cross-sectional study conducted among 211 individuals in communities in Harris and Waller Counties, Texas. Sociodemographic, food purchase, food consumption and food handling activities during the COVID-19 pandemic were assessed with a validated COVID-19 Nutrition questionnaire. RESULTS Non-Hispanic Black participants constituted 42.6%, and 28.4% were Hispanics. Participants were made up of mostly aged 18-24 years (39.3%), 47.9% single household composition, 30.4% in full time employment, and 29.1% partook in food assistance programs. A large proportion of them had never used grocery pickup services, online grocery shopping and a farmers' market. During the COVID-19 pandemic, majority of the participants used more of large supermarkets, restaurant/fast food, and online grocery but food consumption seemed to remain the same for the majority of participants. For beverages, majority of participants consumed more water, less soda, and no alcohol. There was a significant association between single person household and higher restaurant/fast foods purchase. Many of the participants reported weight gain and less physical activity during the pandemic. CONCLUSION Restaurant meal purchases was more prevalent in single-person families. The results from the study have the potential to contribute to how public policy officials, food service, and health authorities forecast how different categories of consumers will react in pandemics and may be used to inform area-specific alleviation strategies to minimize the impact of the COVID-19 pandemic and future events.
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Affiliation(s)
- Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, United States of America
| | - Yetunde Olawuyi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, United States of America
| | - Shadiamon Bain
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, United States of America
| | - Kyndall Samuel
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, United States of America
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30
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John S, Melendrez B, Leng K, Nelms A, Seligman H, Krieger J. Advancing Equity in the Farm Bill: Opportunities for the Gus Schumacher Nutrition Incentive Program (GusNIP). Nutrients 2023; 15:4863. [PMID: 38068722 PMCID: PMC10707921 DOI: 10.3390/nu15234863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/24/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
The Gus Schumacher Nutrition Incentive Program (GusNIP) is a federally funded grant program that provides nutrition incentives-subsidies for purchasing fruits and vegetables (FV)-to Supplemental Nutrition Assistance Program (SNAP) participants. GusNIP currently advances nutrition equity by improving FV access for people with low incomes, yet inequities exist within GusNIP. We sought to identify inequities in GusNIP at the community, organization, partner, and individual levels and develop recommendations for farm bill provisions to make the program more equitable. In Spring 2021, a group of nutrition incentive experts (n = 11) from across the country convened to discuss opportunities to enhance equity in GusNIP. The iterative recommendation development process included feedback from key stakeholders (n = 15) and focus group participants with GusNIP lived experience (n = 12). Eleven recommendations to advance equity in GusNIP in the farm bill emerged across six categories: (1) increase total GusNIP funding, (2) increase funding and support to lower-resourced organizations and impacted communities, (3) eliminate the match requirement, (4) support statewide expansion, (5) expand and diversify retailer participation, and (6) expand program marketing. Including these recommendations in the upcoming and future farm bills would equitably expand GusNIP for SNAP participants, program grantees, and communities across the country.
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Affiliation(s)
- Sara John
- Center for Science in the Public Interest, Washington, DC 20005, USA;
| | - Blanca Melendrez
- Center for Community Health, University of California San Diego, La Jolla, CA 92037, USA;
| | - Kirsten Leng
- Healthy Food America, Seattle, WA 98122, USA; (K.L.); or (J.K.)
| | - Amy Nelms
- Center for Science in the Public Interest, Washington, DC 20005, USA;
| | - Hilary Seligman
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA 94143, USA;
| | - James Krieger
- Healthy Food America, Seattle, WA 98122, USA; (K.L.); or (J.K.)
- School of Public Health, University of Washington, Seattle, WA 98195, USA
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31
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Kibe LW, Schrode K, Bazargan M, Shaheen M. Impact of food insecurity and food environment on the diet quality of older African Americans during the COVID-19 pandemic. Front Public Health 2023; 11:1268961. [PMID: 38035278 PMCID: PMC10682682 DOI: 10.3389/fpubh.2023.1268961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction A high quality diet is vital in promoting wellbeing and ensuring good health, particularly for those living with chronic conditions. Older African Americans, already burdened with a higher prevalence of chronic conditions, also face a higher risk for suboptimal diets. The COVID-19 pandemic had lasting effects on access to healthy food for all Americans, but some demographic groups were disproportionately affected. Older African Americans, who already experienced reduced access to healthy food pre-pandemic, were particularly afflicted, but the full extent of the pandemic's impact on their food insecurity and food environment remains unclear. Methods To address this gap, we conducted a study among 102 older African Americans in South Los Angeles between October 2021 and July 2022 during the COVID-19 pandemic. Participants completed surveys on dietary intake, food insecurity, and neighborhood food environment. We measured dietary quality using the healthy eating index (HEI)-2015. The analysis included descriptive, bivariate chi-square, t-tests, analysis of variance, and multiple linear and logistic regression. Results While overall dietary quality was suboptimal, most participants met the guidelines for fruit and vegetable consumption. Food insecurity was associated with lower overall diet quality and lower total fruit and whole fruit intake. However, there was no association between food environment and diet quality. Discussion In light of our findings, further intervention is critical to improving diet quality, especially among older African Americans living with chronic conditions in the post-pandemic era.
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Affiliation(s)
- Lucy W. Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Katrina Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, United States
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA, United States
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32
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Vu M, Trinh D, Kandula NR, Pham NHT, Makelarski J, Seligman HK. Low-Income Asian Americans: High Levels Of Food Insecurity And Low Participation In The CalFresh Nutrition Program. Health Aff (Millwood) 2023; 42:1420-1430. [PMID: 37729587 PMCID: PMC11184507 DOI: 10.1377/hlthaff.2023.00116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Little is known about food insecurity and the extent of Supplemental Nutrition Assistance Program (SNAP) participation in the heterogeneous Asian American population. Using California Health Interview Survey data from the period 2011-20, we examined both issues among low-income Asian American adults from six origin groups: Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese. We found high and varied levels of overall food insecurity, with the highest burden among Filipino adults (40 percent). Food insecurity by severity was also heterogenous; very low food security affected 2 percent of Chinese adults but 9 percent and 10 percent of Filipino and Japanese adults, respectively. Participation in CalFresh (California-implemented SNAP) ranged from 11 percent and 12 percent among Korean and Chinese adults, respectively, to 20 percent among Vietnamese adults. Compared with English-proficient low-income Asian American adults, those with limited English proficiency were no less likely to participate in CalFresh, possibly reflecting language assistance required by California law and provided by community-based organizations. These results underscore the importance of collecting and reporting disaggregated data by Asian origin group that could inform targeted outreach and interventions.
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Affiliation(s)
- Milkie Vu
- Milkie Vu , Northwestern University, Chicago, Illinois
| | - Duy Trinh
- Duy Trinh, Princeton University, Princeton, New Jersey
| | | | - Nhat-Ha Tran Pham
- Nhat-Ha Tran Pham, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Hilary K Seligman
- Hilary K. Seligman, University of California San Francisco, San Francisco, California
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33
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Braga BC, Cash SB, Sarson K, Chang R, Mosca A, Wilson NLW. The gamification of nutrition labels to encourage healthier food selection in online grocery shopping: A randomized controlled trial. Appetite 2023; 188:106610. [PMID: 37269883 DOI: 10.1016/j.appet.2023.106610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023]
Abstract
Food purchase choices, one of the main determinants of food consumption, is highly influenced by food environments. Given the surge in online grocery shopping because of the COVID-19 pandemic, interventions in digital environments present more than ever an opportunity to improve the nutritional quality of food purchase choices. One such opportunity can be found in gamification. Participants (n = 1228) shopped for 12 items from a shopping list on a simulated online grocery platform. We randomized them into four groups in a 2 × 2 factorial design: presence vs. absence of gamification, and high vs. low budget. Participants in the gamification groups saw foods with 1 (least nutritious) to 5 (most nutritious) crown icons and a scoreboard with a tally of the number of crowns the participant collected. We estimated ordinary least squares and Poisson regression models to test the impact of the gamification and budget on the nutritional quality of the shopping basket. In the absence of gamification and low budget, participants collected 30.78 (95% CI [30.27; 31.29]) crowns. In the gamification and low budget condition, participants increased the nutritional quality of their shopping basket by collecting more crowns (B = 4.15, 95% CI [3.55; 4.75], p < 0.001). The budget amount ($50 vs. $30) did not alter the final shopping basket (B = 0.45, 95% CI [-0.02; 1.18], p = 0.057), nor moderated the gamification effect. Gamification increased the nutritional quality of the final shopping baskets and nine of 12 shopping list items in this hypothetical experiment. Gamifying nutrition labels may be an effective strategy to improve the nutritional quality of food choices in online grocery stores, but further research is needed.
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Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Katrina Sarson
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Remco Chang
- Computer Science, Halligan Hall, Tufts University, 161 College Avenue, Medford, MA, 02155, USA.
| | - Ab Mosca
- Khoury College of Computer Sciences, Northeastern University, 440 Huntington Avenue, 202 West Village H, Boston, MA, 02115, USA.
| | - Norbert L W Wilson
- Divinity School and Sanford School of Public Policy, 304 Gray, 407 Chapel Drive, Duke Box, #90968, Durham, NC, 27708-0968, USA.
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34
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Park JK, Yi SS. Transportation and language access as crucial pillars for an immigrant-inclusive 21st-century food security program. Public Health Nutr 2023; 26:1925-1929. [PMID: 37016771 PMCID: PMC10478048 DOI: 10.1017/s1368980023000575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/09/2023] [Accepted: 02/24/2023] [Indexed: 04/06/2023]
Abstract
Though food insecurity has long been recognised to impact health, population-specific determinants of food insecurity have recently been studied systematically as an important public health concern. Indeed, while immigrant populations face particular challenges to equitable access to the food system, many of these concerns have not been systematically described. To this end, we critically review recent work that demonstrates the importance of transportation and language access as independent determinants of access to food for immigrant populations. Furthermore, we highlight proposals to mitigate barriers to access, including both academic and community-driven approaches to create overlapping institutional commitments for inclusive policymaking that meets the specific needs of diverse populations.
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Affiliation(s)
| | - Stella S Yi
- Department of Population Health, NYU Grossman School of Medicine, New York, NY10016, USA
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35
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Alhomsi A, Quintero SM, Ponce S, Mendez I, Stewart AL, Napoles AM, Strassle PD. Racial/Ethnic Disparities in Financial Hardship During the First Year of the Pandemic. Health Equity 2023; 7:453-461. [PMID: 37771448 PMCID: PMC10523407 DOI: 10.1089/heq.2022.0196] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction The economic impact of the COVID-19 pandemic has been substantial, yet little is known about the financial effects resulting from lost employment or financial hardship racial-ethnic disparities. Methods We conducted a nationally representative, online survey of 5500 English- and Spanish-speaking American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, from December 2020 to February 2021. Six financial hardship domains were measured (lost income, debt, unmet expenses, unmet health care expenses, housing insecurity, and food insecurity). Prevalence of financial hardship among each racial-ethnic group was estimated using multivariable Poisson regression. Results Overall, 70.3% reported experiencing financial hardship; debt (57.6%), lost income (44.5%), and unmet expenses (33.7%) were most common. American Indian/Alaska Native (adjusted prevalence ratio [aPR]=1.19, 95% confidence interval [CI]=1.04 to 1.35), Black/African American (aPR=1.18, 95% CI=1.06 to 1.32), Latino (English-speaking: aPR=1.15, 95% CI=1.01 to 1.31; Spanish-speaking: aPR=1.27, 95% CI=1.12 to 1.45), and Native Hawaiian/Pacific Islander (aPR=1.21, 95% CI=1.06 to 1.38) adults were more likely to experience financial hardship, compared with White adults. American Indian/Alaska Native, Black/African American, Spanish-speaking Latino, and Native Hawaiian/Pacific Islander adults were also more likely to report hardship in almost all hardship domains (e.g., housing insecurity: aPRs=1.37-1.91). Conclusions Racial/ethnic minorities were more likely to experience financial hardship during the pandemic. The prevalence of lost income was similar across most racial/ethnic groups, suggesting that preexisting wealth disparities led to some groups being less able to handle the economic shocks caused by the COVID-19 pandemic. Financial hardship may be underestimated for communities without English or Spanish fluency. Without intervention, financial hardship will likely exacerbate wealth disparities in the United States.
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Affiliation(s)
- Alia Alhomsi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Stephanie M. Quintero
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Stephanie Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Izabelle Mendez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Anita L. Stewart
- Center for Aging in Diverse Communities, Institute for Health & Aging, University of California San Francisco, San Francisco, California, USA
| | - Anna Maria Napoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
| | - Paula D. Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, Maryland, USA
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Pokhrel P, Lipperman-Kreda S, Wills TA, Keaweʻaimoku Kaholokula J, Kawamoto CT, Amin S, Herzog TA. Ethnicity, Coronavirus Disease-Related Stress, and E-cigarette Use and Cigarette Smoking Among Young Adults: A Longitudinal Study. Nicotine Tob Res 2023; 25:1676-1686. [PMID: 37330693 PMCID: PMC10445257 DOI: 10.1093/ntr/ntad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Research has rarely examined ethnic differences in exposure to coronavirus disease (COVID)-related stress in relation to smoking and e-cigarette use. AIMS AND METHODS Using pre- and post-COVID data from a sample of predominantly Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) young adults, this study aimed to test the effects of ethnicity on cigarette smoking and e-cigarette use through exposure to COVID-related stress. Young adults from Hawaii who provided pre-COVID data in or before January 2020 were followed up with in March-May 2021. N = 1907 (mean age = 24.9 [SD = 2.9], 56% women) provided complete data relevant to the current analysis at both waves of data collection. Structural equation modeling was used to test the effects of ethnicity (white, Asian [eg, Japanese, Chinese], Filipino, NHPI, and other) on pre- to post-COVID changes in cigarette and e-cigarette use via effects on COVID-related stress. RESULTS Relative to Asian young adults, members of all other ethnic groups (NHPI, Filipino, white, and other) indicated greater exposure to COVID-related stress. Higher levels of COVID-related stress were associated with increased dual-use status and increased current e-cigarette and cigarette use frequencies. Higher COVID-related stress mediated the effects of NHPI, Filipino, and other ethnicity on increased dual-use status. CONCLUSIONS The current data indicate that young adults of vulnerable ethnic groups who experience higher COVID-related stress are at increased risk for dual use of cigarettes and e-cigarettes. IMPLICATIONS The findings imply that tobacco use prevention and treatment efforts may need to pay increased attention to racial or ethnic groups that have experienced greater adverse impact of the COVID-19 pandemic.
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Affiliation(s)
- Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Thomas A Wills
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Joseph Keaweʻaimoku Kaholokula
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Crissy T Kawamoto
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Samia Amin
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Thaddeus A Herzog
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
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Park C, Delgado C, Irfan A. Perspectives on the Doctor of Public Health (DrPH) education among students and alumni in the United States: a cross-sectional national online survey. BMC Public Health 2023; 23:1558. [PMID: 37587431 PMCID: PMC10428527 DOI: 10.1186/s12889-023-16402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND This study explored the current and desired identity of the DrPH degree, focusing on whether the competencies set by the Council on Education for Public Health (CEPH) adequately prepare DrPH graduates for effective public health practice. Additionally, the study investigated the necessity of standardization in DrPH training, referring to a consensus-driven approach that equips future public health practitioners with practical skillsets applicable in real-world scenarios. METHODS A national cross-sectional online survey titled "National DrPH leaders & practitioners needs assessment" was conducted from November 2020 to February 2021. The survey was based on a self-report by DrPH students and DrPH professionals, consisting of the following two main components: (1) how their DrPH training aligns with CEPH competencies and (2) how they perceive the identity of the DrPH degree. Convenience sampling was used to collect the data, which may have limited representation for all DrPH institutions in the United States. RESULTS A total of 222 participants (140 current DrPH students and 82 alumni) completed the survey. The mean of the 10-point Likert scale for the degree to which the DrPH training aligns with 26 CEPH competencies (1: not at all - 10: absolutely) ranged from 6.3 (SD: 2.78) to 7.96 (SD: 2.16). The majority of participants (191/222, 86.04%) were satisfied with the knowledge and skills reflected in their training based on the CEPH competencies. However, more than half of the participants (117/222, 52.70%) sought additional professional development/training outside their institutions. DrPH leaders and practitioners faced barriers where the value of their work might not be fully recognized and endorsed. Participants indicated that the DrPH education should be further distinguished from the PhD education. CONCLUSIONS The DrPH degree holds significant value within the academic sphere of public health practice in the United States. However, its distinction from PhD programs poses a challenge for employers and organizations in the field, requiring attention from higher education programs. By solidifying the DrPH's identity, graduates can effectively address diverse public health issues and contribute to creating a safe and healthy environment, including addressing the challenges posed by the COVID-19 pandemic.
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Affiliation(s)
- Chulwoo Park
- Department of Public Health and Recreation, San José State University, San Jose, CA, USA.
| | | | - Ans Irfan
- Department of Environmental and Occupational Health, The George Washington University, Washington D.C, USA
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Ro S, Pham NH, Huynh VN, Wafford QE, Vu M. Food insecurity among Asian Americans: A scoping review protocol. PLoS One 2023; 18:e0287895. [PMID: 37399223 DOI: 10.1371/journal.pone.0287895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 06/13/2023] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION Food insecurity is prevalent in the U.S. and is associated with deleterious health, behavioral, and social consequences. Food insecurity is currently addressed largely through public and private food assistance programs (e.g., the Supplementary Nutrition Assistance Program, and food pantries). A body of research has explored racial and ethnic disparities and differences in food insecurity and coping strategies. However, limited literature has explored these experiences among Asian Americans and Asian origin groups in the United States. OBJECTIVE The aim of this review is to establish what is known about the experience of food insecurity and nutrition program participation in the Asian American population and among Asian origin groups and to suggest further research and policy action to better address food insecurity in this population. METHODS Our review is guided by the methodological framework proposed by Arksey and O'Malley and refined and outlined by Levac and colleagues and the Joanna Briggs Institute. We will search key terms related to food insecurity and Asian Americans in Medline (Ovid), the Cochrane Library (Wiley), CINAHL Plus with Full Text (Ebsco), PsycINFO (Ebsco), and Scopus (Elsevier). An article will be included if it was published in the English language; is a peer reviewed research manuscript and reports primary research findings from analyses; and describes food insecurity or strategies to cope with food insecurity among individuals of Asian origins living in the U.S. An article will be excluded if it is a book, conference proceedings, or grey literature (e.g., thesis or dissertation); is a commentary, editorial, or opinion piece without primary research data; contains only research conducted outside of the U.S.; includes Asians in the sample but does not provide separate data on food insecurity or strategies to cope with food insecurity among Asians; and describes only dietary changes or patterns but not food insecurity. Two or more reviewers will participate in the study screening and selection process. We will record information from the final articles chosen to be included in the review in a data table template and will also prepare a summary narrative with key findings. EXPECTED OUTPUTS Results will be disseminated through peer-reviewed publications and conference presentations. The findings from this review will be of interest to researchers and practitioners and inform further research and policy to better address food insecurity among this population.
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Affiliation(s)
- Suji Ro
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, Illinois, United States of America
| | - Nhat-Ha Pham
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Victoria N Huynh
- Emory College of Arts & Sciences, Emory University, Atlanta, Georgia, United States of America
| | - Q Eileen Wafford
- Galter Health Sciences Library & Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Milkie Vu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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Zhu K, Wang S, Yue Y, Smith BA, Zhang ZF, Freudenheim JL, Niu Z, Zhang J, Smith E, Ye J, Cao Y, Zhang J, Hennessy DA, Lei L, Mu L. Disparities in insecurity, social support, and family relationships in association with poor mental health among US adults during the COVID-19 pandemic. Sci Rep 2023; 13:9731. [PMID: 37322075 PMCID: PMC10272217 DOI: 10.1038/s41598-023-35981-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact on mental health. Identifying risk factors and susceptible subgroups will guide efforts to address mental health concerns during the pandemic and long-term management and monitoring after the pandemic. We aimed to examine associations of insecurity (concerns about food, health insurance, and/or money), social support, and change in family relationships with poor mental health and to explore disparities in these associations. An online survey was collected from 3952 US adults between May and August 2020. Symptoms of anxiety, depression, stress, and trauma-related disorders were assessed by the Generalized Anxiety Disorder 7-item scale, the Patient Health Questionnaire-9, the Perceived Stress Scale-4, and the Primary Care Post-Traumatic Stress Disorder Screen, respectively. Social support was measured by the Oslo Social Support Scale. Logistic regression was used and stratified analyses by age, race/ethnicity, and sex were performed. We found a higher prevalence of poor mental health among those who were younger, female, with lower socioeconomic status, and racial/ethnic minorities. Participants who were worried about money, health insurance, or food had higher odds of symptoms of anxiety (OR = 3.74, 95% CI: 3.06-4.56), depression (OR = 3.20, 95% CI: 2.67-3.84), stress (OR = 3.08, 95% CI: 2.67-3.57), and trauma-related disorders (OR = 2.93, 95% CI: 2.42-3.55) compared to those who were not. Compared to poor social support, moderate and strong social support was associated with lower odds of all four symptoms. Participants who had changes in relationships with parents, children, or significant others had worse mental health. Our findings identified groups at higher risk for poor mental health, which offers insights for implementing targeted interventions.
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Affiliation(s)
- Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Siyi Wang
- Department of Psychology, Vassar College, Poughkeepsie, NY, USA
| | - Yihua Yue
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Beth A Smith
- Department of Psychiatry and Pediatrics, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Zhongzheng Niu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | | | | | - Joshua Ye
- The Quarry Lane School, Dublin, CA, USA
| | - Ying Cao
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jie Zhang
- Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Dwight A Hennessy
- Department of Psychology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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Kim Y, Kim J, Li Y. Racial Disparity in Disruption to Basic Needs Among Medicare Beneficiaries During the COVID-19 Pandemic. J Am Med Dir Assoc 2023; 24:921-923.e1. [PMID: 37127132 PMCID: PMC10067454 DOI: 10.1016/j.jamda.2023.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 04/05/2023]
Affiliation(s)
- Yeunkyung Kim
- Department of Healthcare Administration and Policy, University of Nevada, Las Vegas, NV, USA.
| | - Jihye Kim
- Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, NV, USA
| | - Yue Li
- Division of Health Policy and Outcomes Research, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
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Cai J. Food Insecurity and COVID-19 Infection: Findings From the 2020-2021 National Health Interview Survey. AJPM FOCUS 2023; 2:100069. [PMID: 36687320 PMCID: PMC9847318 DOI: 10.1016/j.focus.2023.100069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Introduction The purpose of this study was to examine the sociodemographic and health-related factors associated with food insecurity and the association between food insecurity and COVID-19 infection using a nationally representative sample in the U.S. Methods Cross-sectional data of 61,050 adults (aged ≥18 years) from the 2020 and 2021 National Health Interview Survey were analyzed. Food insecurity was measured by the 10-item U.S. Department of Agriculture Food Security Survey Module. Weighted multivariable logistic regression models were used to estimate associations with food insecurity. Results A total of 6.8% of the National Health Interview Survey participants lived in food-insecure households, and 18.9% tested positive for COVID-19 infection. Young (aged 18-34 years) or middle (aged 35-64 years) age, female sex, minor race/ethnicity (Hispanic/non-Hispanic Black/non-Hispanic Asian/others), education level less than high school, unmarried status, unemployment, poverty (below the federal poverty level), having no health insurance, a larger number of adults and children in the household, poorer self-reported health status, and the presence of chronic conditions were significantly associated with food insecurity (AOR ranged from 1.20 to 3.15, all p<0.0001). Food insecurity was independently associated with positive COVID-19 infection (AOR=1.25, 95% CI=1.11, 1.40), controlling for sociodemographic and health-related factors. The greatest magnitude of the association was observed for the non-Hispanic Black participants (AOR=1.47, 95% CI=1.15, 1.88), female participants (AOR=1.44, 95% CI=1.20, 1.71), and those below the federal poverty level (AOR=1.39, 95% CI=1.12, 1.73) across all the subgroups. Conclusions Food insecurity disproportionately affected vulnerable subgroups such as young adults, female individuals, minority race/ethnicity groups, and those with lower socioeconomic status, and was associated with positive COVID-19 infection. Policies addressing food insecurity may help to reduce the likelihood of COVID-19 infection, especially for those vulnerable subgroups.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana
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Alhasan DM, Riley NM, Jackson II WB, Jackson CL. Food insecurity and sleep health by race/ethnicity in the United States. J Nutr Sci 2023; 12:e59. [PMID: 37252683 PMCID: PMC10214135 DOI: 10.1017/jns.2023.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 05/31/2023] Open
Abstract
Food insecurity, poised to increase with burgeoning concerns related to climate change, may influence sleep, yet few studies examined the food security-sleep association among racially/ethnically diverse populations with multiple sleep dimensions. We determined overall and racial/ethnic-specific associations between food security and sleep health. Using National Health Interview Survey data, we categorised food security as very low, low, marginal and high. Sleep duration was categorised as very short, short, recommended and long. Sleep disturbances included trouble falling/staying asleep, insomnia symptoms, waking up feeling unrested and using sleep medication (all ≥3 d/times in the previous week). Adjusting for socio-demographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95 % confidence intervals (95 % CIs) for sleep dimensions by food security. Among 177 435 participants, the mean age of 47⋅2 ± 0⋅1 years, 52⋅0 % were women, and 68⋅4 % were non-Hispanic (NH)-White. A higher percent of NH-Black (7⋅9 %) and Hispanic/Latinx (5⋅1 %) lived in very low food security households than NH-White (3⋅1 %) participants. Very low v. high food security was associated with a higher prevalence of very short (PR = 2⋅61 [95 % CI 2⋅44-2⋅80]) sleep duration as well as trouble falling asleep (PR = 2⋅21 [95 % CI 2⋅12-2⋅30]). Very low v. high food security was associated with a higher prevalence of very short sleep duration among Asian (PR = 3⋅64 [95 % CI 2⋅67-4⋅97]) and NH-White (PR = 2⋅73 [95 % CI 2⋅50-2⋅99]) participants compared with NH-Black (PR = 2⋅03 [95 % CI 1⋅80-2⋅31]) and Hispanic/Latinx (PR = 2⋅65 [95 % CI 2⋅30-3⋅07]) participants. Food insecurity was associated with poorer sleep in a racially/ethnically diverse US sample.
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Affiliation(s)
- Dana M. Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Nyree M. Riley
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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Azhar S, Ross AM, Keller E, Weed J, Acevedo G. Predictors of Food Insecurity and Childhood Hunger in the Bronx During the COVID-19 Pandemic. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2023:1-14. [PMID: 37363071 PMCID: PMC10183692 DOI: 10.1007/s10560-023-00927-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
Using a community-based participatory research approach, we conducted a survey of 218 food pantry recipients in the south Bronx to determine predictors of food insecurity and childhood hunger. In adjusted multiple regression models, statistically significant risk factors for food insecurity included: having one or more children and not having health insurance. Statistically significant protectors against childhood hunger were: having a graduate degree, having health insurance and Spanish being spoken at home. Experiencing depression symptoms was positively associated with both food insecurity and childhood hunger. Frequency of food pantry use was not significantly associated with either food insecurity nor childhood hunger. This study suggests that targeting families with multiple children and without insurance will best help to promote food security among residents of the south Bronx. Social policy implications related to food security and benefit provision through the COVID-19 pandemic are also provided.
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Affiliation(s)
- Sameena Azhar
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
| | - Abigail M. Ross
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
| | - Eve Keller
- Fordham University, Fordham College at Rose Hill, New York, USA
| | | | - Gregory Acevedo
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
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Nicklett EJ, Cheng GJ, Morris ZA. Predictors of food insecurity among older adults before and during COVID-19 in the United States. Front Public Health 2023; 11:1112575. [PMID: 37250079 PMCID: PMC10213641 DOI: 10.3389/fpubh.2023.1112575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/29/2023] [Indexed: 05/31/2023] Open
Abstract
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.
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Affiliation(s)
- Emily Joy Nicklett
- Department of Social Work, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Greta Jianjia Cheng
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zachary A. Morris
- School of Social Welfare, Stony Brook University, Stony Brook, NY, United States
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Lo AE, Duffy EW, Ng SW. Differences in a Chain Supermarket's Sales to SNAP Shoppers Before and Since the COVID-19 Pandemic. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:343-353. [PMID: 37164550 PMCID: PMC10228633 DOI: 10.1016/j.jneb.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This study 1) compares grocery sales to Supplemental Nutrition Assistance Program (SNAP) shoppers in rural and urban grocery stores and 2) estimates changes in sales to SNAP shoppers in North Carolina (NC) since the pandemic. DESIGN Weekly transaction data among loyalty shoppers at a large grocery chain across NC from October 2019 to December 2020 (n = 32; 182 store weeks) to assess nutritional outcomes. SETTING North Carolina large chain grocery stores. PARTICIPANTS Large chain grocery store/SNAP shoppers. INTERVENTION Rural/urban status of the stores and COVID-19 pandemic onset. MAIN OUTCOME MEASURES Share of total calories sold from fruits, vegetables, nuts, and legumes (FVNL) with and without additives, sugar-sweetened beverages (SSB), less healthful foods (LHF), and processed meats (PM). ANALYSIS Multivariate random effects models with robust standard errors to examine the association of rural/urban status before and since coronavirus disease 2019 with the share of calories sold to SNAP shoppers from each food category. We controlled for county-level factors (eg, sociodemographic composition, food environment) and store-level factors. RESULTS We did not find significant rural-urban differences in the composition of sales to SNAP shoppers in adjusted models. There was a significant decrease in the mean share of total calories from sugar-sweetened beverages (-0.43%) and less healthful food (-1.32%) and an increase in the share from processed meats (0.09%) compared with before the pandemic (P < 0.05). CONCLUSIONS AND IMPLICATIONS Urban-rural definitions are insufficient to understand nuances in food environments, and more support is needed to ensure healthy food access.
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Affiliation(s)
- Amy Elizabeth Lo
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily Welker Duffy
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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46
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Baxter SLK, Koob CE, Hossfeld CML, Griffin SF, Mobley C, Hossfeld LH. Food Insecurity, the Food Environment, and COVID-19 in Rural South Carolina. FAMILY & COMMUNITY HEALTH 2023; 46:128-135. [PMID: 36799946 PMCID: PMC9930688 DOI: 10.1097/fch.0000000000000355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In this study, we explored the relationship between the food environment and food security among rural adults during the COVID-19 pandemic. Researchers, with assistance from community partners, conducted a cross-sectional survey assessing the impact of COVID-19 on food access, food security, and physical activity in 9 rural South Carolina (SC) counties. This survey was administered to a purposive sample (N = 587) from August 2020 to March 2021. The dependent variable was a binary indicator of food insecurity (past 3 months), in accordance with the USDA Household Food Security Survey Module. Independent variables were sociodemographic characteristics, food environment factors (eg, shopping at grocery stores, partial markets, and farmers' markets), and shopping behaviors during the pandemic. Overall, 31% of respondents were food insecure. Food security status differed by income and household composition. Results indicate that the odds of food insecurity were higher for respondents who shopped frequently at partial markets (adjusted odds ratio [AOR] = 1.61, 95% confidence interval [CI]: 1.01-2.56) and shopped more for food before the pandemic than during the pandemic (AOR = 1.68, 95% CI: 1.07-2.64). Findings underscore the importance of examining the relationship between the food environment and food insecurity during COVID-19 in rural settings.
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Affiliation(s)
- Samuel L. K. Baxter
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Caitlin E. Koob
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Cassius M. L. Hossfeld
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Sarah F. Griffin
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Catherine Mobley
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
| | - Leslie H. Hossfeld
- Public Health Science, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Baxter, Koob, Hossfeld and Griffin); Sociology, Athropology and Criminal Justice, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Mobley); and Dean of College of Behavioral, Social, and Health Sciences, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina (Hossfeld)
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47
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Kibe LW, Bazargan M, Bosah A, Schrode KM, Kuo Y, Andikrah E, Shaheen M. Diet Quality of Older African Americans: Impact of Knowledge and Perceived Threat of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5274. [PMID: 37047890 PMCID: PMC10094625 DOI: 10.3390/ijerph20075274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/25/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Confusing health messages and environmental changes intended to prevent the spread of the COVID-19 virus have affected the dietary behavior of older African Americans. We investigated the impact of COVID-19-related factors on diet quality and the relationship between food access and diet quality. We surveyed 150 African Americans aged 55 years and above during the COVID-19 pandemic. The data obtained included socio-demographic and health information, and COVID-19-related knowledge and perceptions. Dietary intake data was obtained using the Diet History Questionnaire III. Analyses included bivariate and multivariable statistics. Overall, based on United States Department of Agriculture guidelines, the diet quality of older African Americans was poor. Lower knowledge and a lower perceived threat of COVID-19 were significantly associated with poor diet quality. Additionally, older African Americans with chronic diseases and food insecurity had poor diet quality. The COVID-19 pandemic has highlighted the fragility of diet quality. The combined impact of poor knowledge and perceived threat of COVID-19, chronic disease, and food insecurity contribute to poor diet quality in this population. This study adds to the well-known need for strategies to support the right to a healthy diet, particularly during COVID-19 and future pandemics. Proactive interventions to counteract the potential consequences of poor diets are needed.
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Affiliation(s)
- Lucy W. Kibe
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
| | - Mohsen Bazargan
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
- Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
- Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA
| | - Adaobi Bosah
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
| | - Katrina M. Schrode
- Department of Psychiatry, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
| | - Yufu Kuo
- Physician Assistant Program, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
| | - Edward Andikrah
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
| | - Magda Shaheen
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA
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48
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Austin SB, Beccia AL, Raffoul A, Jackson DA, Sarda V, Hart JE, Chavarro JE, Rich-Edwards J. Financial precarity, food insecurity, and psychological distress prospectively linked with use of potentially dangerous dietary supplements during the pandemic in the US. Front Public Health 2023; 11:1120942. [PMID: 36935695 PMCID: PMC10018192 DOI: 10.3389/fpubh.2023.1120942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Supplements sold with claims to promote weight loss, cleansing/detoxing, increased energy, or boosted immunity can be dangerous, and consumers experiencing extreme stressors may be especially vulnerable to deceptive claims. The purpose of our study was to investigate associations of financial strain and psychological distress during the COVID-19 pandemic with use of supplements sold for weight loss, cleanse/detox, energy, or immunity. Methods We used repeated-measures data gathered over five survey waves from April/May 2020-April 2021 from the COVID-19 Substudy (N = 54,951), within three prospective US national cohorts (Nurses' Health Study 2, Nurses' Health Study 3, and Growing Up Today Study), to investigate longitudinal associations between financial strain and psychological distress and risk of use of potentially dangerous types of supplements. Surveys assessed use of supplements prior to and during the first year of the pandemic, as well as financial precarity, food insecurity, depressive and anxiety symptoms, perceived stress, and daily hassles. We fit sociodemographic-adjusted modified Poisson GEE models to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for associations between baseline or lagged time-varying predictors and prevalent or incident (i.e., new-onset) use of each supplement type. Results At baseline in April/May 2020, soon after pandemic onset, current use of supplement types was: weight loss 2.7%; cleanse/detox 3.2%; energy 4.4%; immune 22.6%. By the end of the study period, cumulative incidence was: weight loss 3.5%; cleanse/detox 3.7%; energy 4.5%; immune 21.3%. In prevalent-use analyses, financial precarity, food insecurity, and psychological distress were associated with up to 2.4 times the risk of use of these types of supplements across the study period. Similarly, in incident-use analyses, financial precarity and psychological distress were associated with up to 2.1 times the risk of initiating use; whereas, high food insecurity was associated with nearly 1.8 times higher risk of onset of weight-loss supplements use but was not associated with onset of use of other types of supplements. Discussion We found consistent evidence that during the first year of the pandemic, participants experiencing elevated financial strain and psychological distress were at heightened risk of initiating use of potentially dangerous types of supplements. Our findings raise concerns about deceptive claims about the safety and product effectiveness by manufacturers of these supplements to profit from vulnerable consumers during the pandemic.
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Affiliation(s)
- S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Amanda Raffoul
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Destiny A. Jackson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Vishnudas Sarda
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Jorge E. Chavarro
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Janet Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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49
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Anand S, Cao E, Kimura R, Guo W, Bassi N. Asian American Vaccination, Testing, and Other Healthcare Knowledge & Behaviors during COVID-19, A Systematic Review. Pathog Glob Health 2023; 117:120-133. [PMID: 35892162 PMCID: PMC9970223 DOI: 10.1080/20477724.2022.2106110] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Novel COVID-19 variants continue to endanger global public health. Increasing COVID-19 vaccination, healthcare-related preventative behaviors, and general knowledge rates are all critical in halting COVID-19 spread. We evaluated Asian American COVID-19 healthcare-related behaviors and knowledge, due to the dearth of knowledge in this area and the unique social factor of COVID-19 related discrimination; discriminatory acts during the pandemic may play a role in COVID-19 related behavior adherence. Following PRISMA-P protocol, we conducted a systematic review. The search strategy combined synonyms of health-care behaviors and knowledge. Reviewers synthesized key themes across articles and assessed studies utilizing modified Newcastle-Ottawa criteria. Of the 2,518 articles, 32 were selected. Asian Americans reported greater COVID-19 vaccination willingness and decreased COVID-19 testing relative to other racial groups. Common COVID-19 vaccination concerns included vaccination side effects, long-term safety, and distrust of COVID-19 information sources. Asian Americans had high COVID-19 preventative behavior rates including mask-wearing, handwashing, and social isolation compared to other ethnic groups. Asian Americans, conversely, had lower COVID-19-related healthcare knowledge and telemedicine adoption levels relative to other participants. This systematic review informs public health officials and clinicians of COVID-19 related healthcare knowledge and behaviors in the Asian American population. Equipped with this knowledge, public health officials can better target messaging about vaccine safety concerns to the Asian American community and recognize the importance of tailoring COVID-19 educational materials to the heterogeneous Asian American subpopulations. This systematic review also provides insight into the unique telemedicine challenges physicians may face when engaging with Asian American patients.
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Affiliation(s)
- Sahil Anand
- Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
| | - Evan Cao
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Reona Kimura
- Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - William Guo
- Department of Dermatology, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Naresh Bassi
- Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA
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50
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Lindau ST, Jagai JS, Abramsohn EM, Fuller CM, Wroblewski KE, Pinkerton EA, Makelarski JA. Unwanted sexual activity among United States women early in the COVID-19 pandemic. Am J Obstet Gynecol 2023; 228:209.e1-209.e16. [PMID: 36241078 PMCID: PMC9553968 DOI: 10.1016/j.ajog.2022.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Female sexual activity and, accordingly, birth rates tend to decline in times of stress, such as a pandemic. In addition, when resources are scarce or exogenous conditions are threatening, some women may engage in sexual activity primarily to maintain socioeconomic security. Having unwanted sex may indicate sexual activity in exchange for economic security. OBJECTIVE This study aimed to describe patterns and correlates of unwanted sex, defined as having sex more frequently than desired, among US women early in the COVID-19 pandemic. STUDY DESIGN The National US Women's Health COVID-19 Study was conducted in April 2020, using a nested quota sample design to enroll 3200 English-speaking women (88% cooperation rate) aged 18 to 90 years recruited from a research panel. The quota strata ensured sufficient sample sizes in sociodemographic groups of interest, namely, racial and ethnic subgroups. Patterns of sexual activity, including unwanted sex early in the pandemic, were described. To further elucidate the experiences of women reporting unwanted sex, open-ended responses to an item querying "how the coronavirus pandemic is affecting your sex life" were assessed using conventional content analysis. Logistic regression analyses-adjusting for sociodemographic characteristics, self-reported health, and prepandemic health-related socioeconomic risk factors, including food insecurity, housing instability, utilities and transportation difficulties, and interpersonal violence-were used to model the odds of unwanted sex by a pandemic-related change in health-related socioeconomic risk factors. RESULTS The proportion of women who were sexually active early in the pandemic (51%) was about the same as in the 12 months before the pandemic (52%), although 7% of women became active, and 7% of women became inactive. Overall, 11% of sexually active women were having unwanted sex in the early pandemic. The rates of anxiety, depression, traumatic stress symptoms, and each of the 5 health-related socioeconomic risk factors assessed were about 2 times higher among women having unwanted sex than other women (P<.001). Women having unwanted sex were also 5 times more likely than other women to report an increased frequency of sex since the pandemic (65% vs 13%; P<.001) and 6 times more likely to be using emergency contraception (18% vs 3%; P<.001). Women reporting unwanted sex commonly described decreased libido or interest in sex related to mood changes since the pandemic, having "more sex," fear or worry about the transmission of the virus because of sex, and having sex to meet the partner's needs. Among sexually active women, the odds of unwanted sex (adjusting for demographic, reproductive, and health factors) were higher among women with 1 prepandemic health-related socioeconomic risk factor (adjusted odds ratio, 2.0; 95% confidence interval, 1.1-3.8) and 2 or more prepandemic health-related socioeconomic risk factors (adjusted odds ratio, 6.0; 95% confidence interval, 3.4-10.6). Among sexually active women with any prepandemic health-related socioeconomic risk factor, those with new or worsening transportation difficulties early in the pandemic were particularly vulnerable to unwanted sex (adjusted odds ratio, 2.7; 95% confidence interval, 1.7-4.3). CONCLUSION More than 1 in 10 sexually active US women was having unwanted sex early in the COVID-19 pandemic. Socioeconomically vulnerable women, especially those with new or worsening transportation problems because of the pandemic, were more likely than others to engage in unwanted sex. Pandemic response and recovery efforts should seek to mitigate unwanted sexual activity and related health and social risks among women.
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Affiliation(s)
- Stacy T Lindau
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL; Medicine Geriatrics, The University of Chicago, Chicago, IL.
| | - Jyotsna S Jagai
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Emily M Abramsohn
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Charles M Fuller
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | | | - El A Pinkerton
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL
| | - Jennifer A Makelarski
- Departments of Obstetrics and Gynecology, The University of Chicago, Chicago, IL; College of Science and Health, Benedictine University, Lisle, IL
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