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Spence EH, Niles MT, Bertmann F, Belarmino EH. Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: an investigation in Vermont. Nutr J 2024; 23:74. [PMID: 39004722 PMCID: PMC11247766 DOI: 10.1186/s12937-024-00963-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] [Received: 06/13/2022] [Accepted: 05/28/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated with public health outcomes. METHODS Using data from a representative statewide survey administered in Vermont (n = 600) between July and September 2020, we examined participant experiences with major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explored quantitative and qualitative responses regarding perceptions of program utility, and used nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality. RESULTS One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we found higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < 0.001), an association that persisted even when we compared similar households using matching techniques (p ≤ 0.001). From matched analyses, we found that, compared to low-income non-participants, low-income program participants were less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants were less likely to meet vegetable intake recommendations (p = 0.035). We also found lower rates of perceived stress among low-income school meal participant households compared to low-income non-participants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use. CONCLUSIONS We found that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.
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Affiliation(s)
- Emma H Spence
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Meredith T Niles
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Gund Institute for Environment, University of Vermont, 210 Colchester Ave, Burlington, VT, 05405, USA
| | - Farryl Bertmann
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA
| | - Emily H Belarmino
- Food Systems Program, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA.
- Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT, 05405, USA.
- Gund Institute for Environment, University of Vermont, 210 Colchester Ave, Burlington, VT, 05405, USA.
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Carey N, Coley RL, Hawkins SS, Baum CF. Emerging Adult Mental Health During COVID: Exploring Relationships Between Discrete and Cumulative Individual and Contextual Stressors and Well-Being. J Adolesc Health 2024; 75:26-34. [PMID: 38483379 DOI: 10.1016/j.jadohealth.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Indicators of poor mental health increased during the COVID-19 pandemic among emerging adults aged 18-24 years, a group already at elevated risk. This study explores associations between contextual and personal stressors with symptoms of emerging adults' anxiety and depression, assessing both multidimensional and distinct measures of stress. METHODS Using Census Household Pulse Surveys from emerging adults aged 18 to 24 years (N = 71,885) and administrative data from April 23, 2020 to March 29, 2021, we estimated logistic regression models adjusted for state and wave fixed effects. RESULTS Rates of elevated anxiety and depressive symptoms rose dramatically among emerging adults during the first year of the COVID-19 pandemic. Results indicate that potential contextual stressors-state COVID-19 rates and state COVID-19 mitigation policies limiting social interactions (stay-at-home orders, restaurant closures, large gathering restrictions, and mask mandates)-were not significantly associated with symptoms. In contrast, personal economic stressors (nonemployment, household income loss, food insecurity, housing insecurity, lacking health insurance) and disruptions to education were associated significantly with elevated anxiety and depressive symptoms, with greater numbers of stressors associated with worse well-being. DISCUSSION Emerging adults reported persistently high levels of elevated anxiety and depressive symptoms during the first year of the pandemic, outcomes associated not with COVID-19 rates or mitigation policies, but with economic inequities, and other personal stressors heightened by the pandemic. Providing targeted support for young adults, including ensuring access to mental health supports, health care, and economic relief, is critical.
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Affiliation(s)
- Naoka Carey
- Department of Counseling, Developmental & Educational Psychology, Boston College Lynch School of Education & Human Development, Chestnut Hill, Massachusetts.
| | - Rebekah Levine Coley
- Department of Counseling, Developmental & Educational Psychology, Boston College Lynch School of Education & Human Development, Chestnut Hill, Massachusetts
| | | | - Christopher F Baum
- Boston College School of Social Work, Chestnut Hill, Massachusetts; Department of Economics, Morrissey School of Arts & Sciences, Boston College, Chestnut Hill, Massachusetts
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Cai J, Parker M, Tekwe C, Bidulescu A. Food insecurity and mental health among US adults during the COVID-19 pandemic: Results from National Health Interview Survey, 2020-2021. J Affect Disord 2024; 356:707-714. [PMID: 38608771 DOI: 10.1016/j.jad.2024.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To examine socio-demographic disparities in food insecurity during the COVID-19 pandemic and the association between food insecurity and mental health among US adults overall and communities vulnerable to food insecurity. METHODS A cross-sectional study was conducted using the 2020-2021 National Health Interview Survey of 57,456 US adults. Weighted multivariable logistic regression models were used to estimate the association between food insecurity and anxiety or depression symptoms in overall US adults and subgroups including young adults (18-34 years), females, Hispanic people, non-Hispanic Black people, individuals with prior COVID-19 infection, the unemployed, low-income participants, participants with children, and Supplemental Nutrition Assistance Program (SNAP) participants. RESULTS Young or middle age, female sex, Hispanic/non-Hispanic Black/other race/ethnicity, lower education level, unmarried/other marital status, unemployment, being below the federal poverty level, and greater number of persons in the household were associated with food insecurity (AOR ranged from 1.35 to 2.70, all p < 0.05). Food insecurity was independently associated with anxiety (AOR = 2.67, 99 % CI: 2.33, 3.06) or depression (AOR = 3.04, 99 % CI: 2.60, 3.55) symptoms in the overall adults. Significant associations between food insecurity and anxiety or depression symptoms were also observed in all subgroups (AOR ranged from 1.95 to 3.28, all p < 0.0001). Compared with overall adults, the magnitude of the association was greater for participants with children, females (for depression only), and non-Hispanic Black people (for depression only). LIMITATIONS The cross-sectional design prevents inference of causality. CONCLUSIONS Comprehensive policies are needed to ensure accessible and affordable food resources to reduce disparities in food insecurity and improve mental health, especially for those socioeconomically disadvantaged communities.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America.
| | - Maria Parker
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
| | - Carmen Tekwe
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
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Onyeaka H, Ejiohuo O, Taiwo OR, Nnaji ND, Odeyemi OA, Duan K, Nwaiwu O, Odeyemi O. The Intersection of Food Security and Mental Health in the Pursuit of Sustainable Development Goals. Nutrients 2024; 16:2036. [PMID: 38999784 PMCID: PMC11243539 DOI: 10.3390/nu16132036] [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: 06/07/2024] [Revised: 06/25/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Food insecurity, a multifaceted global challenge, intertwines with mental health concerns, necessitating nuanced strategies for sustainable solutions. The intricate web of challenges posed by these intersections has made it imperative to delineate a strategic way forward, incorporating solutions and robust policy recommendations. This study aims to comprehensively examine the intricate relationship between food security and its intersection with mental health on a global scale, offering insights into case studies, responses, and innovative approaches to inform effective strategies for addressing these pressing challenges. This study involved an analysis of a literature search, mainly between 2013 and 2023, with an updated addition of relevant 2024 studies. Examining responses across regions unveils varied interventions, from targeted social safety net programs in West Africa to technology-driven solutions in Asia. Success stories, such as Ghana's sustainable agricultural practices and Canada's income transfer programs, underscore the efficacy of multifaceted approaches. Innovative initiatives like community food programs offer promising alternatives to traditional food banks. Furthermore, international cooperation and policy innovations, exemplified by the European Union's "Farm to Fork Strategy", demonstrate the potential for collective action in addressing food insecurity. By prioritizing integrated strategies, global collaboration, and evidence-based policymaking, we lay the groundwork for sustainable development where communities thrive nutritionally and mentally. We emphasize continuous research and evaluation and incorporating mental health support into community programs to pave the way for a future where communities are not only food-secure but also mentally resilient.
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Affiliation(s)
- Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B152TT, UK; (N.D.N.); (O.N.)
| | - Ovinuchi Ejiohuo
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, 60-806 Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
- Molecular and Cell Biology Unit, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Oluseyi Rotimi Taiwo
- Faculty of Veterinary Medicine, University of Ibadan, Ibadan 200132, Oyo, Nigeria;
| | - Nnabueze Darlington Nnaji
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B152TT, UK; (N.D.N.); (O.N.)
- Department of Microbiology, University of Nigeria, Nsukka, Enugu 410001, Enugu, Nigeria
| | - Omowale A. Odeyemi
- College of Nursing, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife 220005, Osun, Nigeria;
| | - Keru Duan
- Birmingham Business School, Department of Management, University of Birmingham, University House Edgbaston Park Road, Birmingham B15 2TY, UK;
| | - Ogueri Nwaiwu
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B152TT, UK; (N.D.N.); (O.N.)
| | - Olumide Odeyemi
- Ecology and Biodiversity Centre, Institute for Marine and Antarctic Studies (IMAS), University of Tasmania, Launceston, TAS 7004, Australia;
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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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Kelley K, Campbell E, Steiber A, Yakes Jimenez E. Repeated Cross-Sectional Surveys of Registered Dietitian Nutritionists Demonstrate Rapid Practice Changes to Address Food Insecurity During the Coronavirus Disease 2019 Pandemic. J Acad Nutr Diet 2024; 124:268-278.e13. [PMID: 35963532 PMCID: PMC9364914 DOI: 10.1016/j.jand.2022.08.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/08/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic had worldwide economic impact, exacerbating food insecurity risk for vulnerable populations. OBJECTIVE To describe changes in practice and challenges and areas of need related to addressing food insecurity during the coronavirus disease 2019 pandemic for registered dietitian nutritionist survey respondents. DESIGN A cross-sectional, anonymous, online survey distributed via the Academy of Nutrition and Dietetics e-mail communication platform and social media accounts from April through May 2020 (Wave 1 [W1]) and December 2020-February 2021 (Wave 2 [W2]). PARTICIPANTS AND SETTING Participants were US-based registered dietitian nutritionists practicing in community-based settings to address food insecurity (W1: n = 454; W2: n = 331). STATISTICAL ANALYSES Responses were descriptively summarized using means ± SD, medians and interquartile ranges, or number of observations and percentages. Open-ended responses were manually reviewed and organized into major themes. RESULTS Respondents had about 10 years of experience in addressing food insecurity and were most commonly involved with the Special Supplemental Nutrition Program for Women, Infants and Children, federal school nutrition programs, or food banks. Participants described increased demand for food security assistance (W1: 68%; W2: 60%). Among respondents involved in food preparation and handling (W1: n = 183; W2: n = 110), supply chain (W1: 61%; W2: 56%) and staffing (W1: 37%; W2: 50%) challenges were commonly reported. Child nutrition program professionals (W1: n = 143; W2: n = 84) reported widespread implementation of optional program waivers, with the most commonly implemented waivers allowing noncongregate meal service (W1: 83%; W2: 81%), caregivers to pick up meals (W1: 69%; W2: 85%), and flexibility in mealservice times (W1: 75%; W2: 87%). CONCLUSIONS Respondents quickly adapted programs to ensure staff and client safety while continuing to provide essential food security services. They identified the need for ongoing nutrition program policy advocacy and timely access to best practice resources during public health emergencies.
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Affiliation(s)
- Kathryn Kelley
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois.
| | - Elizabeth Campbell
- Legislative and Government Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Alison Steiber
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Elizabeth Yakes Jimenez
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois; Department of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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Choi Y, Kim HH. Social capital, food insecurity, and health outcomes in the US during the COVID-19 pandemic. Perspect Public Health 2024; 144:39-51. [PMID: 35836405 DOI: 10.1177/17579139221106339] [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: 11/17/2022]
Abstract
AIMS The purpose of this study was first, to investigate the harmful effects of food insufficiency on health outcomes - self-rated health (SRH) and self-assessed depressive symptoms - during the COVID-19 pandemic and, second, to test whether these effects fluctuated across the US in terms of state-level social capital. METHODS Data were drawn from the Census Household Pulse Survey (fielded between April 2020 and February 2021) consisting of community-dwelling American adults (N = 1.5M+). Social capital measures were taken from the 'Social Capital Project' sponsored by the US Congress. We estimated three-level mixed effects models to analyze multiple waves of repeated cross-sectional surveys. RESULTS Post-COVID-19 food insufficiency was significantly negatively associated with SRH and positively associated depression, adjusting for controls including food insufficiency prior to the onset of the pandemic. These relationships were also more pronounced in areas with higher aggregate social capital. CONCLUSIONS The health burdens of the new coronavirus disease have fallen disproportionately on the economically marginalized, as measured by food insufficiency. Contrary to the conventional literature, living in a state with a greater stock of social capital worsened its health effects.
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Affiliation(s)
- Y Choi
- Department of Sociology, Chung-Ang University, Seoul, Republic of Korea
| | - H H Kim
- Department of Sociology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea
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Kemp CG, Mensa-Kwao A, Concepcion T, Hughsam M, Queen E, Sinha M, Collins PY. COVID-19, the COVID-19 response, and racial injustice: Associations with depressive and anxiety symptoms among US adults from April 2020 to March 2021. SSM - MENTAL HEALTH 2023; 3:100214. [PMID: 37124707 PMCID: PMC10122769 DOI: 10.1016/j.ssmmh.2023.100214] [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: 08/18/2022] [Revised: 03/20/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023] Open
Abstract
Background People in the United States have faced numerous large and intersecting threats to their mental health since the onset of the coronavirus disease pandemic. This study aimed to understand the unique relationships between these co-occurring threats - including the police killings of unarmed Black people and the fight for racial justice - and how they affect mental health symptoms among various demographic groups. Methods Data on population mental health, state-level COVID-19 incidence rates, cases of police-involved killings, and occurrences of racial justice protests were analyzed. The primary outcome was depression or anxiety symptoms. Regression models were used to estimate prospective associations between individual-, household-, and state-level exposures to hypothesized mental health threats and subsequent depression or anxiety symptoms. Results Data from 2,085,041 individual participants were included. Most were women (51.2%), and most were white, non-Hispanic (61.2%), with almost half (47.7%) reporting some loss of household income since March 13, 2020. Neither the killing of unarmed Black people by police, nor the above-average occurrence of Black Lives Matter (BLM) protests, were observed to be associated with anxiety or depressive symptoms in the overall population, though the BLM protests were associated with reduced depressive and anxiety symptoms among younger participants. State-level COVID-19 incidence risk was more strongly associated with depressive and anxiety symptoms among women, Black people, older people, and higher income people, compared to men, white people, younger people, and lower income people. Conclusion Our findings are relevant for anticipating and addressing the mental health consequences of social injustice and protest movements in the context of COVID-19 pandemic, as well as future pandemics. Promoting population mental health requires addressing underlying social and structural inequities and prioritizing the pursuit of social justice and health equity as a primary mental health intervention.
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Affiliation(s)
- Christopher G Kemp
- Johns Hopkins University, Department of International Health, Baltimore, MD, USA
| | | | - Tessa Concepcion
- University of Washington, Department of Global Health, Seattle, WA, USA
| | | | | | | | - Pamela Y Collins
- University of Washington, Department of Global Health, Seattle, WA, USA
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Sanjeevi N, Monsivais P. Association of emergency allotment discontinuation with household food insufficiency in Supplemental Nutrition Assistance Program participants: A quasi-experimental study. Prev Med 2023; 177:107784. [PMID: 38007199 DOI: 10.1016/j.ypmed.2023.107784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE The Supplemental Nutrition Assistance Program (SNAP) was modified to mitigate food insecurity faced by low-income families during the pandemic. These changes included enhancement of SNAP benefits via 2020 emergency allotments (EA). Despite the high food price inflation in 2022, 17 states ceased providing EA benefits by end of 2022. The objective of this research is to examine the impact of EA discontinuation on food insufficiency. METHODS Using Household Pulse Survey data from December 2021-January 2023, SNAP participants (n = 57,556) from states that discontinued EA at some point during the study period and those from states that did not discontinue EA were included. The main analyses examined the impact of EA discontinuation on food insufficiency via staggered difference-in-difference models using two-way fixed effects (TWFE) regression. Additional analyses examined this association using Callaway-Sant'Anna approach for difference-in-difference analyses. RESULTS Using TWFE, EA discontinuation was significantly associated with increased food insufficiency in the overall sample, as well as in individuals who were non-Hispanic White and Hispanic, and who had annual family incomes of less than $25,000. Investigation of time-varying association of EA termination with food insufficiency suggested that EA discontinuation was significantly associated with greater food insufficiency in the second week following rollback. DiD analyses using Callaway-Sant'Anna approach suggested that states' rollback of EA was significantly associated with higher food insufficiency in non-Hispanic White individuals. CONCLUSION Findings imply that EA discontinuation, amidst the corresponding surge in inflation, could have contributed to increased rates of household food insufficiency.
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Affiliation(s)
- Namrata Sanjeevi
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.
| | - Pablo Monsivais
- Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
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Korenman S, Hyson RT. Health insurance, labor market shocks, and mental health during the first year of the COVID-19 crisis. ECONOMICS AND HUMAN BIOLOGY 2023; 51:101298. [PMID: 37659212 DOI: 10.1016/j.ehb.2023.101298] [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: 12/09/2022] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 09/04/2023]
Abstract
We use the Census Household Pulse Survey (HPS) to examine employment and earnings loss, health insurance, and hardships related to physical and mental health and health care, as well as food insecurity and difficulty meeting expenses, during the first year of the COVID-19 pandemic. Pandemic job loss is strongly associated with uninsurance in the HPS. Moreover, among those who were not employed due to a pandemic economic reason such as a business closure, we find substantial regression-adjusted differences in hardship by insurance status, especially in the domains of mental health, mental health care and financial difficulties (food insufficiency and difficulty paying usual expenses). The uninsured generally, and uninsured job losers especially, were at high risk of untreated or under-treated mental health symptoms. We also find evidence among non-employed persons of substantial differences by gender and race/ethnicity in uninsurance, mental health symptoms and unmet needs for mental health care.
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Affiliation(s)
- Sanders Korenman
- Austin W. Marxe School of Public and International Affairs, Baruch College, CUNY and CUNY Institute for Demographic Research, New York, NY, United States.
| | - Rosemary T Hyson
- Austin W. Marxe School of Public and International Affairs, Baruch College, CUNY and CUNY Institute for Demographic Research, New York, NY, United States
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Doyle O, Wood EK, Sullivan EL, Mackiewicz-Seghete K, Graham A, Gustafsson HC. COVID-19 pandemic-related trauma symptoms are associated with postpartum alcohol consumption. Gen Hosp Psychiatry 2023; 85:19-27. [PMID: 37729720 PMCID: PMC10841071 DOI: 10.1016/j.genhosppsych.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/02/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has led to escalations in substance use, including alcohol consumption. Of particular concern are the potential impacts during the postpartum period, a time of heightened vulnerability to stress and potential transmission of the negative sequelae of substance use to offspring. However, postpartum alcohol consumption during the COVID-19 pandemic has not been well characterized. METHOD Postpartum drinking habits and COVID-19-related stress were repeatedly assessed (every two weeks for 12 weeks, and at one-, six-, and 12-months postpartum) from N = 378 individuals during the COVID-19 pandemic. Average alcohol use trajectories as well as heterogeneity in trajectories were characterized. COVID-19-related trauma symptoms and coping were examined in relation to alcohol use over time. RESULTS Average postpartum alcohol use included an initial quadratic increase from one-to-four-months postpartum, followed by a plateau between four-to-12-months. Higher (15.08%), moderate (26.90%), and lower consumption (57.90%) subgroups were identified. Endorsement of COVID-19-related trauma symptoms and using alcohol to cope with stress predicted higher consumption. CONCLUSIONS Findings suggest a potential sensitive period in establishing postpartum alcohol use patterns from one-to-four-months postpartum. Findings further suggest that postpartum alcohol use is heterogenous and that individual response to major traumatic stressors, like the COVID-19 pandemic, may influence emerging patterns of postpartum alcohol use.
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Affiliation(s)
- Olivia Doyle
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Elizabeth K Wood
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Elinor L Sullivan
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | | | - Alice Graham
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Hanna C Gustafsson
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
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12
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Parenteau AM, Boyer CJ, Campos LJ, Carranza AF, Deer LK, Hartman DT, Bidwell JT, Hostinar CE. A review of mental health disparities during COVID-19: Evidence, mechanisms, and policy recommendations for promoting societal resilience. Dev Psychopathol 2023; 35:1821-1842. [PMID: 36097815 PMCID: PMC10008755 DOI: 10.1017/s0954579422000499] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Social and economic inequality are chronic stressors that continually erode the mental and physical health of marginalized groups, undermining overall societal resilience. In this comprehensive review, we synthesize evidence of greater increases in mental health symptoms during the COVID-19 pandemic among socially or economically marginalized groups in the United States, including (a) people who are low income or experiencing homelessness, (b) racial and ethnic minorities, (c) women and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) communities, (d) immigrants and migrants, (e) children and people with a history of childhood adversity, and (f) the socially isolated and lonely. Based on this evidence, we propose that reducing social and economic inequality would promote population mental health and societal resilience to future crises. Specifically, we propose concrete, actionable recommendations for policy, intervention, and practice that would bolster five "pillars" of societal resilience: (1) economic safety and equity, (2) accessible healthcare, including mental health services, (3) combating racial injustice and promoting respect for diversity, equity, and inclusion, (4) child and family protection services, and (5) social cohesion. Although the recent pandemic exposed and accentuated steep inequalities within our society, efforts to rebuild offer the opportunity to re-envision societal resilience and policy to reduce multiple forms of inequality for our collective benefit.
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Affiliation(s)
- Anna M. Parenteau
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | - Chase J. Boyer
- Department of Human Ecology, University of California-Davis
| | | | | | - LillyBelle K. Deer
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | | | - Julie T. Bidwell
- Betty Irene Moore School of Nursing, University of California-Davis
| | - Camelia E. Hostinar
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
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13
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Li Y, Zhang S, Wang L, Lu G, Pfeiffer R, Zou Z. The Association of Supplemental Nutrition Assistance Program Participation and Food Insufficiency among Households with Children in the United States during COVID-19. J Nutr 2023; 153:3110-3121. [PMID: 37604384 PMCID: PMC10613719 DOI: 10.1016/j.tjnut.2023.08.020] [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: 06/21/2023] [Revised: 07/20/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND As the expansion of Supplemental Nutrition Assistance Program (SNAP) benefits and pandemic emergency assistance programs ended in late 2021, little is known about subsequent trends in food insufficiency (FI) among households with children. OBJECTIVES This research examined the association between SNAP participation and FI among households with children in the United States, particularly non-Hispanic Black (Black) and Hispanic households. METHODS This cross-sectional analysis used Household Pulse Survey data collected from December 2021 to May 2022. Spatial analysis was conducted to visualize FI and SNAP participation rates across 50 states. With state SNAP policy rules as exogenous instruments and sociodemographic factors as control variables, 2-stage probit models were utilized to assess the SNAP and FI association among all (n = 135,074), Black (n = 13,940), and Hispanic households with children (n = 17,869). RESULTS Approximately 13.9% [95% confidence interval (CI): 13.85%, 13.99%] of households experienced FI, and 20.4% (CI: 20.35%, 20.51%) received SNAP benefits. Among Black and Hispanic households, higher rates were observed, with 23.3% (CI: 23.12%, 23.4%) and 20.8% (CI: 20.61%, 20.95%) experiencing FI and 36.3% (CI: 36.1%, 36.5%) and 26.9% (CI: 26.61%, 27.13%) receiving SNAP benefits. These rates varied across states, ranging from 8% (Utah) to 21.1% (Mississippi) for FI and from 8.8% (Utah) to 32.7% (New Mexico) for SNAP participation. SNAP participants demonstrated a 12% lower likelihood of FI than nonparticipants (CI: -0.18, -0.05, P < 0.001). Among Black households, SNAP participants had a 29% lower likelihood of FI than nonparticipants (CI: -0.54, -0.03, P < 0.001). However, SNAP participation was not significant among Hispanic households (P = 0.99), nor did it narrow the FI gap between Hispanic and non-Hispanic households (P = 0.22). CONCLUSIONS SNAP participation was associated with lower levels of FI among households with children, particularly for Black households. However, there was no significant association between SNAP participation and FI among Hispanic households with children.
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Affiliation(s)
- Yingru Li
- Department of Sociology, University of Central Florida, Orlando, FL, United States.
| | - Shunpu Zhang
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
| | - Liqiang Wang
- Department of Computer Science, University of Central Florida, Orlando, FL, United States
| | - Guoqing Lu
- Department of Biology and School of Interdisciplinary Informatics, University of Nebraska Omaha, Omaha, NE, United States
| | - Ruth Pfeiffer
- Biostatistics Branch, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, United States
| | - Zihang Zou
- Department of Computer Science, University of Central Florida, Orlando, FL, United States
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14
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Nagata JM, Chu J, Cervantez L, Ganson KT, Testa A, Jackson DB, Murray SB, Weiser SD. Food insecurity and binge-eating disorder in early adolescence. Int J Eat Disord 2023; 56:1233-1239. [PMID: 37013949 PMCID: PMC10247527 DOI: 10.1002/eat.23944] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Food insecurity is defined as lack of consistent access to adequate food for healthy living. The objective of this study was to determine the associations between food insecurity and binge-eating disorder in a national cohort of 9- to 14-year-old children. METHOD We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,035, 2016-2020). Logistic regression analyses estimated the associations between food insecurity at baseline, year 1, or year 2 (exposure) and binge eating, subclinical binge-eating disorder (Other Specified Feeding and Eating Disorder-Binge-Eating Disorder [OSFED-BED]), and binge-eating disorder (BED) (outcome) based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at 2-year follow-up. RESULTS The prevalence of food insecurity in the study was 15.8%. At 2-year follow-up, 1.71% of the sample received a diagnosis of BED or OSFED-BED, while 6.62% reported binge eating. Food insecurity was associated with 1.67 higher odds of BED or OSFED-BED (95% CI 1.04-2.69) and 1.31 higher odds of binge-eating symptoms (95% CI 1.01-1.71). DISCUSSION Food insecurity in early adolescence is associated with higher odds of developing future binge-eating and BED or OSFED-BED. Clinicians may consider assessing for binge eating in adolescents with food insecurity and provide support in accessing appropriate food resources. PUBLIC SIGNIFICANCE Prior research has shown that food insecurity is associated with disordered eating behaviors, including binge eating in adulthood. This study explored whether food insecurity in early adolescence increases risk for developing binge-eating disorder (BED). Targeted screening for BED in adolescents experiencing FI, and vice versa, may be warranted.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, California, 94143, USA
| | - Jonathan Chu
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, California, 94143, USA
| | - Levi Cervantez
- Department of Pediatrics, University of California, San Francisco, 550 16 Street, 4 Floor, Box 0503, San Francisco, California, 94143, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, Ontario, M5S 1V4, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, TX, 77030, USA
| | - Dylan B. Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, USA
| | - Stuart B. Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA
| | - Sheri D. Weiser
- Department of Medicine, University of California, San Francisco, 1001 Potrero Avenue, San Francisco, CA, 94110, USA
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15
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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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16
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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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17
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Nkwanyana A, Florence M, Swart EC. Scoping review protocol exploring the relationship between food insecurity, mental health and diet intake among adolescents across the globe. BMJ Open 2023; 13:e069436. [PMID: 37105700 PMCID: PMC10152043 DOI: 10.1136/bmjopen-2022-069436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Studies, exploring the effect of food insecurity on physical and mental health, have shown that food insecurity is associated with lower self-reports of physical and mental health. With the COVID-19 pandemic, food insecurity has increased leading to higher risks of poor mental health. Despite evidence of the negative implications of food insecurity on mental health, there is a paucity of research on these variables for adolescents specifically. The current evidence shows there is a gap in adolescent centred research linking mental health and food insecurity globally. Adolescence is a crucial period of development where habits, nutritional inadequacies linked to food insecurity and mental health problems formed due to these inadequacies can be conveyed into adulthood. The aim of this study is to systematically scope the literature exploring the relationship between mental health, food (in)security and/or diet intake of adolescents. METHODS This review will be guided by Arksey and O'Malley's extended framework. The search strategy was developed by two of the authors and will be used to search literature from January 2012 to December 2022 in PubMed, Academic search complete, PsychARTICLES, Google, ScienceDirect, Scopus and Web of science core collection. Searching published and unpublished literature will be done in the chosen databases. References used in included literature will be reviewed for additional studies/sources. Articles will be assessed for eligibility by two reviewers, and any discrepancies reviewed by a third reviewer. The inclusion and exclusion criteria will be used for screening. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will be used to document the selection process. A narrative summary and descriptive analysis will be used to summarise and report the extracted data. ETHICS AND DISSEMINATION Approval for this study has been granted by the University of the Western Cape Biomedical Research Ethics Committee (BM21/8/3). Strict measures will be followed to ensure methodological rigour.
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Affiliation(s)
- Akhona Nkwanyana
- Department of Psychology, University of the Western Cape, Bellville, Western Cape, South Africa
| | - Maria Florence
- Department of Psychology, University of the Western Cape, Bellville, Western Cape, South Africa
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18
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Testa A, Sharma BB. Food Insecurity and COVID-19 Vaccination Status and Vaccination Hesitancy in the United States. FAMILY & COMMUNITY HEALTH 2023; 46:136-142. [PMID: 36799947 PMCID: PMC9930687 DOI: 10.1097/fch.0000000000000357] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
During the COVID-19 pandemic, vaccination hesitancy emerged as a factor that impacted vaccine uptake. In addition, during this period, there was a substantial increase in food insecurity in the United States (US). However, there is a lack of research on the potential connection between food insecurity and COVID-19 vaccine intentions. This study assesses whether experiencing food insecurity during the COVID-19 pandemic is associated with COVID-19 vaccination uptake and vaccination hesitancy. Data were from the 2021 Crime, Health, and Politics Survey, a national probability sample of community-dwelling adults 18 years and older living in the US (N = 1741) conducted from May 10, 2021, to June 1, 2021. Results from multinomial logistic regression analyses found that mild food insecurity and moderate-to-severe food insecurity were associated with an increased relative risk of not planning to get the COVID-19 vaccination compared with having been vaccinated or planning to get vaccinated. Moderate-to-severe food insecurity was associated with an increased risk of being unsure about getting the COVID-19 vaccine. The results suggest that efforts to expand vaccination and health literacy outreach to food-insecure populations are essential steps to promote greater health equity.
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Affiliation(s)
- Alexander Testa
- Department of Management, Community and Policy, School of Public Health, University of Texas Health Science Center at Houston (Dr Testa); and Department of Social Work, College for Health, Community & Policy, University of Texas at San Antonio (Dr Sharma)
| | - Bonita B. Sharma
- Department of Management, Community and Policy, School of Public Health, University of Texas Health Science Center at Houston (Dr Testa); and Department of Social Work, College for Health, Community & Policy, University of Texas at San Antonio (Dr Sharma)
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19
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Ahmed D, Benavente P, Diaz E. Food Insecurity among International Migrants during the COVID-19 Pandemic: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5273. [PMID: 37047889 PMCID: PMC10093953 DOI: 10.3390/ijerph20075273] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/01/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
The SARS-CoV-2 coronavirus and the measures imposed to control it have impacted food security globally, particularly among vulnerable populations. Food insecurity, in turn, has repercussions on health, exacerbating pre-existing inequalities. This scoping review maps the literature describing associations between the COVID-19 pandemic and food insecurity among migrants, with a particular view toward health. A total of 909 papers were extracted through four electronic databases, and 46 studies were included. The migrant populations described originated mainly from Latin America (11/46) and were located in North America (21/46). Most studies included refugees and asylum seekers (20/46). The main challenges described were financial hardship (28/46), the effect of migrants' documentation status on using public food aid (13/46), and the suspension of or reduction in humanitarian assistance due to the economic recession (7/46). The impact of food insecurity on migrants' mental and physical health was described in 26 of the 46 studies. Authorities in all destination countries should focus their attention and efforts into ensuring nutrition security for migrants in a holistic way, including their economic and legal integration, to be better prepared for health crises in the future.
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Affiliation(s)
- Doua Ahmed
- Centre of International Health, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway
| | - Pierina Benavente
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway
| | - Esperanza Diaz
- Pandemic Centre, Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, 5020 Bergen, Norway
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20
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Cai J, Bidulescu A. The association between food insecurity and cognitive impairment among the US adults: The mediation role of anxiety or depression. J Affect Disord 2023; 325:73-82. [PMID: 36603601 DOI: 10.1016/j.jad.2022.12.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/08/2022] [Accepted: 12/18/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Using a nationally representative sample, this study aimed to examine (1) socio-demographic and health-related disparities in cognitive impairment, (2) the association between food insecurity and cognitive impairment, and (3) the mediation role of anxiety or depression in the pathway between food insecurity and cognitive impairment. METHODS Cross-sectional data of 28,508 adults from the 2020 National Health Interview Survey were analyzed. Multivariable logistic regression models were used to estimate associations with cognitive impairment. Mediation analyses were conducted using the four-way decomposition method under a counterfactual framework. RESULTS Disparities in cognitive impairment were observed across socio-demographic and health-related characteristics (all p < 0.0001). Food insecurity was significantly associated with cognitive impairment in the overall population and the magnitude of the association was greater for the young or middle-aged, females and non-Hispanic Blacks than the general population (AOR ranged from 1.19 to 2.54, all p < 0.01). With anxiety as a mediator, 28.66 % of the total effect of food insecurity on cognitive impairment was attributable to mediation only, and 22.39 % was attributable to interaction (between food insecurity and anxiety) and mediation. With depression as a mediator, 22.33 % of the total effect was attributable to mediation only, and 16.00 % was attributable to interaction (between food insecurity and depression) and mediation. LIMITATIONS The cross-sectional design prevents inference of causality. CONCLUSIONS Ensuring available and adequate food resources is important to prevent adverse cognitive outcomes. Clinical interventions or treatments for anxiety or depression may help improve cognitive function.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America.
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
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21
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Cai J, Bidulescu A. The association between chronic conditions, COVID-19 infection, and food insecurity among the older US adults: findings from the 2020-2021 National Health Interview Survey. BMC Public Health 2023; 23:179. [PMID: 36703149 PMCID: PMC9880360 DOI: 10.1186/s12889-023-15061-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND This study aims to examine how the presence of chronic conditions or positive COVID-19 infection (as exposures) is related to food insecurity (as an outcome) in the older population and whether there is a dose-response relationship between the number of chronic conditions and the severity of food insecurity. METHODS Cross-sectional data of 17,977 older adults (≥ 65 years) from the 2020-2021 National Health Interview Survey were analyzed. Chronic conditions included physical health conditions (i.e., arthritis, coronary heart diseases, hypertension, stroke, prediabetes, diabetes, asthma, chronic obstructive pulmonary disease, and disability) and mental health conditions (i.e., anxiety and depression disorder). COVID-19 infection status was determined by a self-reported diagnosis of COVID-19. Household food insecurity was measured using the 10-item US Department of Agriculture (USDA) Food Security Survey Module with a 30-day look-back window. Multinomial logistic regression models were used to examine the association between health conditions and food insecurity controlling for socio-demographic factors. RESULTS Our results indicated that 4.0% of the older adults lived in food-insecure households. The presence of chronic conditions was significantly associated with higher odds of being food insecure independent of socio-demographic factors (AOR ranged from 1.17 to 3.58, all p < 0.0001). Compared with participants with 0-1 chronic condition, the odds of being (low or very low) food insecure was 1.09 to 4.07 times higher for those with 2, or ≥ 3 chronic conditions (all p < 0.0001). The severity of food insecurity significantly increased as the number of chronic conditions increased (p for trend < 0.0001). Besides, COVID-infected participants were 82% more likely to be very low food secure than the non-infected participants (AOR = 1.82, 95% CI: 1.80, 1.84). CONCLUSIONS The presence of chronic conditions or positive COVID-infection is independently associated with household food insecurity. Clinical health professionals may help identify and assist individuals at risk of food insecurity. Management and improvement of health conditions may help reduce the prevalence and severity of food insecurity in the older population.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, USA.
| | - Aurelian Bidulescu
- grid.411377.70000 0001 0790 959XDepartment of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN USA
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Household Food Insufficiency and Chronic Pain among Children in the US: A National Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020185. [PMID: 36832314 PMCID: PMC9954897 DOI: 10.3390/children10020185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023]
Abstract
This study aimed to determine the prevalence of pediatric chronic pain by household food sufficiency status and examine whether food insufficiency would be associated with greater risk for chronic pain. We analyzed data from the 2019-2020 National Survey of Children's Health of 48,410 children (6-17 years) in the United States. Across the sample, 26.1% (95% CI: 25.2-27.0) experienced mild food insufficiency and 5.1% (95% CI: 4.6-5.7) moderate/severe food insufficiency. The prevalence of chronic pain was higher among children with mild (13.7%) and moderate/severe food insufficiency (20.6%) relative to children in food-sufficient households (6.7%, p < 0.001). After adjusting for a priori covariates (individual: age, sex, race/ethnicity, anxiety, depression, other health conditions, adverse childhood events; household: poverty, parent education, physical and mental health; community: region of residence), multivariable logistic regression revealed that children with mild food insufficiency had 1.6 times greater odds of having chronic pain (95% CI: 1.4-1.9, p < 0.0001) and those with moderate/severe food insufficiency, 1.9 higher odds (95% CI: 1.4-2.7, p < 0.0001) relative to food-sufficient children. The dose-response relationship between food insufficiency and childhood chronic pain highlights the importance of further research to identify underlying mechanisms and evaluate the impact of food insufficiency on the onset and persistence of chronic pain across the lifespan.
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23
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Kim-Mozeleski JE, Pike Moore SN, Trapl ES, Perzynski AT, Tsoh JY, Gunzler DD. Food Insecurity Trajectories in the US During the First Year of the COVID-19 Pandemic. Prev Chronic Dis 2023; 20:E03. [PMID: 36657063 PMCID: PMC9856052 DOI: 10.5888/pcd20.220212] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The objective of this study was to characterize population-level trajectories in the probability of food insecurity in the US during the first year of the COVID-19 pandemic and to examine sociodemographic correlates associated with identified trajectories. METHODS We analyzed data from the Understanding America Study survey, a nationally representative panel (N = 7,944) that assessed food insecurity every 2 weeks from April 1, 2020, through March 16, 2021. We used latent class growth analysis to determine patterns (or classes) of pandemic-related food insecurity during a 1-year period. RESULTS We found 10 classes of trajectories of food insecurity, including 1 class of consistent food security (64.7%), 1 class of consistent food insecurity (3.4%), 5 classes of decreasing food insecurity (15.8%), 2 classes of increasing food insecurity (4.6%), and 1 class of stable but elevated food insecurity (11.6%). Relative to the class that remained food secure, other classes were younger, had a greater proportion of women, and tended to identify with a racial or ethnic minority group. CONCLUSION We found heterogeneous longitudinal patterns in the development, resolution, or persistence of food insecurity during the first year of the COVID-19 pandemic. Experiences of food insecurity were highly variable across the US population, with one-third experiencing some form of food insecurity risk. Findings have implications for identifying population groups who are at increased risk of food insecurity and related health disparities beyond the first year of the pandemic.
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Affiliation(s)
- Jin E. Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Stephanie N. Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Erika S. Trapl
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Adam T. Perzynski
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio
| | - Janice Y. Tsoh
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Douglas D. Gunzler
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio
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Muacevic A, Adler JR. Racial Disparity and Trend of Food Scarcity Amid COVID-19 Pandemic in the United States. Cureus 2023; 15:e33232. [PMID: 36733557 PMCID: PMC9889840 DOI: 10.7759/cureus.33232] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 01/04/2023] Open
Abstract
An increase in households with food insecurity has been reported during the COVID-19 pandemic, but the trend of food insecurity during the pandemic remains unclear. Using Household Pulse Survey (HPS) data over 34 weeks from June 2020 to September 2021 (nationally representative samples of US adults in the households from the US Census Bureau), we examined racial disparity and trends of food scarcity amid the COVID-19 pandemic. The time series plots illustrated that the food scarcity rate was incremental until December 2020 and began improving thereafter across all racial groups. Such improvements in food scarcity were accompanied by the rise in regular income rates while the use of food assistance programs, unemployment insurance, and stimulus payments remained unchanged or reduced. As the US economy recovered, the gaps in food scarcity rates also narrowed between Black/Hispanic and White households.
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Jung JH, Choi KW, Kim HHS. Examining the Complex (Curvilinear and Contingent) Associations between Social Distancing Compliance and Subjective Health during a Global Health Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16058. [PMID: 36498132 PMCID: PMC9738174 DOI: 10.3390/ijerph192316058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This study investigated a potential curvilinear link between social distancing behavior and subjective health in later life. It also evaluated whether food insecurity and community social capital moderated the focal relationship. METHODS Data were drawn from three waves of the COVID Impact Survey (N = 19,234). Mixed-effects models were fitted. RESULTS Social distancing has a non-monotonic (U-shaped) relationship with subjective health, i.e., individuals with low and high levels of social distancing show relatively better health. Moreover, the negative linear relationship between social distancing and health is weaker among people suffering from food insecurity as well as those living in communities with lower stocks of social capital. DISCUSSION This study sheds new light on the health implications of social distancing during the pandemic. Our findings dovetail with the steeling hypothesis, i.e., that social distancing is less harmful for U.S. older adults exposed to prior stressful or vulnerable conditions.
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Affiliation(s)
- Jong Hyun Jung
- Department of Sociology, Sungkyunkwan University, Seoul 03063, Republic of Korea
| | - Kyung Won Choi
- Department of Sociology, University of Chicago, Chicago, IL 60637, USA
| | - Harris Hyun-soo Kim
- Department of Sociology, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Republic of Korea
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Obesity in Adolescents: Understanding the Combined Role of Food Security and Emotional and Behavioral Disorders. J Adolesc Health 2022; 71:502-507. [PMID: 35739006 DOI: 10.1016/j.jadohealth.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/16/2022] [Accepted: 05/02/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the associations and interactions between levels of food security and emotional and behavioral disorders with obesity in adolescents. METHODS Multiple logistic regression modeling was used to analyze the association of adolescent obesity with levels of food security and emotional and behavior disorders in children aged 12-17 years using data from National Health Interview Survey 2016-2018 combined years. Presence of emotional and behavioral disorders within food security categories was added to logistic regression modeling to examine interactions. RESULTS When added individually to multiple logistic regression models, marginal and low food security, Attention Deficit Hyperactivity Disorder (ADHD) and anxiety were associated with increased odds of obesity, but very low food security and depression were not. Within the group of adolescents with very low food security, those with anxiety, depression, or ADHD had a nearly two to three-fold increase in odds of obesity compared to adolescents with very low food security and no emotional and behavioral disorders. A similar increase in the odds of obesity with the presence of anxiety, depression, or ADHD was not seen in the adolescents with high food security. DISCUSSION This study finds a significant interaction between food security level and emotional and behavioral disorders. The distinction that very low food security in adolescents is only associated with obesity when either anxiety, depression or ADHD are present, but not independently, is an important contribution to understanding complex interactions contributing to obesity.
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Wolfson JA, Posluszny H, Kronsteiner-Gicevic S, Willett W, Leung CW. Food Insecurity and Less Frequent Cooking Dinner at Home Are Associated with Lower Diet Quality in a National Sample of Low-Income Adults in the United States during the Initial Months of the Coronavirus Disease 2019 Pandemic. J Acad Nutr Diet 2022; 122:1893-1902.e12. [PMID: 35569728 PMCID: PMC9186786 DOI: 10.1016/j.jand.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Food insecurity is a critical public health problem in the United States that has been associated with poor diet quality. Cooking dinner more frequently is associated with better diet quality. OBJECTIVE This study aimed to examine how food insecurity and dinner cooking frequency are associated with diet quality during the initial months of the coronavirus disease 2019 pandemic. DESIGN This cross-sectional study analyzed data from a national web-based survey (June 23 to July 1, 2020). PARTICIPANTS/SETTING Participants were 1,739 low-income (<250% of the federal poverty level) adults in the United States. MAIN OUTCOME MEASURES The outcome was diet quality, measured by the Prime Diet Quality Score (PDQS-30D). The PDQS-30D is a food frequency questionnaire-based, 22-component diet quality index. STATISTICAL ANALYSES PERFORMED Food security status (high, marginal, low, or very low) and frequency of cooking dinner (7, 5 to 6, 3 to 4, or 0 to 2 times/week) were evaluated in relation to PDQS-30D scores (possible range = zero to 126) in age- and sex and gender-, and fully adjusted linear regression models. Postestimation margins were used to predict mean PDQS-30D score by food security status and dinner cooking frequency. The interaction between food security status and frequency of cooking dinner was also tested. RESULTS Overall, the mean PDQS-30D score was 51.9 ± 11 points (possible range = zero to 126). The prevalence of food insecurity (low/very low) was 43%, 37% of the sample cooked 7 times/week and 15% cooked 0 to 2 times/week. Lower food security and less frequent cooking dinner were both associated with lower diet quality. Very low food security was associated with a 3.2-point lower PDQS-30D score (95% CI -4.6 to -1.8) compared with those with high food security. Cooking dinner 0 to 2 times/week was associated with a 4.4-point lower PDQS-30D score (95% CI -6.0 to -2.8) compared with cooking 7 times/week. The relationship between food insecurity and diet quality did not differ based on cooking dinner frequency. CONCLUSIONS During the initial months of the coronavirus disease 2019 pandemic food insecurity and less frequently cooking dinner at home were both associated with lower diet quality among low-income Americans. More research is needed to identify and address barriers to low-income households' ability to access, afford and prepare enough nutritious food for a healthy diet.
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Affiliation(s)
- Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Hannah Posluszny
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Walter Willett
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
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Green NS, Manwani D, Smith‐Whitley K, Aygun B, Appiah‐Kubi A, Smaldone AM. Mental health assessment of youth with sickle cell disease and their primary caregivers during the COVID-19 pandemic. Pediatr Blood Cancer 2022; 69:e29797. [PMID: 35614571 PMCID: PMC9348143 DOI: 10.1002/pbc.29797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/21/2022] [Accepted: 05/06/2022] [Indexed: 11/07/2022]
Abstract
Youth with sickle cell disease (SCD) and their caregivers are susceptible to stress and depression, perhaps exacerbated by pandemic-associated health and economic concerns. Most of the 50 youth-caregiver dyads enrolled in the multisite trial, Hydroxyurea Adherence for Personal Best in Sickle Cell Treatment (HABIT), took an online survey of self-reported mental health symptoms and food insecurity during the 2020 COVID-19 pandemic. Compared to largely pre-pandemic results, prevalence of mental health symptoms in dyad members appeared to have shifted: fewer youth and more caregivers were affected during the pandemic; many of both groups lacked optimism. Pandemic/post-pandemic screening of youth with SCD for mental health symptoms and food insecurity appears warranted.
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Affiliation(s)
- Nancy S. Green
- Division of Hematology, Oncology and Stem Cell Transplantation, Department of PediatricsColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Deepa Manwani
- Division of Hematology and Oncology, Department of PediatricsAlbert Einstein College of MedicineNew YorkNew YorkUSA
| | - Kim Smith‐Whitley
- Division of Hematology and Oncology and Stem cell transplantationChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - Banu Aygun
- Division of Hematology and Oncology and Cellular TherapyCohen Children's Medical CenterNew Hyde ParkNew YorkUSA
| | - Abena Appiah‐Kubi
- Division of Hematology and Oncology and Cellular TherapyCohen Children's Medical CenterNew Hyde ParkNew YorkUSA
| | - Arlene M. Smaldone
- School of Nursing and College of Dental MedicineColumbia University Irving Medical CenterNew YorkNew YorkUSA
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Lee H, Singh GK. Food Insecurity–Related Interventions and Mental Health Among US Adults During the COVID-19 Pandemic, April 2020 through August 2021. Public Health Rep 2022; 137:1187-1197. [PMID: 35993183 PMCID: PMC9548446 DOI: 10.1177/00333549221110294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: Financial hardships, job losses, and social isolation during the COVID-19 pandemic have increased food insecurity. We examined associations between food insecurity–related interventions and mental health among US adults aged ≥18 years from April 2020 through August 2021. Methods: We pooled data from the Household Pulse Survey from April 2020 through August 2021 (N = 2 253 567 adults). To estimate associations between mental health and food insecurity, we examined the following interventions: the Supplemental Nutrition Assistance Program (SNAP), Economic Impact Payments (stimulus funds), unemployment insurance, and free meals. We calculated psychological distress index (PDI) scores (Cronbach α = 0.91) through principal components analysis using 4 mental health variables: depression, anxiety, worry, and lack of interest (with a standardized mean score [SD] = 100 [20]). We conducted multivariable linear regression to estimate the interactive effects of the intervention and food insecurity on psychological distress, controlling for sociodemographic characteristics. Results: During the study period, adults with food insecurity had higher mean PDI scores than adults without food insecurity. Food insecurity was associated with increased PDI scores after controlling for sociodemographic characteristics. In stratified models, negative associations between food insecurity and mental health (as shown by reductions in PDI scores) were mitigated by SNAP (−4.5), stimulus fund (−4.1), unemployment insurance (−4.4), and free meal (−4.4) interventions. The mitigation effects of interventions on PDI were greater for non-Hispanic White adults than for non-Hispanic Black or Asian adults. Conclusions: Future research on food insecurity and mental health should include investigations on programs and policies that could be of most benefit to racial and ethnic minority groups.
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Affiliation(s)
- Hyunjung Lee
- Department of Public Policy and Public Affairs, John McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, Boston, MA, USA
| | - Gopal K. Singh
- Center for Global Health and Health Policy, Global Health and Education Projects, Inc, Riverdale, MD, USA
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Role of social determinants in anxiety and depression symptoms during COVID-19: A longitudinal study of adults in North Carolina and Massachusetts. Behav Res Ther 2022; 154:104102. [PMID: 35561644 PMCID: PMC9056067 DOI: 10.1016/j.brat.2022.104102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 12/15/2022]
Abstract
Trajectory studies of the COVID-19 pandemic have described patterns of symptoms over time. Yet, few have examined whether social determinants of health predict the progression of depression and anxiety symptoms during COVID-19 or identified which social determinants worsen symptom trajectories. Using a racially, ethnically, and linguistically diverse sample of adults participating in a randomized clinical trial with pre-existing moderate to severe depression and/or anxiety symptoms, we compare symptom patterns before and during COVID-19; characterize symptom trajectories over a 20-week follow-up period; and evaluate whether social determinants are associated with within- and between- person differences in symptom trajectories. Data were collected before and during COVID-19 in Massachusetts and North Carolina. On average, depression and anxiety symptoms did not seem to worsen during the pandemic compared to pre-pandemic. During COVID-19, anxiety scores at follow-up were higher for participants with baseline food insecurity (vs no food insecurity). Depression scores at follow-up were higher for participants with food insecurity and for those with utilities insecurity (vs no insecurity). Participants with child or family care responsibilities at baseline had depression symptoms decreasing at a slower rate than those without these responsibilities. We discuss the important implications of these findings.
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A Qualitative Investigation of the Experiences of Tobacco Use among U.S. Adults with Food Insecurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127424. [PMID: 35742673 PMCID: PMC9223458 DOI: 10.3390/ijerph19127424] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/30/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022]
Abstract
Background: Low-income U.S. adults experiencing food insecurity have a disproportionately high prevalence of cigarette smoking, and quantitative studies suggest that food insecurity is a barrier to quitting. To guide effective tobacco control strategies, this study aimed to understand the experiences, perceptions, and context of tobacco use and cessation among low-income populations experiencing food insecurity. Methods: We conducted in-depth, semi-structured interviews with 23 adults who were currently smoking cigarettes and were experiencing food insecurity, mostly living in rural settings. Participants were recruited through food-pantry-based needs assessment surveys and study flyers in community-based organizations. The interview guide explored participants’ histories of smoking, the role and function of tobacco in their lives, their interest in and barriers to quitting, as well as lived experiences of food insecurity. We used reflexive thematic analysis to analyze transcribed interviews. Results: Within a broader context of structural challenges related to poverty and financial strain that shaped current smoking behavior and experiences with food insecurity, we identified the following five themes: smoking to ignore hunger or eat less; staying addicted to smoking in the midst of instability; smoking being prioritized in the midst of financial strain; life stressors and the difficulty of quitting smoking and staying quit; and childhood adversity at the intersection of food insecurity and tobacco use. Conclusion: The context of tobacco use among adults with food insecurity was highly complex. To effectively address tobacco-related disparities among those who are socially and economically disadvantaged, tobacco control efforts should consider relevant lived experiences and structural constraints intersecting smoking and food insecurity. Findings are applied to a conceptualization of clustering of conditions contributing to nicotine dependence, food insecurity, and stress.
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Hunger relief: A natural experiment from additional SNAP benefits during the COVID-19 pandemic. LANCET REGIONAL HEALTH. AMERICAS 2022; 10:100224. [PMID: 35284905 PMCID: PMC8901427 DOI: 10.1016/j.lana.2022.100224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background COVID-19 has directly affected millions of people. Others have been indirectly affected; for example, there has been a startling increase in hunger brought about by the pandemic. Many countries have sought to relieve this problem through public policy. This research examines the effectiveness of enhanced Supplemental Nutrition Assistance Program (SNAP) benefits in the U.S. to alleviate hunger. Methods Using a biweekly cross-sectional survey and corresponding population weights from the U.S. Census Bureau, we estimate the effects of enhanced SNAP benefits on hunger in the U.S. as measured by food insufficiency. We use a Bayesian structural time series analysis to predict counterfactual values of food insufficiency. We supplement these findings by examining the effect of enhanced SNAP benefits on observed visits to a food pantry network in a midsized U.S. city. Findings Our primary finding estimates that nationwide a total 850,000 (95% credible interval 0·24–1·46 million) instances of food insufficiency were prevented per week by the 15 percent increase in SNAP benefits enacted in January 2021. Secondarily, we find similar effects associated with SNAP benefit increases and local food pantry visits. Specifically, enhanced SNAP benefits resulted in fewer visits to the food pantry network than were predicted in the counterfactual model. Interpretation These results not only indicate that the policies enacted to mitigate hunger caused by the COVID-19 pandemic helped, but also quantifies how much these benefits helped on a national scale. As a result, policymakers can use this data to benchmark future policy actions at scale. Funding None.
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Marchionatti LE, Caye A, Kieling C. The mental health of children and young people living in big cities in a revolving postpandemic world. Curr Opin Psychiatry 2022; 35:200-206. [PMID: 35579874 DOI: 10.1097/yco.0000000000000769] [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: 11/26/2022]
Abstract
PURPOSE OF REVIEW The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structures living conditions. In this sense, it is timely to discuss what are the social and structural determinants of mental health of children and young people in such settings. RECENT FINDINGS Three domains of determinants of mental health were selected for discussion: economics and living conditions, crime and violence, and urban layouts. For each, we debated realities faced by urban children and young people, providing an overview of recent evidence on implications for mental disorders and well being. We also discuss the potential impacts of the covid-19 pandemic on each domain, as well as recommendations for future action. SUMMARY Structural factors are of major relevance for the mental health of children and young people living in cities. The agenda of mental health promotion and prevention must include whole-of-society interventions aimed at improving living conditions, including economic and social capital, violence prevention and urbanistic planning.
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Affiliation(s)
| | - Arthur Caye
- Department of Psychiatry
- Child and Adolescent Psychiatry Division, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Christian Kieling
- Department of Psychiatry
- Child and Adolescent Psychiatry Division, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Experiences of increased food insecurity, economic and psychological distress during the COVID-19 pandemic among Supplemental Nutrition Assistance Program-enrolled food pantry clients. Public Health Nutr 2022; 25:1027-1037. [PMID: 34865672 PMCID: PMC8712963 DOI: 10.1017/s1368980021004717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The COVID-19 pandemic initially doubled the rates of food insecurity across the USA and tripled rates among households with children. Despite the association among food insecurity, chronic disease and psychological distress, narratives depicting the experiences of already food insecure populations are notably underrepresented in the literature. The current study assessed the impact of COVID-19 on clients of a food pantry who were also enrolled in the Supplemental Nutrition Assistance Program (SNAP). DESIGN A qualitative study probing the effects of the pandemic on daily living, food needs, food buying and food insecurity. Interview transcripts were analysed using a combined deductive and inductive approach. SETTING Interviews were conducted via telephone between May and June of 2020. PARTICIPANTS Equal numbers of English- and Spanish-speaking clients (n 40 total). RESULTS Three main findings emerged: (1) the pandemic increased economic distress, such as from job loss or increased utility bills due to sustained home occupancy and (2) the pandemic increased food needs, food prices and food shortages. In combination with economic stressors, this led to greater food insecurity; (3) increased economic stress and food insecurity contributed to increased psychological stress, such as from fear of infection, isolation and children being confined at home. CONCLUSIONS Despite federal legislation and state and local programmes to alleviate food insecurity, COVID-19 exacerbated economic hardship, food insecurity and psychological distress among urban SNAP and food pantry clients. Additional research is needed to identify the most effective policies and programmes to ameliorate the short- and long-term health and economic inequities exacerbated by the pandemic.
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Nagata JM, Ganson KT, Bonin SL, Twadell KL, Garcia ME, Langrock O, Vittinghoff E, Tsai AC, Weiser SD, Abdel Magid HS. Prevalence and Sociodemographic Correlates of Unmet Need for Mental Health Counseling Among Adults During the COVID-19 Pandemic. Psychiatr Serv 2022; 73:206-209. [PMID: 34189929 PMCID: PMC8716612 DOI: 10.1176/appi.ps.202100111] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to determine the prevalence and correlates of unmet need for mental health counseling among U.S. adults during the COVID-19 pandemic. METHODS Data from the December 9-21, 2020, cross-sectional Household Pulse Survey (N=69,944) were analyzed. RESULTS Overall, 12.8% of adults reported an unmet need for mental health counseling in the past month, including 25.2% of adults with a positive screen for depression or anxiety. Among adults with a positive screen, risk factors associated with an unmet need for mental health counseling included female sex, younger age, income below the federal poverty line, higher education, and household job loss during the pandemic, while protective factors included Asian and Black race. CONCLUSIONS Over one-quarter of U.S. adults with a positive screen for depression or anxiety experienced an unmet need for mental health counseling during the pandemic. Policy makers should consider increasing funding for mental health services as part of pandemic relief legislation.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Sydell L. Bonin
- Public Health Sciences Program, Santa Clara University, Santa Clara, CA, USA
| | - Kaitlyn L. Twadell
- Public Health Sciences Program, Santa Clara University, Santa Clara, CA, USA
| | - Maria E. Garcia
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Olivia Langrock
- Public Health Sciences Program, Santa Clara University, Santa Clara, CA, USA
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Alexander C. Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Sheri D. Weiser
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Hoda S. Abdel Magid
- Public Health Sciences Program, Santa Clara University, Santa Clara, CA, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
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Thorndike AN, Fung V, McCurley JL, Clark CR, Howard S, Levy DE. COVID-19 stressors and one-year changes in depression and anxiety in a longitudinal cohort of low-income adults in the United States. Prev Med Rep 2022; 26:101730. [PMID: 35155086 PMCID: PMC8824255 DOI: 10.1016/j.pmedr.2022.101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/23/2021] [Accepted: 02/06/2022] [Indexed: 11/17/2022] Open
Abstract
Emerging data suggest that adults with low income are at highest risk for COVID-19-related stressors and mental health disorders. This study aimed to determine if COVID-19-related stressors were associated with worsening depression and anxiety in a cohort of low-income adults one year after the start of the pandemic. Participants included 253 Medicaid and commercial accountable care organization recipients from 5 community health centers around Boston, MA who enrolled December 2019-March 2020 in a larger longitudinal study of a Medicaid program. Participants completed surveys at baseline and one-year follow-up that measured depression (Patient Health Questionnaire-8 [PHQ-8]) and anxiety (Generalized Anxiety Disorder-7 [GAD-7]) symptoms. Follow-up surveys assessed COVID-19-related stressors experienced over the prior 12 months. A stressor score included COVID-19-related infectious, social, and economic stressors categorized into tertiles (low, 0–3; medium, 4–6; high, 7–19). Mean age (SD) was 45.2 (11.5) years; 71.2% were female, 42.3% Hispanic and 14.6% Black. At baseline, 126 (49.8%) had moderate or severe depression (PHQ-8 ≥ 10), and 109 (43.1%) had moderate or severe anxiety (GAD-7 ≥ 10). The mean (SD) number of COVID-19 stressors was 4.9 (3.1); the most frequent were food insecurity (52.2%) and job or income loss (43.9%). Compared to the low tertile, those in high and medium tertiles had significantly greater one-year increases in depression and anxiety symptoms. Low-income adults facing multiple COVID-19-related stressors, particularly health-related social needs, had worsening mental health symptoms over one year. Interventions are urgently needed to address the dual burden of health-related social needs and poor mental health exacerbated by COVID-19.
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Ku L. The Association of Social Factors and Health Insurance Coverage with COVID-19 Vaccinations and Hesitancy, July 2021. J Gen Intern Med 2022; 37:409-414. [PMID: 34845582 PMCID: PMC8629592 DOI: 10.1007/s11606-021-07213-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/08/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND There are racial differences in COVID-19 vaccination rates, but social factors, such as lack of health insurance or food insecurity, may explain some of the racial disparities. OBJECTIVE To assess social factors, including insurance coverage, that may affect COVID-19 vaccination as of June-July 2021 and vaccine hesitancy among those not yet vaccinated, and how these may affect racial equity in vaccinations. DESIGN Cross-sectional analysis of nationally representative survey data. PARTICIPANTS Adults 18 to 64 participating in the Census Bureau's Household Pulse Survey for June 23 to July 5, 2021. MAIN MEASURES Vaccination: receipt of at least one dose of a COVID-19 vaccine. Vaccine hesitancy: among those not yet vaccinated, intent to definitely or probably not get vaccinated. KEY RESULTS In unadjusted analyses, black adults were less likely to be vaccinated than other respondents, but, after social factors were included, including health insurance status, food sufficiency, income and education, and state-level political preferences, differences between black and white adults were no longer significant and Hispanics were more likely to be vaccinated (OR = 1.87, p < .001). Among those not yet vaccinated, black and Hispanic adults were vaccine hesitant than white adults (ORs = .37 and .45, respectively, both p < .001) and insurance status and food insufficiency were not significantly associated with vaccine hesitancy. The percent of state voters for former President Trump in 2020 was significantly associated with lower vaccination rates and with increased vaccine hesitancy. DISCUSSION The results indicate that much of the gap in COVID vaccination rates for minority adults are due to social barriers, rather than differences in racial attitudes. Unvaccinated minority adults expressed less vaccine hesitancy than white adults. Social barriers like food insecurity and insurance coverage could have deterred prompt COVID-19 vaccinations. Reducing these problems might help increase vaccination rates.
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Affiliation(s)
- Leighton Ku
- Dept of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
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Nagata JM, Ganson KT, Cattle CJ, Whittle HJ, Tsai AC, Weiser SD. Food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic. Public Health Nutr 2022; 25:76-81. [PMID: 34261566 PMCID: PMC8367866 DOI: 10.1017/s1368980021003001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/18/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate the association between food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic. DESIGN Cross-sectional study. Multiple logistic regression models were used to estimate the associations between food insufficiency and mental health service utilisation. SETTING US Census Household Pulse Survey data collected in October 2020. PARTICIPANTS Nationally representative sample of 68 611 US adults. RESULTS After adjusting for sociodemographic factors, experiencing food insufficiency was associated with higher odds of unmet mental health need (adjusted OR (AOR) 2·90; 95 % CI 2·46, 3·43), receiving mental health counselling or therapy (AOR 1·51; 95 % CI 1·24, 1·83) and psychotropic medication use (AOR 1·56; 95 % CI 1·35, 1·80). Anxiety and depression symptoms mediated most of the association between food insufficiency and unmet mental health need but not the associations between food insufficiency and either receiving mental health counselling/therapy or psychotropic medication use. CONCLUSIONS Clinicians should regularly screen patients for food insufficiency, especially in the wake of the COVID-19 pandemic. Expanding access to supplemental food programmes may help to mitigate the need for higher mental health service utilisation during the COVID-19 pandemic.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA94158, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Chloe J Cattle
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA94158, USA
| | - Henry J Whittle
- Division of Psychiatry, University College London, London, UK
| | - Alexander C Tsai
- Center for Global Health, Mongan Institute, Massachusetts General Hospital; Harvard Medical School, Boston, MA, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Rogus S, Coakley KE, Martin S, Gonzales-Pacheco D, Sroka CJ. Food Security, Access, and Challenges in New Mexico during COVID-19. Curr Dev Nutr 2022; 6:nzab139. [PMID: 35047719 PMCID: PMC8758401 DOI: 10.1093/cdn/nzab139] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/18/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) pandemic disrupted food systems and economies across the United States. Public health measures, including stay-at-home orders, led to employment disruptions and food system shocks that increased barriers to food access. OBJECTIVES We aimed to examine food insecurity and food access challenges in New Mexico (NM) during the COVID-19 pandemic. METHODS A cross-sectional study using a validated survey was conducted in NM in May and June 2020. Adults 18 y and older were recruited through convenience sampling via email, websites, and targeted social media ads from major universities, nongovernmental organizations, state agencies, and media outlets. Survey questions assessed food insecurity and food-related challenges and worry. Bivariate and multivariate logistic regression examined relations between food insecurity and demographic characteristics. z Tests were used to compare the proportions of individuals who responded affirmatively to food challenge and worry questions between food-secure and food-insecure respondents. RESULTS A total of 1487 residents participated in the study. Thirty percent of respondents reported experiencing food insecurity and 16% experienced very low food security since the pandemic started. Food insecurity was associated with each of 7 characteristics examined in bivariate logistic regression analyses. Multivariate logistic regression results showed that Hispanic (adjusted OR: 1.70; 95% CI: 1.18, 2.44) and female (adjusted OR: 1.78; 95% CI: 1.09, 2.90) respondents were more likely to experience food insecurity than non-Hispanic white and male respondents. Larger household sizes were associated with higher odds of food insecurity except for those in the lowest and highest income categories. z Tests showed that a higher proportion of food-insecure respondents experienced food-related challenges and worry than food-secure respondents. CONCLUSIONS Disparities in food insecurity persisted during the COVID-19 pandemic and food-insecure individuals were more likely to report experiencing food-related challenges and worry. Researchers and policy makers in NM may consider continuing efforts to mitigate food access issues as the pandemic continues.
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Affiliation(s)
- Stephanie Rogus
- Department of Family and Consumer Sciences, New Mexico State University, Las Cruces, NM, USA
| | - Kathryn E Coakley
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, USA
| | - Shadai Martin
- Department of Family and Consumer Sciences, New Mexico State University, Las Cruces, NM, USA
| | - Diana Gonzales-Pacheco
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, USA
| | - Christopher J Sroka
- Department of Economics, Applied Statistics and International Business, New Mexico State University, Las Cruces, NM, USA
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Food Security, Financial Resources, and Mental Health: Evidence during the COVID-19 Pandemic. Nutrients 2021; 14:nu14010161. [PMID: 35011036 PMCID: PMC8746951 DOI: 10.3390/nu14010161] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 11/30/2022] Open
Abstract
COVID-19 has negatively impacted many households’ financial well-being, food security, and mental health status. This paper investigates the role financial resources play in understanding the relationship between food security and mental health among U.S. households using data from a survey in June 2020. Results show job loss and savings draw down to pay for household bills had a significant relationship with both lower food security and greater numbers of poor mental health days during the pandemic.
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Differences in COVID-19 Risk by Race and County-Level Social Determinants of Health among Veterans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413140. [PMID: 34948748 PMCID: PMC8701661 DOI: 10.3390/ijerph182413140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/04/2021] [Accepted: 12/05/2021] [Indexed: 11/17/2022]
Abstract
COVID-19 disparities by area-level social determinants of health (SDH) have been a significant public health concern and may also be impacting U.S. Veterans. This retrospective analysis was designed to inform optimal care and prevention strategies at the U.S. Department of Veterans Affairs (VA) and utilized COVID-19 data from the VAs EHR and geographically linked county-level data from 18 area-based socioeconomic measures. The risk of testing positive with Veterans’ county-level SDHs, adjusting for demographics, comorbidities, and facility characteristics, was calculated using generalized linear models. We found an exposure–response relationship whereby individual COVID-19 infection risk increased with each increasing quartile of adverse county-level SDH, such as the percentage of residents in a county without a college degree, eligible for Medicaid, and living in crowded housing.
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Social and Behavioral Impacts of COVID-19 on People Living with HIV: Review of the First Year of Research. Curr HIV/AIDS Rep 2021; 19:54-75. [PMID: 34826067 PMCID: PMC8617547 DOI: 10.1007/s11904-021-00593-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/25/2022]
Abstract
Purpose of the Review The SARS-CoV-2 (COVID-19) pandemic brought unprecedented social change with the most severe impacts on the most vulnerable populations, including people living with HIV (PLWH). This review examined findings from empirical studies of social and behavioral impacts of COVID-19 on PLWH in the first year of the pandemic. Recent Findings Impacts of COVID-19 on PLWH fit within an HIV syndemics framework, with overlapping COVID-19 and HIV comorbid conditions concerning mental health and structural inequality. Early impacts of COVID-19 on social isolation, emotional distress, stigma, and substance use varied across studies with few consistent patterns. Structural inequalities, particularly impacts on food security and housing stability, were observed more consistently and globally. Summary COVID-19 intersects with HIV infection along with multiple interlocking comorbidities that are best characterized and understood within a syndemics framework.
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Goode RW, Watson HJ, Masa R, Bulik CM. Prevalence and contributing factors to recurrent binge eating and obesity among black adults with food insufficiency: findings from a cross-sectional study from a nationally-representative sample. J Eat Disord 2021; 9:154. [PMID: 34823600 PMCID: PMC8620158 DOI: 10.1186/s40337-021-00509-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/12/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Living in a food-insecure or food insufficient household may increase risk for binge eating and obesity. Because racial disparities in food access, obesity, and access to treatment for disordered eating exist, it is important to examine these relationships in Black populations. METHODS We conducted a secondary analysis of data from the National Survey of American Life (N = 4553), a nationally-representative sample of Black Americans, including African Americans and Afro-Caribbeans. Logistic regression was used to explore the association of food insufficiency with obesity and binge eating. RESULTS In the total sample of Black Americans, the prevalence of food insufficiency was 10.9% (95% CI 10.0-11.8%). Food insufficiency was not significantly associated with obesity in Black Americans, but when associations were explored in analyses stratified by ethnicity and sex, food insufficiency significantly predicted an increased odds of obesity in Afro-Caribbeans (odds ratio [OR] = 1.47, 95% CI 1.01, 2.13). Individuals experiencing food insufficiency were more likely to report recurrent binge eating in the last 12 months (3% v 2%, P = 0.02) and a lifetime history of binge eating (6% v 3%, P = 0.004) compared to those who were food sufficient. After adjusting for socio-demographic factors, food insufficiency was not significantly associated with recurrent binge eating in Black Americans or in sex- and ethnicity-stratified analyses. CONCLUSION The present study reveals a more complex relation between food insufficiency and binge eating than previously thought-although an association existed, it was attenuated by an array of sociodemographic factors. Our results also underscore the importance of considering ethnicity as different patterns emerged between African American and Afro-Caribbean participants.
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Affiliation(s)
- Rachel W Goode
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB #3550, Chapel Hill, NC, 27599, USA.
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hunna J Watson
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Australia
| | - Rainier Masa
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB #3550, Chapel Hill, NC, 27599, USA
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Liu L, Ni SY, Yan W, Lu QD, Zhao YM, Xu YY, Mei H, Shi L, Yuan K, Han Y, Deng JH, Sun YK, Meng SQ, Jiang ZD, Zeng N, Que JY, Zheng YB, Yang BN, Gong YM, Ravindran AV, Kosten T, Wing YK, Tang XD, Yuan JL, Wu P, Shi J, Bao YP, Lu L. Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: A systematic review, meta-analysis and call for action. EClinicalMedicine 2021; 40:101111. [PMID: 34514362 PMCID: PMC8424080 DOI: 10.1016/j.eclinm.2021.101111] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has evolved into a worldwide pandemic, and has been found to be closely associated with mental and neurological disorders. We aimed to comprehensively quantify the association between mental and neurological disorders, both pre-existing and subsequent, and the risk of susceptibility, severity and mortality of COVID-19. METHODS In this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, PsycINFO, and Cochrane library databases for studies published from the inception up to January 16, 2021 and updated at July 7, 2021. Observational studies including cohort and case-control, cross-sectional studies and case series that reported risk estimates of the association between mental or neurological disorders and COVID-19 susceptibility, illness severity and mortality were included. Two researchers independently extracted data and conducted the quality assessment. Based on I2 heterogeneity, we used a random effects model to calculate pooled odds ratios (OR) and 95% confidence intervals (95% CI). Subgroup analyses and meta-regression analysis were also performed. This study was registered on PROSPERO (registration number: CRD 42021230832). FINDING A total of 149 studies (227,351,954 participants, 89,235,737 COVID-19 patients) were included in this analysis, in which 27 reported morbidity (132,727,798), 56 reported illness severity (83,097,968) and 115 reported mortality (88,878,662). Overall, mental and neurological disorders were associated with a significant high risk of infection (pre-existing mental: OR 1·67, 95% CI 1·12-2·49; and pre-existing neurological: 2·05, 1·58-2·67), illness severity (mental: pre-existing, 1·40, 1·25-1·57; sequelae, 4·85, 2·53-9·32; neurological: pre-existing, 1·43, 1·09-1·88; sequelae, 2·17, 1·45-3·24), and mortality (mental: pre-existing, 1·47, 1·26-1·72; neurological: pre-existing, 2·08, 1·61-2·69; sequelae, 2·03, 1·66-2·49) from COVID-19. Subgroup analysis revealed that association with illness severity was stronger among younger COVID-19 patients, and those with subsequent mental disorders, living in low- and middle-income regions. Younger patients with mental and neurological disorders were associated with higher mortality than elders. For type-specific mental disorders, susceptibility to contracting COVID-19 was associated with pre-existing mood disorders, anxiety, and attention-deficit hyperactivity disorder (ADHD); illness severity was associated with both pre-existing and subsequent mood disorders as well as sleep disturbance; and mortality was associated with pre-existing schizophrenia. For neurological disorders, susceptibility was associated with pre-existing dementia; both severity and mortality were associated with subsequent delirium and altered mental status; besides, mortality was associated with pre-existing and subsequent dementia and multiple specific neurological diseases. Heterogeneities were substantial across studies in most analysis. INTERPRETATION The findings show an important role of mental and neurological disorders in the context of COVID-19 and provide clues and directions for identifying and protecting vulnerable populations in the pandemic. Early detection and intervention for neurological and mental disorders are urgently needed to control morbidity and mortality induced by the COVID-19 pandemic. However, there was substantial heterogeneity among the included studies, and the results should be interpreted with caution. More studies are needed to explore long-term mental and neurological sequela, as well as the underlying brain mechanisms for the sake of elucidating the causal pathways for these associations. FUNDING This study is supported by grants from the National Key Research and Development Program of China, the National Natural Science Foundation of China, Special Research Fund of PKUHSC for Prevention and Control of COVID-19, and the Fundamental Research Funds for the Central Universities.
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Affiliation(s)
- Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Shu-Yu Ni
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Qing-Dong Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Yi-Miao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Ying-Ying Xu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Huan Mei
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jia-Hui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Zheng-Dong Jiang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jian-Yu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Bei-Ni Yang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Yi-Miao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | | | - Thomas Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, United States
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Xiang-Dong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center and Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jun-Liang Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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Jackson M, Lee Williams J. COVID-19 mitigation policies and psychological distress in young adults. SSM - MENTAL HEALTH 2021; 2:100027. [PMID: 34608462 PMCID: PMC8482549 DOI: 10.1016/j.ssmmh.2021.100027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic has seen an unusually high proportion of the population suffering from mental health difficulties, but of particular concern is the disproportionate increase in psychological distress among younger adults. In this article, we exploit an explanatory sequential mixed-methods design to examine which aspects of the COVID-19 pandemic 18-25-year-olds found most challenging. We report analyses of American Voices Project (AVP) qualitative in-depth interview data, a MyVoice text-message open-ended survey, and Census Bureau Household Pulse Survey (HPS) data, all collected in 2020. Our interview and text-message results show that young adults were distressed about the effects of COVID-19 on the health of loved ones and older Americans. Young adults expressed concerns that the pandemic was not being treated sufficiently seriously by some politicians and the general public. The policy response was seen to be inadequate to the task of containing the disease, and some feared that the pandemic would never end. Statistical analyses of the HPS confirm that young adults' scores on the HPS's anxiety scale were significantly negatively associated with state-level policy responses. Overall, our results show that young adults found virus mitigation strategies challenging, but that a strong policy response was associated with reduced levels of psychological distress. Our results suggest that public health policy might have also operated as mental health policy during the COVID-19 pandemic.
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Affiliation(s)
- Michelle Jackson
- Department of Sociology, 450 Jane Stanford Way, Stanford University, CA, 94305, USA
| | - Joanna Lee Williams
- Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ, 08854-8020, USA
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Zheng S, Ngo AL, Forman MR, Barcellos AL, Liao L, Ferrara A, Zhu Y. Associations of household food insufficiency with childhood depression and anxiety: a nationwide cross-sectional study in the USA. BMJ Open 2021; 11:e054263. [PMID: 34493526 PMCID: PMC8424875 DOI: 10.1136/bmjopen-2021-054263] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Household food insufficiency (HFIS) is a major public health threat to children. Children may be particularly vulnerable to HFIS as a psychological stressor due to their rapid growth and accelerated behavioural and cognitive states, whereas data focusing on HFIS and childhood mental disorders are as-yet sparse. We aimed to examine the associations of HFIS with depression and anxiety in US children. DESIGN Cross-sectional study. SETTING The 2016-2018 National Survey of Children's Health, a nationally-representative study. PARTICIPANTS Primary caregivers of 102 341 children in the USA. PRIMARY AND SECONDARY OUTCOME MEASURES Physician diagnosed depression and anxiety were assessed by questionnaires administered to primary caregivers of 102 341 children. Multivariable logistic regression models estimated adjusted OR (aOR) for current depression or anxiety associated with HFIS measured through a validated single-item instrument. RESULTS Among children aged 3-17 years, 3.2% and 7.4% had parent-reported physician-diagnosed current depression and anxiety, respectively. Compared with children without HFIS, children with HFIS had approximately twofold higher weighted prevalence of anxiety or depression. After adjusting for covariates, children with versus without HFIS had a 1.53-fold (95% CI 1.15 to 2.03) and 1.48-fold (95% CI 1.20 to 1.82) increased odds of current depression and anxiety, respectively. Associations were slightly more pronounced among girls (aOR (95% CI): depression 1.69 (1.16 to 2.48); anxiety 1.78 (1.33 to 2.38)) than boys (1.42 (0.98 to 2.08); 1.32 (1.00 to 1.73); both P-for-interaction <0.01). The associations did not vary by children's age or race/ethnicity. CONCLUSIONS HFIS was independently associated with depression and anxiety among US children. Girls presented slightly greater vulnerability to HFIS in terms of impaired mental health. Children identified as food-insufficient may warrant mental health assessment and possible intervention. Assessment of HFIS among children with impaired mental health is also warranted. Our findings also highlight the importance of promptly addressing HFIS with referral to appropriate resources and inform its potential to alleviate childhood mental health issues.
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Affiliation(s)
- Siwen Zheng
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Amanda L Ngo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Michele R Forman
- Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Anna L Barcellos
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Lauren Liao
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Fink-Samnick E. The Social Determinants of Mental Health: Assessment, Intervention, and Wholistic Health Equity: Part 2. Prof Case Manag 2021; 26:224-241. [PMID: 34397650 DOI: 10.1097/ncm.0000000000000518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ellen Fink-Samnick
- Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CCTP, CMHIMP, CRP, DBH-C, is an award-winning industry thought leader who empowers the healthcare interprofessional workforce. She is a sought-out professional speaker, author, and educator for her innovative content and vibrant presence. Ellen is an international national expert on the social determinants of health and mental health, workplace bullying, professional ethics, professional case management practice, and Wholistic Case Management. Her recent books include The Essential Guide to Interprofessional Ethics for Healthcare Case Management, The Social Determinants of Health: Case Management's Next Frontier, and End of Life for Case Management , all through HCPro. The Social Determinants of Mental Health: Case Management's Essential Guide will be published through Blue Bayou Press/HCP2HCP in November 2021. Along with several academic teaching appointments, Ellen is a doctoral in behavioral health (DBH) candidate at Cummings Graduate Institute for Behavioral Health Studies. View more on her LinkedIn profile
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Smith M. Getting On in Gotham: The Midtown Manhattan Study and Putting the "Social" in Psychiatry. Cult Med Psychiatry 2021; 45:385-404. [PMID: 34491491 PMCID: PMC8421468 DOI: 10.1007/s11013-021-09751-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 11/22/2022]
Abstract
In the spring of 1962, a series of alarming headlines greeted American newspaper readers. From "New York Living for Nuts Only" and "One in Five Here Mentally Fit" to "Scratch a New Yorker, and What Do You Find?" and "City Gets Mental Test, Results are Real Crazy," the stories highlighted the shocking and, to some, incredible statistics that fewer than one in five (18.5%) Manhattanites had good mental health. Approximately a quarter of them had such bad mental health that they were effectively incapacitated, often unable to work or function socially. The headlines were gleaned from Mental Health in the Metropolis (1962), the first major output of the Midtown Manhattan Study, a large-scale, interdisciplinary project that surveyed the mental health of 1660 white Upper East Side residents between the ages of 20 and 59. One of the most significant social psychiatry projects to emerge following the Second World War, the Midtown Manhattan Study endeavored to "test the general hypothesis that biosocial and sociocultural factors leave imprints on mental health which are discernible when viewed from the panoramic perspective provided by a large population." Despite initial media and academic interest, however, the Midtown Manhattan Study's findings were soon forgotten, as American psychiatry turned its focus to individual-rather than population-psychopathology, and turned to the brain-rather than the environment-for explanations. Relying on archival sources, contemporary medical and social scientific literature, and oral history interviews, this article explains why the Midtown Manhattan Study failed to become more influential, concluding that its emphasis on the role of social isolation and poverty in mental illness should be taken more seriously today.
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Affiliation(s)
- Matthew Smith
- Centre for the Social History of Health and Healthcare, University of Strathclyde, Glasgow, UK.
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Consavage Stanley K, Harrigan PB, Serrano EL, Kraak VI. Applying a Multi-Dimensional Digital Food and Nutrition Literacy Model to Inform Research and Policies to Enable Adults in the U.S. Supplemental Nutrition Assistance Program to Make Healthy Purchases in the Online Food Retail Ecosystem. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168335. [PMID: 34444084 PMCID: PMC8394533 DOI: 10.3390/ijerph18168335] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
The United States (U.S.) Department of Agriculture (USDA)-administered Supplemental Nutrition Assistance Program (SNAP) made substantial changes in response to the coronavirus disease 2019 (COVID-19) pandemic. These changes highlight the need to identify the digital literacy skills and capacities of SNAP adults to purchase healthy groceries online. We conducted a scoping review of four electronic databases, Google and Google Scholar to identify studies that measured food and nutrition literacy outcomes for U.S. adults. We applied a multi-dimensional digital food and nutrition literacy (MDFNL) model to assess six literacy levels and components. Of 18 studies published from 2006-2021, all measured functional and interactive literacy but no study measured communicative, critical, translational, or digital literacy. Six studies examined SNAP or SNAP-Education outcomes. Adults with higher food or nutrition literacy scores had better cognitive, behavioral, food security and health outcomes. We suggest how these findings may inform research, policies, and actions to strengthen the multi-dimensional literacy skills of SNAP participants and SNAP-eligible adults to support healthy purchases in the online food retail ecosystem.
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Affiliation(s)
- Katherine Consavage Stanley
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
- Correspondence: ; Tel.: +1-540-231-9638
| | - Paige B. Harrigan
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
| | - Elena L. Serrano
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
- Virginia Family Nutrition Program, Virginia Tech, Blacksburg, VA 24061, USA
| | - Vivica I. Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University (Virginia Tech), Blacksburg, VA 24061, USA; (P.B.H.); (E.L.S.); (V.I.K.)
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Lee H, Singh GK. Monthly trends in self-reported health status and depression by race/ethnicity and socioeconomic status during the COVID-19 Pandemic, United States, April 2020 - May 2021. Ann Epidemiol 2021; 63:52-62. [PMID: 34358622 PMCID: PMC8435379 DOI: 10.1016/j.annepidem.2021.07.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/18/2021] [Accepted: 07/25/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Research has shown worsening physical and mental health outcomes during the COVID-19 pandemic. Trends in general and mental health inequalities during the pandemic in the US have not been analyzed in detail. METHODS Using Census Bureau's nationally representative pooled Household Pulse Survey (HPS) from April 2020 to May 2021 (N = 1,144,405), we examined monthly trends and disparities in health status by race/ethnicity and socioeconomic status (SES). Logistic regression models and disparity indices were used to analyze trends and inequalities. RESULTS During the pandemic, the adjusted odds of fair and/or poor health were, respectively, 33%, 157%, 398%, 22% higher for non-Hispanic others, adults with <high school education, those with income <$25,000, and renters, compared to non-Hispanic Whites, those with ≥master's degree, those with incomes ≥$200,000, and homeowners. The adjusted odds of serious depression were, respectively, 49%, 130%, 25% higher for adults with <high school education, with income <$25,000, and renters, compared to their higher-SES counterparts. Disparity indices show increasing trends in racial and/or ethnic and some SES disparities in general and mental health during the pandemic. CONCLUSIONS In light of the rising trends and inequalities in physical and mental health, increased policy efforts are needed to reduce health disparities during the ongoing pandemic and beyond.
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Affiliation(s)
- Hyunjung Lee
- Department of Public Policy and Public Affairs, John McCormack Graduate School of Policy and Global Studies, University of Massachusetts Boston, 100 William T Morrissey Blvd, Boston, MA 02125, USA.
| | - Gopal K Singh
- The Center for Global Health and Health Policy, Global Health and Education Projects, Inc., Riverdale, MD, USA
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