Rural Household Food Insecurity among Latino Immigrants during the COVID-19 Pandemic

U.S. food insecurity rates rapidly increased during the COVID-19 pandemic, with disproportionate impacts on Latino immigrant households. We conducted a qualitative study to investigate how household food environments of rural Latino immigrants were affected during the COVID-19 pandemic. Thirty-one respondents (42% from low food security households) completed interviews (July 2020–April 2021) across four rural counties in California. A rural household food security conceptual framework was used to analyze the data. Early in the pandemic, food availability was impacted by school closures and the increased consumption of meals/snacks at home; food access was impacted by reduced incomes. Barriers to access included limited transportation, excess distance, and lack of convenience. Key resources for mitigating food insecurity were the Supplemental Nutrition Assistance Program (SNAP), the Pandemic Electronic Benefits Transfer (P-EBT), school meals, charitable food programs, and social capital, although the adequacy and acceptability of charitable food distributions were noted issues. Respondents expressed concern about legal status, stigma, and the public charge rule when discussing barriers to government nutrition assistance programs. They reported that food pantries and P-EBT had fewer access barriers. Positive coping strategies included health-promoting food substitutions and the reduced consumption of meals outside the home. Results can inform the development of policy and systems interventions to decrease food insecurity and nutrition-related health disparities among rural Latino immigrants.     

Food Insecurity and Associated Factors in Brazilian Undergraduates during the COVID-19 Pandemic

Undergraduates may face challenges to assure food security, related to economic and mental distress, especially during the COVID-19 pandemic. This study aimed to assess food insecurity and its associated factors in undergraduates during the COVID-19 pandemic. An online cross-sectional study was conducted from August 2020 to February 2021 with 4775 undergraduates from all Brazilian regions. The questionnaire contained socio-economic variables, the validated Brazilian food insecurity scale, and the ESQUADA scale to assess diet quality. The median age of the students was 22.0 years, and 48.0% reported income decreasing with the pandemic. Food insecurity was present in 38.6% of the students, 4.5% with severe food insecurity and 7.7% moderate. Logistic regressions showed students with brown and black skin color/race presented the highest OR for food insecurity; both income and weight increase or reduction during the pandemic was also associated with a higher OR for food insecurity, and better diet quality was associated with decreased OR for food insecurity. Our study showed a considerable presence of food insecurity in undergraduates. Policy for this population must be directed to the most vulnerable: those with brown and black skin color/race, who changed income during the pandemic, and those presented with difficulties maintaining weight and with poor diet quality.     

Food Insecurity,Dietary Diversity,and Coping Strategies in Jordan during the COVID-19 Pandemic: A Cross-Sectional Study

The 2019 coronavirus disease (COVID-19) is an emerging respiratory infection with severe impacts on the nutritional status of the worldwide population. This cross-sectional study was conducted to assess the food insecurity, dietary diversity, and food-related coping strategies in Jordan during the pandemic using an online, self-administered questionnaire. Among the 740 adults who completed the survey, the prevalence of food security was 84.1%, whereas 2% and 13.9% were moderately and severely food-insecure, respectively. The determinants of food insecurity were educational level, monthly income, marital status, availability of health insurance, and type of residence. In addition, food insecurity was significantly higher among the participants who consumed two or fewer meals per day (p = 0.015). Moreover, an acceptable food consumption score was shown among 76.2% of the participants, and the remaining participants were at borderline (14.1%) or had poor scores (9.7%), with a significant association between food insecurity and food consumption scores (p < 0.001). The food-related coping strategies studied were significantly associated with food insecurity at both levels (p < 0.001) and were more evident in the severely food-insecure group. These findings highlight the adverse effects of COVID-19 restrictions on nutritional status, especially among food-insecure households, which might reduce food accessibility due to economic difficulties.     

Food Insecurity Pre- and Post the COVID-19 Pandemic and Economic Crisis in Lebanon: Prevalence and Projections

The coronavirus (COVID-19) pandemic has had serious repercussions on the global economy, work force, and food systems. In Lebanon, the pandemic overlapped with an economic crisis, which threatened to exacerbate food insecurity (FI). The present study aims to evaluate the trends and projections of FI in Lebanon due to overlapping health and economic crises. Data from Gallup World Poll (GWP) 2015–2017 surveys conducted in Lebanon on nationally representative adults (n = 3000) were used to assess FI trends and explore its sociodemographic correlates. Predictive models were performed to forecast trends in FI (2018–2022), using GWP data along with income reduction scenarios to estimate the impact of the pandemic and economic crises. Pre crises, trend analyses showed that FI could reach 27% considering wave year and income. Post crises, FI was estimated to reach on average 36% to 39%, considering 50–70% income reduction scenarios among Lebanese population. FI projections are expected to be higher among females compared to males and among older adults compared to younger ones (p < 0.05). These alarming findings call for emergency food security policies and evidence-based programs to mitigate the burden of multiple crises on the FI of Lebanese households and promote resilience for future shocks.     

Prevalence of SARS-CoV-2 Antibodies after First 6 Months of COVID-19 Pandemic,Portugal

In September 2020, we tested 13,398 persons in Portugal for antibodies against severe acute respiratory syndrome coronavirus 2 by using a quota sample stratified by age and population density. We found a seroprevalence of 2.2%, 3–4 times larger than the official number of cases at the end of the first wave of the pandemic.     

COVID-19 Pandemic and Eating Disorders among University Students

An online cross-sectional study was conducted in May 2021 to identify factors, such as changes in food choices, lifestyle, risk and protective behavior, mental health, and social demographics, on eating disorders (ED) among students of a French university. Students were invited to fill out an online questionnaire. ED were identified using the French version of the five-item “Sick, Control, One stone, Fat, Food” (SCOFF) questionnaire. The Expali™-validated algorithmic tool, combining SCOFF and body mass index, was used to screen EDs into four diagnostic categories: bulimic ED, hyperphagic ED, restrictive ED and other ED. A total of 3508 students filled the online questionnaire, 67.3% female, mean age 20.7 years (SD = 2.3). The prevalence of ED was 51.6% in women and 31.9% in men (p < 0.0001). Lower food security scores were associated with a higher risk for all ED categories. Depression and academic stress due to COVID-19 were associated with ED regardless of category. Regarding health behaviors, a high adherence to the National nutrition recommendation was a protective factor for the risk of bulimic ED, hyperphagic ED and restrictive ED. A lower frequency of moderate and vigorous physical activity was associated with a higher risk of hyperphagic ED. Our study has shown a high screening of ED among the students of a French university fourteen months after the beginning of the COVID-19 pandemic. By disrupting academic learning, jobs and social life, the COVID-19 pandemic could have exacerbated existing ED or contributed to the onset of new ED.     

Food Insecurity Prevalence,Severity and Determinants in Australian Households during the COVID-19 Pandemic from the Perspective of Women

This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18–50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity; with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59–15.03). Those who were renting were 2.10 (95% CI: 1.09–4.05) times likely to experience very low food-security than those owning their own home. The COVID-19 pandemic may have contributed to an increased prevalence of household food insecurity. This study supports the need for a range of responses that address mental health, financial, employment and housing support to food security in Australia.     

Urban Youth Perspectives on Food Insecurity during the COVID-19 Pandemic: Evidence from the COACHES Study

School disruptions during the COVID-19 pandemic were a likely threat to food security and exacerbated risk factors associated with poor nutrition and health outcomes among low-income youth. As part of an ongoing school-based study aimed at improving physical activity and dietary behaviors (the COACHES study), associations between youth-reported food insecurity and dietary intake across the pandemic-affected academic year of 2020–2021 were examined. Middle school students (6th and 7th grade, 94% Black/African-American, 92% free-/reduced-price lunch eligible) answered validated surveys on food insecurity and diet and were measured for height and weight for calculation of weight status during Fall 2020 (n = 88) and Spring 2021 (n = 56). During this time, schools underwent a combination of in-person, hybrid, and remote learning. Nearly half of participants were overweight or obese (47%), and self-reported food insecurity was near 30% at both time points. Less than one-third of youth met fruit and vegetable intake guidelines, and more than half drank two or more sugar-sweetened beverages daily. While controlling for sex, maternal education, and weight status, food insecurity was not significantly associated with fruit and vegetable or sugar-sweetened beverage intake. Independent of weight status, youth were aware of being food insecure, yet it did not have an apparent impact on these food groups of concern. These findings highlight the need for greater understanding of youth perceptions of food insecurity in order to adequately address dietary quality and quantity concerns among children.     

Food Insecurity and Eating Behavior Relationships Among Congregate Meal Participants in Georgia

This study explored relationships of food insecurity with cognitive restraint, uncontrolled eating, and emotional eating behaviors among congregate meal participants in northeast Georgia [n = 118 years, age 60 years and older, mean (SD) age = 75 (8 Olson CM, Bove CF, Miller EO. Growing up poor: long-term implications for eating patterns and body weight. Appetite. 2007; 49(1):198–207.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) years, 75% female, 43% Black, 53% obese (Body Mass Index ≥ 30)]. Food insecurity was assessed with a 6-item questionnaire. Scores ranged from 0 to 6 and were defined as high or marginal food security, FS, 0–1 (70%); low food security, LFS, 2–4 (20%); very low food security, VLFS, 5–6 (10%); and low and very low food security, LVLFS, 2–6 (30%). Eating behavior was assessed with an 18-item Three-Factor Eating Questionnaire R-18. In bivariate analyses food insecurity was consistently associated with cognitive restraint scores above the median split and to a lesser extent with uncontrolled eating scores (p ≤ 0.05). No association was found between emotional eating and food insecurity. In multivariate linear and logistic regression analyses, food insecurity was consistently associated with cognitive restraint (p ≤ 0.05) even when controlled for potential confounders (demographics, Body Mass Index, and chronic diseases). Food insecurity was also associated with uncontrolled eating (p ≤ 0.05), but the relationship was attenuated when controlled for potential confounding variables. Although cognitive restraint is defined as the conscious restriction of food intake to control body weight or promote weight loss, these findings suggest there may be other dimensions of cognitive restraint to consider in nutritional assessment and interventions among food-insecure older adults.     

COVID-19 Recession: Young Adult Food Insecurity,Racial Disparities,and Correlates

PurposeThe COVID-19 pandemic has inflicted devastating health, social, and economic effects globally. This study examines the experiences of young adults in the United States with respect to food insecurity during the pandemic and factors associated with higher and lower risk for young adult food insecurity.MethodsUsing the U.S. Census Bureau's Household Pulse Survey, a nationally representative survey collecting information on people's experiences throughout the pandemic, we analyzed prevalence of, and factors associated with young adult food insecurity during the pandemic.ResultsOverall, 13% of young adults aged 18–25 years reported often or sometimes not having enough to eat in the last 7 days at a given time during pandemic, on average, with Black and Hispanic young people facing higher rates of food insecurity (22% and 15%, respectively) than White non-Hispanic peers (11%). Over the observed pandemic period, we find a decline in food insecurity among young adults corresponding with economic policy actions. Factors associated with a higher risk of food insecurity include lower household income, expected job loss, renting as opposed to owning housing, behind on rent or mortgage payment, lack of confidence in an ability to pay next month's rent or mortgage, delayed medical care, and feeling worried or depressed.DiscussionOur analyses reveal alarming levels of food insecurity among young adults, especially Black and Hispanic young people. Policy actions should include multifaceted and sustained interventions with a focus on supporting historically disenfranchised youth and their communities. These should prevent and address food and housing insecurity and mental health needs holistically.     

Unemployment,SNAP Enrollment,and Food Insecurity Before and After California's COVID-19 Shutdown

ObjectivesTo examine whether the decrease in very low food security (VLFS) observed in California shortly after California's coronavirus disease (COVID-19) shutdown remained throughout Federal Fiscal Year (FFY) 2020. To investigate associations among unemployment, Supplemental Nutrition Assistance Program (SNAP) enrollment, and VLFS across FFY 2020.MethodsTelephone interview responses from mothers from randomly sampled households from low-income areas throughout California to the 6-item US Department of Agriculture Food Security Survey Module identified VLFS families. Logistic regression examined VLFS rates before vs after California's COVID-19 shutdown, with race/ethnicity, age, and education as covariates. Pearson correlations were calculated for unemployment, SNAP enrollment, and VLFS.ResultsMost (66.4%) of the 2,682 mothers were Latina. VLFS declined from 19.3% before to 14.5% after California's COVID-19 shutdown (adjusted odds ratio, 0.705; P = 0.002). The correlation for unemployment and SNAP household participation was 0.854 (P = 0.007), and for SNAP participation and VLFS was −0.869 (P = 0.005).Conclusions and ImplicationsPublicly-funded assistance programs may lower food insecurity, even during a time of increased economic hardship. Examining the specific factors responsible for the observed decline in VLFS has merit. Whether VLFS remains below the rate observed before California's COVID-19 shutdown is worthy of ongoing study.     

Change in Employment Status Due to the COVID-19 Pandemic,SNAP Participation,and Household Food Insecurity among Black and Latino Adults in Illinois

The onset of the COVID-19 pandemic resulted in record-high unemployment rates. Black and Latino adults experienced disproportionately higher rates of unemployment. We aimed to examine associations between pandemic-related employment status change and household food insecurity among an economically diverse sample of Black and Latino adults in Illinois during the early months of the COVID-19 pandemic. Furthermore, we evaluated the significance of Supplemental Nutrition Assistance Program (SNAP) participation to determine if it modified associations. We analyzed cross-sectional data collected from 1,809 Black and Latino adults in two waves: May 2020 and June/July 2020. Participants listed their change in employment status as “lost job entirely”, “employed, but paid hours reduced”, “employed, but anticipate job lost”, or “no change”. Participants self-reported their SNAP status and completed the USDA’s six item U.S. Food Security Module to report household food security status. We used logistic regression to assess the significance of associations after controlling for socio-demographics. Approximately 15.5% of participants lost their job entirely, 25.2% were SNAP participants, and 51.8% reported low food security (LFS). All changes in employment were significantly associated with increased odds of LFS after adjusting for socio-demographics. SNAP participants who lost their job had higher odds of LFS (OR: 4.69; 95% CI: 2.69–8.17) compared to non-participants who lost their job (OR: 2.97; 95%: 1.95–4.52). In summary, we observed strong associations between changes in employment and household food insecurity, particularly among SNAP participants, which underscores the pandemic’s impact on low-income and minority populations.     

Sharp Increase in Eating Disorders among University Students since the COVID-19 Pandemic

The COVID-19 pandemic has caused stress as well as modified physical activity and eating habits among university students. The objectives were to identify the changes in body mass index (BMI) and eating disorders among university students between 2009 and 2021. Between 2009 and 2021, five repeated cross-sectional studies were conducted among university students who filled in an anonymous online self-questionnaire. Age, gender, and BMI were recorded, and the SCOFF questionnaire was used for ED screening which, in combination with BMI, allows to identify the four broad categories of ED with the Expali algorithm. With the five studies, 8981 university students were included in total. Obesity steadily increased between 2009 and 2021, for both men and women. The prevalence of ED was stable between 2009 and 2018 and significantly increased from 31.8% in 2018 to 51.8% in 2021 for women (p _trend < 0.0001), and from 13.0% in 2009 to 31.3% in 2021 for men (p _trend < 0.0001). All types of ED increased significantly between 2009 and 2021, except for restrictive ED among men. These results indicate for the first time a significant increase in ED prevalence among students since the COVID-19 pandemic. Initiatives to reinforce early screening of ED to implement targeted interventions in the student population are urgently needed.     

Family Structure and Child Food Insecurity

Objectives. We examined whether food insecurity was different for children in cohabiting or repartnered families versus those in single-mother or married-parent (biological) families.Methods. We compared probabilities of child food insecurity (CFI) across different family structures in 4 national data sets: the Early Childhood Longitudinal Study—Birth Cohort (ECLS-B), the Fragile Families and Child Wellbeing Study (FFCWS), the Early Childhood Longitudinal Study—Kindergarten Cohort (ECLS-K), and the Panel Study of Income Dynamics—Child Development Supplement (PSID-CDS).Results. Unadjusted probabilities of CFI in cohabiting or repartnered families were generally higher than in married-biological-parent families and often statistically indistinguishable from those of single-mother families. However, after adjustment for sociodemographic factors, most differences between family types were attenuated and most were no longer statistically significant.Conclusions. Although children whose biological parents are cohabiting or whose biological mothers have repartnered have risks for food insecurity comparable to those in single-mother families, the probability of CFI does not differ by family structure when household income, family size, and maternal race, ethnicity, education, and age were held at mean levels.In 2012, 10% of US households had food-insecure children, meaning that access to adequate food for these children was limited by their households’ lack of money and other resources.1 Food insecurity poses a serious risk to the health and well-being of children; it has been linked to behavioral problems, developmental risk, poor health in infants and toddlers,2,3 and negative academic, social, and psychological outcomes in older children and adolescents.4,5Traditionally, households headed by single mothers have had the highest rates of child food insecurity (CFI) whereas married-couple households have had the lowest rates: 18.7 versus 6.3%, according to the most recent data from the United States Department of Agriculture (USDA).1 However, federal reports do not provide data on CFI in households characterized by other family structures, which are of increasing prevalence and interest. The most common of these family structures is cohabitation. Today, one fifth of all children in the United States are born to cohabiting, but not married, parents.6–8 There is also little information on CFI in repartnered families, where only 1 of the 2 adults heading the household is a biological parent of the children in the household. Although there are few consistent estimates of the prevalence of these types of families in the United States, US Census Bureau data suggest that between 10% and 20% of children currently live in repartnered families and that more than one third of children will experience this type of living arrangement.9,10 National reports do not provide estimates of CFI for this group; rather, families in which 1 biological parent has remarried are currently grouped with families in which the biological parents of the child are married to each other.1There is good reason to believe that the prevalence of CFI in cohabiting or repartnered families may be very different from its prevalence in married-biological-parent families. Most studies find that cohabiting unions are less stable and that these families have fewer resources than married-parent families,11–13 although findings on child well-being in cohabitating families are mixed. Regarding repartnered families, new partners may contribute resources, thereby improving food security,14 but previous research suggests that stepparents may underinvest in nonbiological children, because they may be providing resources to their prior biological children in other households or because they are less committed to nonbiological children.15–18 Additionally, the instability that often accompanies repartnering may be harmful for a child’s well-being.19,20Economic models for the dynamics of food insecurity21,22 suggest that decisions about food consumption are driven in part by families’ past and future resources and their ability to maintain consistent consumption over time, implying that stability and consistency may be as important for children’s food security as absolute level of resources. Thus, although single-mother families may have the fewest resources, they may not necessarily have a higher risk of food insecurity than these other nontraditional family types (cohabiting parents and repartnered parents), because of the potential instability of these family structures. A handful of previous studies have examined food insecurity across different family structures; however, these studies are dated and have relied on limited measures of food insecurity.11,23–26 The USDA’s 18-item food security module (FSM) is considered the best measure of household food security. Previous studies, however, have often used measures of food insecurity based on 3 or fewer questions, making them of questionable validity. As a consequence, most studies have not been able to identify CFI, which involves limited access to adequate food specifically among children. Separately examining CFI is important, as parents often act to protect children from food insecurity by reducing their own food intake,1 implying that general household measures could indicate food insecurity when children themselves may not be food insecure. One recent study of family change, which used the full 18-item FSM, found that transition into a maternal union was associated with lower household food insecurity. However, this study did not investigate CFI, nor did it report on rates of food insecurity by different family structures.27We investigated 2 complementary research questions: (1) How do rates of CFI for children in cohabiting and repartnered homes compare with those for children living with married biological parents or single mothers? (2) Do any differences in the rates of food insecurity among children in different family structures persist after adjustment for sociodemographic factors typically associated with both family structure and food insecurity? Our study makes a number of concrete contributions. First, we used a highly reliable and valid measure of CFI: the 8 child-referenced items from the USDA’s FSM. Second, our first research question was used to generate comprehensive and contemporary epidemiological evidence about potential differences (or similarities) in rates of CFI in different family types on the basis of analyses of 4 national data sets, an important contribution given limitations in current federal reporting. Last, our adjusted models (which examined differences in CFI between families that were average in all other regards) have the greatest potential to inform policies and programs that aim to eliminate CFI.