Household Dietary Diversity among Households with and without Children with Disabilities in Three Low-Income Communities in Lusaka, Zambia.

The purpose of this manuscript is to describe household dietary diversity (HDDS) in Lusaka, Zambia between households with and without a child with a disability living in the same communities. Cross-sectional data were collected in three low-income compounds in September 2021. Participants included households with a child with a disability enrolled in Kusamala+, a community-based program, (n = 444) and a convenience sample of adults living in the same area without a child with a disability (n = 1027). The HDDS tool asked about food groups consumed in the past 24 h by people in the household. The responses were summed (yes = 1, no = 0), range 0-12. Individual dietary diversity scores (IDDSs) were calculated for children (0-8 items). Analysis included descriptive statistics and linear regression. Mean HDDS for the households with a child with a disability was 4.8 (SD 2.1) vs. 6.1 (SD = 2.2) among households without a child with a disability (p < 0.001). The individual score for children (IDDS) for households with children with disabilities was 2.6 (SD = 1.4) vs. 3.7 (SD = 1.6) for households without a child with a disability. Households with a child with a disability had a significantly lower HDDS and IDDS in unadjusted and adjusted models (p < 0.001). National policy must assure the most vulnerable populations, and often hidden, receive focused financial and food support.

Rapid health impact assessment of COVID-19 on families with children with disabilities living in low-income communities in Lusaka, Zambia.

INTRODUCTION: Worldwide, children with disabilities are a vulnerable population and at high risk for COVID-19 morbidity and mortality. There is little information on the impact that COVID-19 had on children with disabilities and their families, particularly in low-income settings. This assessment describes the extent to which the pandemic impacted seven indicators of well-being in three low-income communities in Lusaka, Zambia. METHODS: Interviews were conducted with a random selection of families participating in an existing program (n = 39), community health workers (n = 6), healthcare workers (n = 7) and government officials (n = 2). Descriptive data was summarized and qualitative responses reviewed for themes. RESULTS: Most families reported a major loss of income resulting in food insecurity (79%), housing instability (67%), stress (36%), and increased risk of child separation and neglect (18%). Most families did not report receiving governmental financial assistance and reported loss of access to health services for their child such as physiotherapy (33%). Stakeholders interviewed reported that COVID-19 information was widely available although few specific interventions for children. Families were seen to have greater food insecurity, more poverty, more crowding, less healthcare services and children left alone or on the streets to beg. DISCUSSION: COVID-19 and related containment measures have impacted the lives of children with disabilities and their families to a great extent. There is an urgent need for disability-inclusive responses that deliberately address the needs of children with disabilities and their families, notably uninterrupted access to adequate food, inclusive education, rehabilitation therapy, and income-generating activities.

Exploring Knowledge, Prevention Methods, and Prevention Barriers of COVID-19 Among Somali, Karen, and Latinx Community Members in Minneapolis, Minnesota, USA.

BACKGROUND: As the COVID-19 pandemic has unfolded, understanding the virus and necessary measures to prevent infection have evolved. While effective preventative measures for COVID-19 have been identified, there are also identifiable barriers to implementation. OBJECTIVE: Explore the access to information, knowledge, and prevention methods and barriers of COVID-19 among Somali, Karen, and Latinx immigrant community members in Minneapolis, Minnesota, USA through analysis of in-depth interviews. METHODS: Data were collected through 32 interviews via phone, video conference on a computer, or in-person with Somali, Karen, and Latinx adults to understand the experiences during the COVID-19 pandemic in each group's native language. All participants were over the age of 18, and identified as Somali, Karen, and Latinx refugee or immigrant. Interview protocol contained 9 main questions including probes. Data were analyzed through use of the qualitative analysis software, Atlas.ti using phenomenology. RESULTS: A total of 32 adults were interviewed (Somali = 12, Karen = 10, and Latinx = 10). One-third were in person and the remainder were remote. The average age recorded was 37 years (range 20-66 years), 43.8% males and 56.3% females. Somali, Karen, and Latinx respondents consistently had accurate knowledge about COVID-19 and were attentive to finding trustworthy information. Information was available in Somali, Karen, and Latinx written language, although Karen elders who are not literate would benefit more from video messaging. Knowledge of preventive measures was consistent; however, barriers included access, working in front-line positions, and living in high density housing. CONCLUSION: Exploring the impact of COVID-19 on Somali, Karen, and Latinx community members in Minneapolis, MN is advantageous in removing identified barriers and disparities in health. The results of this study highlight the need for increased efforts to address barriers in the prevention of COVID-19, as well as future pandemics for immigrant and refugee populations.

COVID-19 and Systemic Racism Pandemics Impact Daily Life for Immigrant/Refugees, Minneapolis, USA.

Background: The pandemics of COVID-19 and systemic racism have a deleterious impact on the daily life experiences and health for populations of color. The experiences are compounded for immigrant/refugee communities that may have other barriers such as English language literacy or trauma. Cumulative stress due to everyday racism is harmful for health. Objectives: This study describes the impact of day-to-day lived experiences of Karen, Somali, and Latinx communities during the COVID-19 pandemic and aftermath of the police murder of George Floyd in the Minneapolis/St. Paul metro area. Methods: In-depth interviews were conducted over three weeks in September and October 2020 to understand the daily life experiences of Karen, Somali and Latinx adults drawn from community contacts during the COVID-19 pandemic and the aftermath of the police murder of George Floyd. Interviewers were bilingual and from the communities they interviewed. Nine questions were asked, ranging from their knowledge of COVID-19, prevention practices, experiences during shelter-in-place, and the perceptions of the police murder of George Floyd. Qualitative analysis included transcript review, coding facilitated by Atlas.ti Cloud software, summaries, and validation by interviewers. Findings: Thirty-two adults were interviewed (Latinx = 10, Karen = 10, Somali = 12). One-third were in person per participant request and complying with COVID-19 precautions, and the remainder were remote. The average age recorded was 37 years (range 20-66 years), 43.8% males and 56.3% females. Respondents reported experiences of discrimination and systemic racism while engaging in daily life activities, including accessing foods and common goods, school, work, transportation, and healthcare, all of which were exacerbated by COVID-19 and the police murder of George Floyd. Conclusions: Immigrant/refugee communities of color in Minneapolis/St. Paul face daily experiences of racism that were compounded by the events of 2020. Discrimination and systemic racism contribute to the persistent health inequities among populations of color.