Impact of COVID-19 on food insecurity using multiple waves of high frequency household surveys.

In response to the rapid spread of COVID-19, governments across the globe have implemented local lockdowns that have led to increased unemployment and have disrupted local and international transport routes and supply chains. Whilst such efforts aim to slow or stop the spread of the SARS-CoV-2 virus, they have also resulted in increased food insecurity, whether due to reduced incomes or increased food prices. This is the first paper to track food insecurity and its determinants during the pandemic using multi-country and multi-wave evidence. Using data from 11 countries and up to 6 waves of High-Frequency Phone Survey data (household-level surveys) on COVID-19 and its impacts, we use a fixed-effects linear probability model to investigate the socioeconomic determinants of food insecurity during the pandemic for each country using household-level data over multiple waves. We control for socioeconomic characteristics including gender and education of the household head; income and poverty status of the households during the pandemic; safety nets in the form of cash and food assistance; coping strategies adopted by households; and price effects of major food items. Our findings suggest that cash safety nets appear to have been more effective than food in terms of reducing food insecurity during the pandemic; and that those particularly hard hit are female headed-households (highest in Malawi: 0.541, 95% CI 0.516, 0.569; lowest in Cambodia: 0.023, 95% CI 0.022, 0.024), the less educated (highest in Djibouti: - 0.232, 95% CI - 0.221, - 0.244; lowest in Nigeria: 0.006, 95% CI - 0.005, - 0.007), and poorer households (highest in Mali: 0.382, 95% CI 0.364, 0.402; lowest in Chad: 0.135, 95% CI 0.129, 0.142). In line with the existing literature, our results show that, even controlling for income loss and poverty status, those households who had to borrow rather than rely on savings had a higher probability of suffering from food insecurity. Distinct differences in the efficacy of safety nets across the 11 countries, and the differential impact of the pandemic on different groups within societies, suggest in-depth country-specific studies are needed to understand why some countries have coped better than others. Our paper highlights the importance of improving household resilience to future systemic crises, and using evidence-based best practice in the design of relevant policy instruments.

Association of the Implementation of Child Tax Credit Advance Payments With Food Insufficiency in US Households.

Importance: A key component of the American Rescue Plan Act of 2021 included an expansion of the Child Tax Credit with advance payments beginning in July 2021, a "child allowance" that was projected to dramatically reduce child poverty. Food insufficiency has increased markedly during the economic crisis spurred by the COVID-19 pandemic, with disparities among marginalized populations, and may be associated with substantial health care and social costs. Objective: To assess whether the introduction of advance payments for the Child Tax Credit in mid-July 2021 was associated with changes in food insufficiency in US households with children. Design, Setting, and Participants: This cross-sectional study used data from several phases of the Household Pulse Survey, conducted by the US Census Bureau from January 6 to August 2, 2021. The survey had 585 170 responses, representing a weighted population size of 77 165 153 households. Exposure: The first advance Child Tax Credit payment, received on July 15, 2021. Main Outcomes and Measures: Household food insufficiency. Results: The weighted sample of 585 170 respondents was mostly female (51.5%) and non-Hispanic White (62.5%), with a plurality aged 25 to 44 years (48.1%), having a 4-year degree or more (34.7%) and a 2019 household income of $75 000 to $149 999 (23.1%). In the weeks after the first advance payment of the Child Tax Credit was made (July 21 to August 2, 2021), 62.4% of households with children reported receiving it compared with 1.1% of households without children present (P < .001). There was a 3.7-percentage point reduction (95% CI, -0.055 to -0.019 percentage points; P < .001) in household food insufficiency for households with children present in the survey wave after the first advance payment of the Child Tax Credit, corresponding to a 25.9% reduction, using an event study specification. Difference-in-differences (-16.4%) and modified Poisson (-20.8%) models also yielded large estimates for reductions in household food insufficiency associated with the first advance payment of the expanded Child Tax Credit. Conclusions and Relevance: This study suggests that the Child Tax Credit advance payment increased household income and may have acted as a buffer against food insufficiency. However, its expansion and advance payment are only a temporary measure for 2021. Congress must consider whether to extend these changes or make them permanent and improve implementation to reduce barriers to receipt for low-income families.

The Impact of Poor Nutrient Intakes and Food Insecurity on the Psychological Distress among Community-Dwelling Middle-Aged and Older Adults during the COVID-19 Pandemic.

This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants' information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24-35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965-0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695-0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic.

Affordability of Heathy, Equitable and More Sustainable Diets in Low-Income Households in Brisbane before and during the COVID-19 Pandemic.

The COVID-19 pandemic has increased food insecurity worldwide, yet there has been limited assessment of shifts in the cost and affordability of healthy, equitable and sustainable diets. This study explores the impact of the COVID-19 pandemic and income supplements provided by the Australian government on diet cost and affordability for low-income households in an Australian urban area. The Healthy Diets ASAP method protocol was applied to assess the cost and cost differential of current and recommended diets before (in 2019) and during the COVID-19 pandemic (late 2020) for households with a minimum-wage and welfare-only disposable household income, by area of socioeconomic disadvantage, in Greater Brisbane, Queensland, Australia. Data were collected between August and October, 2020, from 78 food outlets and compared with data collected in the same locations between May and October, 2019, in an earlier study. The price of most healthy food groups increased significantly during the pandemic-with the exception of vegetables and legumes, which decreased. Conversely, the price of discretionary foods and drinks did not increase during the pandemic. The cost of the current and recommended diets significantly increased throughout this period, but the latter continued to be less expensive than the former. Due to income supplements provided between May and September 2020, the affordability of the recommended diet improved greatly, by 27% and 42%, for households with minimum-wage and welfare-only disposable household income, respectively. This improvement in the affordability of the recommended diet highlights the need to permanently increase welfare support for low-income families to ensure food security.

Role of Government Financial Support and Vulnerability Characteristics Associated with Food Insecurity during the COVID-19 Pandemic among Young Peruvians.

Peruvian households have experienced one of the most prevalent economic shocks due to COVID-19, significantly increasing their vulnerability to food insecurity (FI). To understand the vulnerability characteristics of these households among the Peruvian young population, including the role of the government's response through emergency cash transfer, we analysed longitudinal data from the Young Lives study (n = 2026), a study that follows the livelihoods of two birth cohorts currently aged 18 to 27 years old. FI was assessed using the Food Insecurity Experience Scale. Household characteristics were collected before and during the COVID-19 outbreak in Peru to characterise participants' vulnerability to FI. Multivariate logistic regression was used to evaluate the association between government support and participants' vulnerability characteristics to FI. During the period under study (March to December 2020), 24% (95% CI: 22.1-25.9%) of the participants experienced FI. Families in the top wealth tercile were 49% less likely to experience FI. Larger families (>5 members) and those with increased household expenses and decreased income due to COVID-19 were more likely to experience FI (by 35%, 39% and 42%, respectively). There was no significant association between government support and FI (p = 0.768). We conclude that pre-pandemic socioeconomic status, family size, and the economic disruption during COVID-19 contribute to the risk of FI among the Peruvian young population, while government support insufficiently curtailed the risk to these households.

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.

Feeding Children and Maintaining Food Service Operations during COVID-19: A Mixed Methods Investigation of Implementation and Financial Challenges.

The United States Department of Agriculture (USDA) National School Lunch and Breakfast Programs are critical for the health and food security of U.S. schoolchildren, but access to these programs was disrupted by COVID-19 pandemic-related school closures in spring 2020. While temporary policy changes to the programs enabled school food authorities (SFAs) to pivot towards distributing meals throughout their communities instead of within school buildings, SFAs faced complex challenges during COVID-19 with minimal external support. This mixed methods study investigates the implementation and financial challenges experienced by twelve of the largest urban SFAs in the U.S. during COVID-19. We conducted semi-structured interviews with SFA leaders and analyzed alongside quantitative financial data. We found that SFAs reconfigured their usual operations with nearly no preparation time while simultaneously trying to keep staff from contracting COVID-19, accommodate stakeholders with sometimes competing priorities, and remain financially solvent. Because student participation was much lower than during regular times, and revenue is tied to the number of meals served, SFAs saw drastic decreases in revenue even as they carried regular operating costs. For future crises, disaster preparedness plans that help SFAs better navigate the switch to financially viable community distribution methods are needed.

Perceived ability to comply with national COVID-19 mitigation strategies and their impact on household finances, food security, and mental well-being of medical and pharmacy students in Liberia.

INTRODUCTION: From the outset of the COVID-19 pandemic, guidance from WHO has promoted social distancing, wearing face masks, frequent hand washing, and staying-at-home as measures to prevent the spread of COVID-19. For many across Africa, compliance can be difficult. The aim of this study was to 1) understand the impact of student's household's ability to comply with COVID-19 mitigation strategies, 2) identify predictors of mitigation strategy compliance, and 3) describe the impact of COVID-19 on household economics, food-security, and mental well-being. MATERIALS AND METHODS: We conducted an email-based survey among current medical and pharmacy students of the University of Liberia College of Health Sciences between July and October 2020. The questionnaire was designed to explore their household's ability to comply with current mitigation strategies, as well as the pandemic´s impact on the student's household's finances and food security. Descriptive statistics were used to delineate demographic characteristics. Logistic regression was used to model factors associated with ability to comply with COVID-19 mitigation strategies, as well as participant's food security. RESULTS: 113 persons responded to the questionnaire. Seventy-six (67∙3%) reported income losses as a result of the pandemic, with 93 (82∙3%) reporting being "somewhat" or "very worried" about their households' finances. Seventy-seven (68∙1%) participants reported food stocks that were sufficient for one-week or less. Forty (35%) participants reported eating less preferred foods or skipping meals in the past week. Overall, 20 participants (19∙4%) had a positive depression screen. CONCLUSIONS: Study participants showed mixed results in being able to adhere to national COVID-19 mitigation strategies, with household level stressors experienced around finances and food security. Until Liberia has access to vaccinations for most of its citizens, COVID-19 response measures need to provide social protections that address basic needs (shelter, clothing and food), and which specifically targets food insecurity. Preventative interventions for mental health problems must be incorporated into Liberia's response to the pandemic.

Falling living standards during the COVID-19 crisis: Quantitative evidence from nine developing countries.

Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.

Food Insufficiency and Mental Health in the U.S. During the COVID-19 Pandemic.

INTRODUCTION: During the COVID-19 pandemic, the rates of food insecurity and mental illness have been projected to increase in the U.S. owing to significant social and economic disruption. This study aims to estimate the prevalence of food insufficiency (often the most extreme form of food insecurity), the correlates of food insufficiency, and the associations between food insufficiency and symptoms of poor mental health in the U.S. during the COVID-19 pandemic. METHODS: Cross-sectional data from 63,674 participants of the U.S. Census Household Pulse Survey were collected and analyzed in 2020. Multiple Poisson regression models were used to estimate associations with food insufficiency. RESULTS: Food insufficiency rose from 8.1% to 10.0% from March to June 2020. Factors associated with food insufficiency included lower age, Black/African American or Latinx race/ethnicity, being unmarried, larger household size, recent employment loss, income below the federal poverty line, and lower education (all p<0.001). Food insufficiency was independently associated with all symptoms of poor mental health, adjusting for socioeconomic and demographic factors (adjusted RRs ranged from 1.16 to 1.42, all p<0.001). The association between food insufficiency and poor mental health was attenuated among people who received free groceries or meals. CONCLUSIONS: Food insufficiency has increased during the COVID-19 pandemic and affects vulnerable populations, placing individuals at higher risk for symptoms of poor mental health. Particularly in the current crisis, clinicians should regularly screen patients for food insufficiency and mental health outcomes as well as provide support in accessing appropriate resources.

Food Insecurity and Pediatric Obesity: a Double Whammy in the Era of COVID-19.

PURPOSE OF REVIEW: This review examines the current evidence about the ways in which food insecurity relates to obesity in children and adolescents, examining diet and diet-related behaviors, and taking into consideration the role of stress. RECENT FINDINGS: While living with food insecurity impacts stress and diet-related behaviors in children and adolescents, it is not clear whether food insecurity is associated with obesity above and beyond the influence of poverty. However, strategies to mitigate food insecurity and obesity are inherently connected, and recent examples from clinical practice (e.g., screening for food insecurity among patients) and advocacy (e.g., policy considerations regarding federal food programs such as the Supplemental Nutrition Assistance Program, or SNAP) are discussed. Food insecurity and obesity coexist in low-income children and adolescents in the USA. The COVID-19 pandemic exerts disproportionate burden on low-income children and families, magnifying their vulnerability to both food insecurity and pediatric obesity.

COVID-19, Food Insecurity, and Migration.

In this policy piece, we investigate the coronavirus disease 2019 (COVID-19)-food-insecurity migration channel and develop a policy agenda. The interaction between COVID-19 and the drop in economic activity will lead to increased food insecurity within and across countries. Higher food insecurity may act as a multiplier for the epidemic due to its negative health effects and increased migration. Research has shown that food insecurity affects within-country and cross-border migration. Besides the mean prevalence rate, the distribution of food insecurity affects the migration decision. The impacts of COVID-19 are particularly strong for people in the lower tail of the food-insecurity distribution. In the current context, the effect of food insecurity therefore could be increased migration, including both rural-urban migration and international migration. Importantly, the crisis might lead to a structural break in migration patterns. People might avoid heavily affected COVID-19 destination countries (e.g., United States, Italy, or Spain) and move to other countries. Due to the persistent nature of migration flows, this could have long-lasting effects.

A call to action to address COVID-19-induced global food insecurity to prevent hunger, malnutrition, and eating pathology.

The coronavirus 2019 disease (COVID-19) pandemic has led to food shortages, increased food prices, and loss of income. As a result, global food insecurity alerts have been issued. The pandemic threatens millions of children and adolescents and their families currently living with or at risk for development of food insecurity. The lack of consistent access to nutritious food sources is associated with chronic physical and mental health problems and death. Studies on food insecurity and eating pathology have heightened our concern about the impact the added effect of the pandemic may have on eating behaviors of children and adolescents. Here, we want to draw attention to the need for making food security and healthy eating attitudes and behaviors a global priority during the COVID-19 pandemic to guarantee the current and future health and well-being of our children and adolescents.