RESUMEN
Our intersectional research explored food insecurity and job insecurity as predictors of healthcare insecurity and mental health challenges among households living in economic instability since the COVID19 pandemic began. The New York City COVID19 Research Team adapted a validated, web based, anonymous survey questionnaire using a Social Determinants of Health Framework. The study oversampled underserved populations with a total of 2,099 participants. We report strong associations between food insecurity and job insecurity among healthcare insecure households, and significant mental health challenges among food insecure and healthcare insecure households. This underscores the need for integrated social policies to protect underserved urban populations.
Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Salud Mental , Seguridad del Empleo , Marco Interseccional , Abastecimiento de Alimentos , Inseguridad Alimentaria , Atención a la SaludRESUMEN
In this case study, a formative evaluation was conducted for "Promoting Food Security and Healthy Lifestyles" pilot intervention at a Community-Based Organization in a marginalized neighborhood in Bedford-Stuyvesant in New York City. Utilizing a rigorous, theoretically grounded, and mixed methods approach, a survey was designed to encompass the social, environmental, and behavioral determinants of food insecurity and health promotion for Emergency Food Assistance System users. The final survey tested well for face and content validity and meets the criteria for internal reliability. This will aid to develop culturally tailored programs and policies for low-income, food insecure populations facing social and health disparities in this large urban neighborhood.
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Dieta Saludable , Asistencia Alimentaria , Promoción de la Salud/métodos , Estilo de Vida Saludable , Encuestas Nutricionales , Salud Urbana , Adulto , Anciano , Competencia Cultural , Dieta Saludable/economía , Dieta Saludable/psicología , Salud de la Familia/economía , Femenino , Grupos Focales , Abastecimiento de Alimentos/economía , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York , Estudios de Casos Organizacionales , Proyectos Piloto , Marginación Social/psicología , Factores Socioeconómicos , Estrés Psicológico/prevención & control , Salud Urbana/economíaRESUMEN
BACKGROUND: COVID-19 revealed and broadened existing disparities in large cities. This article interprets the early impacts of COVID-19 on food insecurity (FI) in the Chicago and New York City (NYC) metropolitan areas for Black, Indigenous, and People of Color (BIPOC) and provides a study using a Social Determinants of Health (SDOH) framework. METHODS: A cross-sectional survey adapted from the National Food Access and COVID Research Team (NFACT) was deployed in Chicago (N = 680) and in NYC (N = 525) during summer 2020 and oversampled for race, ethnicity, and socioeconomic status. Multivariate binary logistic regression generated adjusted odds ratios (aOR) and 95% CIs for FI and select SDOH variables, which was conducted on each dataset. RESULTS: The prevalence of FI in NYC increased to 66.8% (from 57.8%) and in Chicago to 44.8% (from 41.0%). While higher income protected against FI before, protection was diminished or eliminated since COVID-19. FI declined for households with children in NYC while odds increased and became significant in Chicago. Respondents with chronic health conditions experienced increased odds of FI since COVID. In Chicago, this variable had the highest odds of FI. Respondents with depression or anxiety had increased odds of FI. In NYC, depression had the highest odds of FI. Females in NYC were protected against FI. Hispanics in NYC lost protection against FI from before to since COVID-19. CONCLUSIONS: Results support the observed rise of FI for BIPOC and its association with health status. The analysis has multifaceted, structural policy implications for reducing FI in urban centers.
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COVID-19 , Niño , Femenino , Humanos , COVID-19/epidemiología , Ciudades , Ciudad de Nueva York/epidemiología , Chicago/epidemiología , Factores Socioeconómicos , Estudios Transversales , Pandemias , Inseguridad Alimentaria , Abastecimiento de AlimentosRESUMEN
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support and identify long-term impacts and needs. OBJECTIVE: The National Food Access and COVID research Team (NFACT) was formed to assess food security over different US study sites throughout the pandemic, using common instruments and measurements. This study presents results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. METHODS: A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA 6-item module. Food security prevalence was analyzed using ANOVA by sampling method to assess statistically significant differences. RESULTS: Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, compared with before the pandemic. In nearly all study sites, there is a higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but a statistically higher prevalence of food insecurity among high-risk compared with convenience surveys. CONCLUSIONS: This comprehensive study demonstrates a higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to the survey implementation method.
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An age at death estimation equation that uses rib histological variables presented by Stout and Paine was used to evaluate a skeletal population of individuals with a known age at death and cause of death from either malnutrition or the niacin deficiency disease pellagra. The sample was comprised of 26 autopsied black South Africans. Histological analysis of mounted thin sections involved the microscopic measurement of cortical area and a count of the number of intact and fragmentary secondary osteons for the entire cross-section of the rib. Rib osteon population density values were then calculated for each case. It was found that this equation under-aged individuals on average by 29.2 years. Overall, secondary osteon size and Haversian canals tended to be larger than expected, while cortical bone area was less when compared with a control population. The implications of these findings are critical given that many of the skeletal remains examined by forensic anthropologists come from marginalized backgrounds, including malnutrition. This research suggests that measurements based on healthy cases may not be useful in an analysis of individuals with poor diet and health. It is argued that new standards for histological age assessment methods need to be created that account for variation in the health status of individuals examined by forensic anthropologists.