Food insecurity during the COVID-19 pandemic who use drugs in Vancouver, Canada.

ABSTRACT

OBJECTIVE: To examine prevalence and factors associated with food insecurity among people who use drugs (PWUD) during the first year of the COVID-19 pandemic and the overdose crisis. DESIGN: This cross-sectional study employs multivariable logistic regression to identify factors associated with self-reported food insecurity. PARTICIPANTS: PWUD who are part of three community-recruited cohorts. SETTING: Interviews conducted in Vancouver, Canada, via phone between July and November 2020 in adherence to COVID-19 safety procedures. RESULTS: Among 765 participants, including 433 (56·6 %) men, eligible for this study, 146 (19·1 %; 95 % CI 16·3 %, 21·9 %) reported food insecurity in the past month. Of the participants reporting food insecurity, 114 (78·1 %) reported that their hunger levels had increased since the beginning of the pandemic. In multivariable analyses, factors independently and positively associated with food insecurity included difficulty accessing health or social services (adjusted OR (AOR) = 2·59; 95 % CI 1·60, 4·17); having mobility difficulties (AOR = 1·59; 95 % CI 1·02, 2·45) and engaging in street-based income generation (e.g. panhandling and informal recycling) (AOR = 2·31; 95 % CI 1·45, 3·65). CONCLUSION: Approximately one in five PWUD reported food insecurity during this time. PWUD with mobility issues, who experienced difficulty accessing services and/or those engaged in precarious street-based income generation were more likely to report food insecurity. Food security is paramount to the success of interventions to prevent COVID-19 and drug toxicity deaths. These findings suggest a need for a more unified state response to food insecurity that prioritises and incorporates accessibility and autonomy of the communities they serve.