Development of a survey tool to assess the environmental determinants of health-enabling food retail practice in Aboriginal and Torres Strait Islander communities of remote Australia.

BACKGROUND: Environmental factors can impact the ability of food retail businesses to implement best practice health-enabling food retail. METHODS: We co-designed a short-item survey on factors influencing food retail health-enabling practice in a remote Australian setting. Publicly available submissions to an Australian Parliamentary Inquiry into food pricing and food security in remote Indigenous communities were coded using an existing remote community food systems assessment tool and thematically analysed. Themes informed survey questions that were then prioritised, refined and pre-tested with expert stakeholder input. RESULTS: One-hundred and eleven submissions were coded, and 100 themes identified. Supply chain related data produced the most themes (n = 25). The resulting 26-item survey comprised questions to assess the perceived impact of environmental factors on a store's health-enabling practice (n = 20) and frequency of occurrence (n = 6). CONCLUSIONS: The application of this evidence-informed, co-designed survey will provide a first-time cross-sectional analysis and the potential for ongoing longitudinal data and advocacy on how environmental factors affect the operations of remote stores.

Mental Health Among Puerto Rican Adolescents Living in the United States During the COVID-19 Pandemic.

OBJECTIVES: The present study examined how different family level (family financial stress, family violence) and individual (food insecurity, gender, race) determinants of health were associated with mental health among Puerto Rican adolescents living in the U.S. during the COVID-19 pandemic. METHOD: A sample consisting of 119 Puerto Rican adolescents, aged 13 to 17, was collected via Qualtrics Panels between November 2020 and January 2021. We examined the association between family financial stress experienced during the pandemic and psychological distress. We also evaluated whether the association between family financial stress and psychological distress was moderated by family violence, food insecurity, and the participant's gender and race. RESULTS: Findings showed that food insecurity positively predicted psychological distress. Results also showed that participants' race moderated the association between family financial stress and psychological distress. Specifically, we found that while there was a significant positive association between family financial stress and psychological distress among Puerto Rican adolescents who identified as a racial minority, this association was nonsignificant among White Puerto Rican adolescents. CONCLUSION: Our research highlights the significant role of COVID-19 related family financial stress and food insecurity on Puerto Rican adolescents' poor mental health during the COVID-19 pandemic.

Racionamiento, inflación e inequidad sanitaria en Venezuela: caso de las enfermedades cardiovasculares / Rationing, inflation and health inequity in Venezuela: case of cardiovascular diseases

los modelos público-sanitarios de caráctermonopólico como el venezolano, suelen asociarse a tendencias al racionamiento de los bienes y servicios que proveen a sus usuarios, así como a la merma de la calidad de estos. Por otro lado, la provisión de dichos bienes y servicios por la vía de mecanismos de mercado, tiene ante sí, el inconveniente que supone el ambiente inflacionario de su economía, cuyo impacto en los precios limita el acceso del paciente a su consumo. El caso de la enfermedad cardiovascular ofrece algunas claves para la comprensión de este fenómeno en el medio venezolano.

Public-health models of a monopolistic nature, suchas the Venezuelan, bring with them trends in the rationing ofthe goods and services they provide to their users, as well as inthe reduction of their quality. On the other hand, the provisionof these goods and services by means of market mechanisms hasbefore it, in our environment, the enormous impediment posedby the inflationary environment of its economy, whose impacton prices limits the patient's access to consumption. The case of cardiovascular disease offers some keys to understanding thisphenomenon in the Venezuelan environment.

Accuracy of Electronic Health Record Food Insecurity, Housing Instability, and Financial Strain Screening in Adult Primary Care.

This study assesses the accuracy of electronic health record­based screening questionnaires about social risk factors using external single-domain questionnaires as a comparator.

Associations of self-reported chronic obstructive pulmonary disease with indicators of economic instability and stress - 16 states, 2017.

OBJECTIVES: To examine the association between chronic obstructive pulmonary disease status and indicators of economic instability and stress to better understand the magnitude of these issues in persons with chronic obstructive pulmonary disease. METHODS: Analyzed 2017 Behavioral Risk Factor Surveillance System data from 16 states that administered the 'Social Determinants of Health' module, which included economic instability and stress measures (N = 101,461). Associations between self-reported doctor-diagnosed chronic obstructive pulmonary disease status and each measure were examined using multinomial logistic models. RESULTS: Adults with chronic obstructive pulmonary disease were more likely (p < 0.001) than adults without to report not having enough money at month end (21.0% vs. 7.9%) or just enough money (44.9% vs. 37.2%); being unable to pay mortgage, rent, or utility bills (19.2% vs. 8.8%); and that often or sometimes food did not last or could not afford to eat balanced meals (37.9% vs. 20.6%), as well as stress all or most of the time (27.3% vs. 11.6%). Associations were attenuated although remained significant after adjustments for sociodemographic and health characteristics. DISCUSSION: Financial, housing, and food insecurity and frequent stress were more prevalent in adults with chronic obstructive pulmonary disease than without. Findings highlight the importance of including strategies to address challenges related to economic instability and stress in chronic obstructive pulmonary disease management programs.

"We're all one bad day away": Impacts on Food Access in Buffalo, New York during the COVID-19 pandemic.

When COVID-19 arrived in Buffalo, New York in March 2020, there was already significant food insecurity in the region. However, barriers to food access were greatly exacerbated by the pandemic. This study assesses the pandemic's impact on food access in Buffalo through 75 surveys and 30 qualitative interviews conducted with users of food pantries. Results show that, while the pandemic did contribute to food insecurity, many food pantry users were already experiencing chronic food access issues. Specifically, issues related to transportation, stigma, and chronic poverty must be addressed for food insecure households to better endure emergency events like pandemics.

Between wealth and hunger: conditions for the promotion of food and nutritional security in the capital cities of Southern Brazil / Entre a riqueza e a fome: condições para a promoção da segurança alimentar e nutricional nas capitais do Sul do Brasil

ABSTRACT Objective: The research was carried out with the objective of evaluating the conditions for the promotion of food and nutrition security in three capitals of the southern region of Brazil. Methods: This is an evaluative research, which used an analysis and judgment matrix composed of 7 dimensions, 11 sub-dimensions, 27 indicators and 56 measures, which classified each of the elements of the matrix as excellent, good, regular or poor for the promotion of food and nutrition security in the three capitals. Data collection took place in public and freely accessible information systems. Results: The three capitals were evaluated as poor in their conditions for promoting food and nutrition security. Florianópolis and Porto Alegre presented less favorable conditions compared to Curitiba. Aspects related to universal access to adequate food and water, agroecological production systems and sustainable food supply, and traditional peoples and communities stood out negatively in the three capitals. Conclusion: Although the evaluated capitals present good socioeconomic indicators, the conditions for promoting food and nutrition security are still fragile, which is reflected in the inability to overcome hunger and food insecurity in the southern region of Brazil. The results indicate the need to qualify territorial strategies for food and nutrition security, considering different contexts, as a condition for guaranteeing the realization of the right to food with equity and priority for families and peoples in situations of social vulnerability.

RESUMO Objetivo: A pesquisa foi conduzida com o objetivo de avaliar as condições para a promoção da segurança alimentar e nutricional nas três capitais da região Sul do Brasil. Métodos: Trata-se de uma pesquisa avaliativa, que utilizou uma matriz de análise e julgamento composta por 7 dimensões, 11 subdimensões, 27 indicadores e 56 medidas. Permitiu também classificar cada um dos elementos da matriz como ótimos, bons, regulares ou ruins para a promoção da segurança alimentar e nutricional nas três capitais. A coleta de dados ocorreu em sistemas de informação públicos e de acesso livre. Resultados: As três capitais foram avaliadas como ruins em suas condições para a promoção da segurança alimentar e nutricional, sendo que Florianópolis e Porto Alegre apresentaram condições menos favoráveis em comparação com Curitiba. Destacaram-se negativamente nas três capitais, aspectos relacionados ao acesso universal à alimentação adequada e à água, aos sistemas de produção agroecológica e ao abastecimento sustentável de alimentos, e aos povos e comunidades tradicionais. Conclusão: Apesar de as capitais avaliadas apresentarem bons indicadores socioeconômicos, ainda são frágeis as condições para a promoção da segurança alimentar e nutricional, o que tem se refletido na incapacidade de superação da fome e da insegurança alimentar na região Sul do país. Os resultados alertam para a necessidade de qualificação das estratégias territoriais de segurança alimentar e nutricional, considerando os diferentes contextos, como condição para garantir a realização do direito à alimentação com equidade e prioridade para as famílias e povos em situação de vulnerabilidade social.

Diálogos regionais: Sudeste

Factors associated with food insecurity among pregnant women assisted by Universal Health Care in Lavras - Minas Gerais State / Fatores associados à insegurança alimentar em gestantes atendidas na rede pública de saúde de Lavras - Minas Gerais

Abstract Objectives: to investigate sociodemographic and economic factors associated with food insecurity among pregnant women assisted by the universal healthcare network of Lavras, Minas Gerais. Methods: a cross-sectional study investigated socioeconomic and demographic, obstetric, and nutritional conditions experienced by pregnant women. Households in which pregnant women lived were classified as food secure or food insecure using the Brazilian Food Insecurity Scale. Prevalence estimates and prevalence ratios with 95% confidence intervals were generated to test for associations between food insecurity and several socioeconomic and demographic indicators using Poisson regression analysis. Results: among 173 pregnant women who participated in the study, 48% lived in households with some level of food insecurity. Adjusted models showed that pregnant women living in food-insecure households had higher prevalence ratios of lower education attainment (aPR = 1.43, CI95% = 1.07-1.91), woman being the head of the household (aPR = 1.39, CI95% = 1.02-1.87), having family monthly income lower than 1 ½ MW (aPR = 1.68, CI95% = 1.11-2.52) and participating in the government cash transfer program (aPR = 1.47, CI95% = 1.08-1.99). Conclusions: the high prevalence of food insecurity in pregnant women assisted by the public healthcare system was associated with structural social factors. Results of this study will contribute to develop an intersectoral health and nutrition policy in order to promote food security among marginalized communities and vulnerable populations, such as pregnant women.

Resumo Objetivos: investigar fatores sociodemográficos e econômicos associados à insegurança alimentar entre gestantes atendidas pelo sistema único de saúde de Lavras - Minas Gerais. Métodos: características socioeconômicas, demográficas, obstétricas e nutricionais de gestantes foram coletadas em estudo transversal. Os domicílios das gestantes foram classificados em segurança ou insegurança alimentar utilizando a Escala Brasileira de Insegurança Alimentar. Estimativas de prevalência e razão de prevalência com intervalos de confiança de 95%, testaram associações entre insegurança alimentar e indicadores socioeconômicos e demográficos utilizando modelos de Poisson. Resultados: entre as 173 gestantes participantes deste estudo, 48% viviam em domicílios com algum nível insegurança alimentar (IA). Modelos ajustados indicaram que gestantes em IAapresentaram maior prevalência de escolaridade inferior a oito anos de estudo (aRP = 1.39, IC95% = 1.07-1.91), ser chefe de família (aRP = 1.39, IC95% = 1.02-1.87), ter renda mensal inferior a 1½ salário mínimo (aRP = 1.68, IC95% =1.11-2.25), e ser participante do Bolsa Família (aRP = 1.47, IC95% = 1.08-1.99). Conclusão: a alta prevalência de insegurança alimentar em gestantes do sistema público de saúde de Lavras está associado a fatores socio-estruturais. Os resultados desta pesquisapoderão contribuir com o desenvolvimento de políticas intersetoriais de saúde e nutrição para a promoção da segurança alimentar entre comunidades marginalizadas e populações vulneráveis.

A PNAN na perspectiva da Segurança Alimentar e Nutricional

Ciclo de debates da Política Nacional de Alimentação e Nutrição. A PNAN na perspectiva da Segurança Alimentar e Nutricional.

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 between diabetes and food insecurity in an urban setting in Angola: a case-control study.

Diabetes is common in urban settings in Sub-Saharan Africa. Household food insecurity has been suggested to increase the chance of developing diabetes among adults. The relationship between diabetes and food insecurity has not been explored in Angolan urban settings so far. This case-control (1:2) study investigated the association between diabetes and food insecurity among adults attending six healthcare facilities in Luanda (Angola) between April 2019 and September 2019. All subjects with fasting blood glucose (FBG) levels ≥ 126 mg/dl were included as cases. For each case, the next two subjects with FBG levels < 110 mg/dl were included as controls, to warrant the achievement of the set 1:2 ratio. Food insecurity was assessed using the Food Insecurity Experience Scale (FIES). A total of 663 participants (221 cases and 442 controls) were enrolled in the study. Median FIES raw score was 7 (IQR 1-8) in cases and 5 (IQR 2-8) in controls (p = 0.09). The distribution of FIES levels (0-3; 4-6; 7-8) was different between cases and controls (p < 0.0001), with highest FIES scores (7-8) recorded in 53.0% of cases and 38.2% of controls. Our findings revealed an association between diabetes and severe food insecurity among adults attending healthcare facilities in the capital city of Angola.

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.

How Food Insecurity and Financial Difficulty Relate to Emotional Well-Being and Social Functioning.

OBJECTIVES: Medically uninsured individuals living in poverty experience poor health and face social barriers that negatively affect their health. The purpose of this study was to examine the association between social barriers, particularly healthy food availability and financial difficulty, and well-being among uninsured free clinic patients in the United States. METHODS: Data were collected using a self-administered paper survey at a free clinic from adult patients who spoke and read English or Spanish (N = 666) from January to April 2019. RESULTS: Better neighborhood healthy food availability is associated with better self-reported general health. Food security is related to better emotional well-being and social functioning. Having difficulty paying rent or a mortgage is linked to worse emotional well-being and social functioning. CONCLUSIONS: Providing health education programs may not be sufficient to promote healthy eating among underserved populations because of the social barriers that they experience, such as food insecurity and financial difficulty. Future research could be performed to determine how these social factors influence those of different social and cultural backgrounds than the participants in this study.

Efeitos da crise e políticas de austeridade na insegurança alimentar e na mortalidade na infância no Brasil / Effects of crisis and austerity policies on food insecurity and in mortality childhood in Brazil

Esta tese visa identificar e analisar fatores associados à insegurança alimentar (IA) e à mortalidade na infância, apontando tendências e distribuições espaciais para estratos de menores níveis de agregação possíveis que em conjunto tenham abrangência em todo o território brasileiro. As análises investigaram a hipótese de piora do desfecho de IA grave, medido pela Escala Brasileira de Insegurança Alimentar (EBIA) e desfecho de morte antes de completar 5 anos, como efeitos da crise e/ou da política de austeridade. O trabalho envolve estudos com desenhos transversais para análises seccionais e ecológico misto de tendências espaçotemporais, a partir de dados de 4 inquéritos nacionais do IBGE, dos sistemas de informações em saúde do Ministério da Saúde para os desfechos e dados das estatísticas do registro civil do IBGE, de indicadores do Programa Bolsa Família (PBF), da Estratégia Saúde da Família (ESF) e de outros indicadores socioeconômicos de variadas fontes, todos como exposições representantes proxies da crise e da austeridade. Para os estudos seccionais adotou-se procedimento de calibração dos pesos segundo distribuição populacional por sexo e faixa etária, assim como a aplicação de métodos de estimação e modelagem que incorporam os efeitos do desenho amostral. A regressão de Poisson com estimação robusta de variância foi empregada para estimar em nível etiológico razões de prevalências de IA grave. Para o nível ecológico, empregou-se duas abordagens de modelagem multinível para 4 ou 14 medidas repetidas de estratos ao longo de dois artigos diferentes: regressão múltipla do tipo log-log para associações e modelagem de splines cúbicas para estimação de tendências. Os achados apontam impactos da austeridade em vigor, com inflexões de tendências no PBF e ESF, com reflexos sobre o aumento da IA grave e da incidência de mortalidade na infância. Projeta-se o aumento da IA e afastamento do alcance da meta 2.1 do objetivo nº 2 dos ODS em 2030 pelo Brasil, a despeito do sucesso já alcançado em 2014 para o primeiro dos ODM. Aponta-se também que, no prosseguindo na rota austera estabelecida pela emenda do teto dos gastos, o Brasil poderá continuar caminhando em sentido oposto ao estabelecido pela meta 3.2 dos ODS, podendo não ter êxito no seu alcance em 2030.

This thesis aims to identify and analyze factors associated with Food Insecurity (FI) and childhood mortality, pointing out trends and spatial distributions for strata with the lowest possible levels of aggregation that together cover the entire Brazilian territory. The analyzes investigated the hypothesis of worsening of the severe FI outcome, measured by the Brazilian Food Insecurity Scale (BFIS) and death outcome before completing 5 years, as effects of the crisis and/or austerity policy. The work involves studies with cross-sectional designs for sectional and mixed ecological analysis of spatio-temporal trends, based on data from 4 national surveys by the IBGE, from the health information systems of the Ministry of Health for outcomes, and data from statistics from the civil registry from the IBGE, from indicators from the Bolsa Família Program (BFP), from the Family Health Strategy (FHS) and from other socioeconomic indicators from various sources such as exposures that are proxies representatives of the crisis and austerity. For the sectional studies, a procedure was adopted to calibrate the weights according to population distribution by sex and age group, as well as the application of estimation and modeling methods that incorporate the effects of the sample design. Poisson regression with robust variance estimation was used to estimate at the etiological level the prevalence ratios of severe FI. For the ecological level, two multilevel modeling approaches were used for 4 or 14 repeated measures of strata over two different articles: log-log multiple regression for associations; and, modeling cubic splines for trend estimation. The findings point to the impacts of the austerity in force, with inflections of trends in the BFP and FHS, with reflections on the increase in severe FI and the incidence of mortality in infancy. It is projected that FI will increase and move away from the achievement of target 2.1 of goal 2 of the SDGs in 2030 by Brazil, despite the success already achieved in 2014 for the first of the MDGs. It is also pointed out that, by continuing on the austere route established by the spending ceiling amendment, Brazil may continue to move in the opposite direction to that established by target 3.2 of the SDGs, and may not be successful in reaching it in 2030.

Association of Food Insecurity With Allostatic Load Among Older Adults in the US.

Importance: Allostatic overload, a biomarker of wear and tear, could be the potential pathway through which food insecurity leads to increased morbidity risk. Objective: To assess the association of food insecurity with allostatic load (AL) among US adults aged 50 years or older. Design, Setting, and Participants: A multiwave longitudinal cohort study was conducted using data from the 2006 to 2014 waves of the Health and Retirement Study in a national cohort study setting. The data comprise 26 509 person-years observations from 14 394 noninstitutionalized individuals aged 50 years or older during the study period. Data were analyzed from September 1 to December 14, 2020. Exposures: Moderate food insecurity (not enough money to buy the food needed) and severe food insecurity (reduced food intake due to financial constraints) measured at the household level. Main Outcomes and Measures: The AL score (0-9, with higher scores indicating a greater risk of physiologic dysregulation) and binary indicators of dysregulated inflammatory (C-reactive protein), cardiovascular (systolic and diastolic blood pressure, pulse rate, and cystatin C), and metabolic (hemoglobin A1c, body mass index, waist-to-height ratio, total cholesterol to high-density lipoprotein cholesterol ratio) systems. Results: Of 14 394 participants included in the analysis, the median age was 60 (IQR, 56-69) years, 8143 (56.6%) were women, 517 (3.6%) were moderately food insecure, and 804 (5.6%) were severely food insecure. In adjusted models, the incidence rate of AL was 1.05 (95% CI, 1.00-1.09) times higher for the participants with moderate food insecurity and 1.11 (95% CI, 1.07-1.15) times higher for the participants with severe food insecurity, compared with those who were food secure. The increased incidence rate of AL among participants with severe food insecurity was associated with C-reactive protein level (odds ratio [OR], 1.22; 95% CI, 1.04-1.44), cystatin C level (OR, 1.23; 95% CI, 1.01-1.51), hemoglobin A1c level (OR, 1.27; 95% CI, 1.01-1.59), body mass index (OR, 1.84; 95% CI, 1.41-2.40), waist-to-height ratio (OR, 1.54; 95% CI, 1.26-1.88), and total to high-density lipoprotein cholesterol ratio (OR, 1.32; 95% CI, 1.10-1.59) inflated to the high-risk range. The interaction between moderate food insecurity and Supplemental Nutrition Assistance Program (SNAP) enrollment (ß = -0.18; P = .001) and the interaction between severe food insecurity and SNAP enrollment (ß = -0.09; P = .02) were associated with a reduction in AL. Conclusions and Relevance: In this national cohort study of US adults aged 50 years or older, food insecurity was associated with higher AL, mainly through dysregulation of the inflammatory and metabolic systems. SNAP enrollment may modify this association between food insecurity and AL.

"Now I Feel a Little Bit More Secure": The Impact of SNAP Enrollment on Older Adult SSI Recipients.

In June 2019, California expanded Supplemental Nutrition Assistance Program (SNAP) eligibility to Supplemental Security Income (SSI) beneficiaries for the first time. This research assesses the experience and impact of new SNAP enrollment among older adult SSI recipients, a population characterized by social and economic precarity. We conducted semi-structured, in-depth interviews with 20 SNAP participants to explore their experiences with new SNAP benefits. Following initial coding, member-check groups allowed for participants to provide feedback on preliminary data analysis. Findings demonstrate that SNAP enrollment improved participants' access to nutritious foods of their choice, contributed to overall budgets, eased mental distress resulting from poverty, and reduced labor spent accessing food. For some participants, SNAP benefit amounts were too low to make any noticeable impact. For many participants, SNAP receipt was associated with stigma, which some considered to be a social "cost" of poverty. Increased benefit may be derived from pairing SNAP with other public benefits. Together, the impacts of and barriers to effective use of SNAP benefits gleaned from this study deepen our understanding of individual- and neighborhood-level factors driving health inequities among low-income, disabled people experiencing food insecurity and SNAP recipients.

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.