High food insecurity in Latinx families and associated COVID-19 infection in the Greater Bay Area, California

Abstract

Background Food insecurity impacts nearly one-in-four Latinx households in the United States and has been exacerbated by the novel coronavirus or COVID-19 pandemic. Methods We examined the impact of COVID-19 on household and child food security in three preexisting, longitudinal, Latinx urban cohorts in the San Francisco Bay Area (N = 375 households, 1875 individuals). Households were initially recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff prior to the COVID-19 pandemic. For this COVID-19 sub-study, participants responded to a 15-min telephonic interview. Participants answered 18 questions from the US Food Security Food Module (US HFSSM) and questions on types of food consumption, housing and employment status, and history of COVID-19 infection as per community or hospital-based testing. Food security and insecurity levels were compared with prior year metrics. Results We found low levels of household food security in Latinx families (by cohort: 29.2%; 34.2%; 60.0%) and child food security (56.9%, 54.1%, 78.0%) with differences between cohorts explained by self-reported levels of education and employment status. Food security levels were much lower than those reported previously in two cohorts where data had been recorded from prior years. Reported history of COVID-19 infection in households was 4.8% (95% Confidence Interval (CI); 1.5–14.3%); 7.2% (95%CI, 3.6–13.9%) and 3.5% (95%CI, 1.7–7.2%) by cohort and was associated with food insecurity in the two larger cohorts (p = 0.03; p = 0.01 respectively). Conclusions Latinx families in the Bay Area with children are experiencing a sharp rise in food insecurity levels during the COVID-19 epidemic. Food insecurity, similar to other indices of poverty, is associated with increased risk for COVID-19 infection. Comprehensive interventions are needed to address food insecurity in Latinx populations and further studies are needed to better assess independent associations between household food insecurity, poor nutritional health and risk of COVID-19 infection.

The citizenship shield: Mediated and moderated links between immigration status, discrimination, food insecurity, and negative health outcomes for latinx immigrants during the COVID‐19 pandemic

“…Similar to Escobar et al ( 2021 ), our study demonstrated low levels of food security among Latinxs during COVID‐19. Although Escobar et al ( 2021 ) did not examine documentation status in their study, they determined that level of education and employment status were associated with decreased levels of food security—two factors that are tied to documentation status.…”

“…Furthermore, an underexplored construct in this link between discrimination and health is food insecurity, which can be defined as lack of access to enough food at all times for an active and healthy life. Food insecurity can be conceptualized as an indicator of vulnerability linked to intersecting social determinants of health that were impacted during the COVID‐19 pandemic (Escobar et al, 2021 ; Owens et al, 2020 ), and which are aggravated with experiences of discrimination. This includes the economic resources and/or connection to social resources that ensure adequate access to food.…”

Household and social characteristics associated with COVID-19 vaccine intent among Latino families in the San Francisco Bay Area

“…Similarly, among the more economically heterogeneous TAB cohort, we also did not find any associations with education or income but crowding indices were also associated with intent to vaccinate against COVID-19. Paradoxically, increased housing density elevates risk for infection with SARS-Co-V2 [ 17 ], and our findings suggest that these same high-risk individuals may be less likely to get access to vaccination against COVID-19. Crowding indices may reflect immigration status, which was not collected in our survey, as previous studies have found that undocumented immigrants live in more crowded and less secure housing situations [ 24 ].…”

“…We re-contacted these cohorts telephonically in 2020 during an early period in the COVID-19 pandemic (May to September 2020) to assess food insecurity (as measured by 18 questions from the US Food Security Food Module (US HFSSM) [ 16 ]), housing conditions (including how many individuals living in a household, number of individuals sharing a bedroom and sharing a bathroom) and risk factors for COVID-19 infection (e.g. as measured by working as an essential worker during lockdown) [ 17 , 18 ].…”

Household Density and Influences from Family and Friends Shape Vaccine Intent Among Latino Families in the San Francisco Bay Area

“…The HEN and LEAD cohorts consist primarily of foreign born mothers (from Mexico and Central American countries) and were recruited primarily from ZSFG whereas TAB includes a more heterogenous mix of Latino families recruited primarily from UCSF Benioff. We re-contacted these cohorts telephonically in 2020 during an early period in the pandemic (May to September 2020) to assess food insecurity, housing conditions and risk for COVID-19 infection (Escobar et al, 2021;Mendez et al, in press).…”