The 30-item self-report survey took approximately 10 minutes to complete. Coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a worldwide pandemic (1). https://www.rti.org/focus-area/coronavirus-united-states-survey. A small proportion of respondents expressed concern about reliable transportation (6.4%) and childcare (8.2%). Telephone: 713-500-9344. Breastfeeding is an issue of health equity. Income can influence many aspects of a person’s life, including their health, where they live and the education that they receive. This key partnership ensures that the conversations, lessons learned, and experiences of towns and cities across the country are part of the national agenda to prevent chronic diseases. For 3 variables (food insecurity, frequency of eating out, and frequency of shopping for produce) we compared responses on similar items in data collected from 3,880 families in the same 4 locations in fall 2019, before the start of the Brighter Bites program; we used the χ2 test to assess changes. One subtheme was lack of personal protective equipment among family members working in a high-risk environment. a Brighter Bites is a nonprofit organization whose mission is to improve access to fresh fruits and vegetables and nutrition education among underserved communities. Overall, 93.5% of respondents reported being food insecure in April 2020. Our results highlight the compounding effect of the COVID-19 pandemic across the spectrum of basic social needs among low-income households with children. That I don’t want to go to the store and that I run out of food, scared to go out. My worry is that this won’t end and we won’t be able to take care of our kids. World Health Organization. Basic human needs, also called the social determinants of health, include employment, food security, housing security, access to health care, and transportation; the lack of these is linked to poor health outcomes (9). The major social determinants affecting the under 5 years' mortality and morbidity include poverty, malnutrition, inequity, lack of education, failure to implement the … Accessed August 27, 2020. Bartsch SM, Ferguson MC, McKinnell JA, O’Shea KJ, Wedlock PT, Siegmund SS, et al. Sharma S, Marshall A, Chow J, Ranjit N, Bounds G, Hearne K, et al. Sociodemographic characteristics. Both surveys provided at least 1 example of each type of store, but the baseline survey did not list “other food distributions” in the same category as food bank/food pantry. I’m worried about my children’s food and about work. https://www.dol.gov/general/topic/statistics/employment. Chowkwanyun M, Reed AL Jr. The survey also invited respondents to write in any other concerns by using this statement: “Please share your greatest concern at this time, or any other thoughts you would like to share with us.”. Corresponding Author: Shreela Sharma, PhD, RDN, LD, Professor, Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler St, Houston, TX 77030. The parent or another adult in the family used the 2-item Hunger Vital Sign screening questionnaire developed and validated by Hager et al (13) to report household food security status during the COVID-19 pandemic. Fear of grocery shopping because of COVID-19. Whitby B, Fitzpatrick K. Survey shows regions of elevated food insecurity due to COVID-19 pandemic. Quantitative data analysis. For low-income, vulnerable households there are particular challenges in creating a sense of home in a new tenancy which may have substantial effects on health and wellbeing. As indicated in subthemes and comments, many respondents were concerned about contracting COVID-19 themselves or concerned about a family member contracting COVID-19. Published May 10, 2018. Levitt L, Schwartz K, Lopez E. Estimated cost of treating the uninsured hospitalized with COVID-19. Social Determinants of Health-Related Needs During COVID-19 Among Low-Income Households With Children Our study highlights the compounding effect of the COVID-19 pandemic on households with children across the spectrum of social needs. Food shopping frequency and behavior. Social determinants of health (SDOH) external icon are conditions in the places where people live, learn, work, and play that affect a wide range of health and … Furthermore, thousands of people diagnosed and hospitalized with COVID-19 are experiencing employment challenges in conjunction with large medical bills (4–6). All values are number (percentage) unless otherwise indicated. Furthermore, the sample size differed across the locations on the basis of the proportion of families enrolled in the Brighter Bites program. Percentages may not add to 100 because of rounding. The survey asked respondents how much they had seen or heard about COVID-19. Program staff members distributed survey links through text messages. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. The social determinants affecting vaccination programs can vary among countries of different income levels, with some social determinants overlapping among these country groups. Kaiser Family Foundation. The survey was administered electronically in April 2020 to 16,436 Brighter Bites families who were enrolled in the program during the 2019–2020 school year. When we stratified results by race/ethnicity, a significantly greater proportion of African American (64.9%) and Non-Hispanic White (63.2%) respondents, compared with Hispanic respondents or in the “other” racial/ethnic group, was concerned about affordability of food (P = .009). I’m worried that my kids won’t have food (fruits, vegetables, milk, and basic hygiene items) because there’s not enough opportunity for work. Government and community agencies must have a role in developing short- and long-term strategies to address the needs of our most vulnerable and underserved populations. In addition, respondents were concerned about limited produce at various food stores, spiked produce prices, and the finances required to purchase food for their families. The other authors have no conflicts of interest relevant to this article to disclose. Healthy diet may decrease the risk of chronicle disease like stroke, heart disease, diabetes, and cancer. Qual Res Psychol 2006;3(2):77–101. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. 5 ICD-10-CM coding options include: Z59.5 extreme poverty Z59.6 low income ©2020 American Planning Association. From infancy through old age, the conditions in the social and physical environments in which people are born, live, work, and age can have a significant influence on health outcomes. Labor force statistics from the current population survey. When asked about the effect of COVID-19 on fruit and vegetable consumption, 41.4% of families reported a decrease in intake of fruits and vegetables because of COVID-19; we found no significant differences by race/ethnicity in this response (Table 2). Starting in early and mid-March, many US states began implementing social distancing measures and lockdowns, which prompted retail outlets, restaurants, schools, universities, businesses, and other entities to close, and implemented a work-from-home policy where possible. More than 100 schools participated during the 2019–2020 school year. Additionally, the survey asked respondents about their store-shopping practices: whether they physically shopped inside the store, shopped online with curbside pick-up, or shopped online with goods delivered to home. Pandemic-EBT (P-EBT) due to COVID-19. Johns Hopkins University & Medicine, Coronavirus Media Center. Published April 7, 2020. N Engl J Med 2020;383(3):201–3. We’re just worried about having a better standard of living than right now. My biggest worry is not being able to pay next month’s rent and not knowing where to go. Accessed August 27, 2020. These differences, however, were small. Impact of a pilot school-based nutrition intervention on fruit and vegetable waste at school lunches. There are major differences in the leading causes of death between low-income, middle income, and high income countries (Moss, 2015). Percentages may not add to 100 because of rounding. Understanding the social needs of our most vulnerable families with children is critical because of the health disparities associated with COVID-19 prevention and treatment (18). 5. My biggest concern is about my husband who is working picking tomatoes and he says that a lot of the workers aren’t being as careful as they should about coronavirus and that the bosses don’t care about them. Kaiser Family Foundation. Fear of returning to normalcy after COVID-19. What’s happening is really hard because there’s no work but being healthy is the important thing. d Fisher exact test. Yancy CW. Social determinants of health. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Saving Lives, Protecting People, National Center for Chronic Disease Prevention and Health Promotion, U.S. Department of Health & Human Services. We obtained informed consent from all respondents, and one parent or adult per family completed the survey. CDC twenty four seven. Our study highlights the compounding effect of the COVID-19 pandemic on households with children across the spectrum of social needs. Respondents reported the frequency (times per month) and type of store at which their household shopped for fruits and vegetables. This difference may be due to a disparity in health literacy and should be explored in future studies, given the high proportion of COVID-19–related complications and death in the African American population. g Stratified analysis showed significant differences (P < .05) in sociodemographic variables by city. f 1-way analysis of variance. Determinant One: Low Income. My biggest worry is that my family gets infected. We collated and analyzed responses to the open-ended question, “Please share your greatest concern at this time, or any other thoughts you would like to share with us.” We used thematic analysis to analyze the survey data by using an inductive approach in which we derived codes and themes on the basis of the content from the survey data (16,17). Accessed August 27, 2020. Learn more about how income affects health with APHA’s storify, Income: Lower Wages Come at Cost to Public Health. Even in affluent countries such as Canada the social gradient exists but is often masked by the high levels of overall population health status (Mikkonen & Raphael, 2010). Response rates by location were 7.7%, Houston; 3.8%, Dallas; 6.4%, Washington, DC; and 6.9%, Southwest Florida. Funding for the study was provided by Brighter Bites through Feeding Texas and the Texas Health and Human Services Commission. The number of unemployed people in the United States increased by 11.5 million from February to September 2020 (25), and this number may increase. In fall 2019, 12.7% of families reported never eating out (P < .001). To better understand the ongoing needs of families and provide critical services during the pandemic, Brighter Bites conducted a rapid-response survey in April 2020 in 4 locations (Houston, Dallas, Washington, DC, and Southwest Florida) among participating families. Interestingly, a smaller proportion of African American respondents than respondents in other racial/ethnic groups were concerned with being infected with COVID-19. https://www.theatlantic.com/family/archive/2020/04/two-pandemics-us-coronavirus-inequality/609622. Centers for Disease Control and Prevention. Although varying models exist, consideration of social determinants of health generally includes: individual and community behaviors, … The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The survey collected data on respondent’s sex, respondent’s relationship to the child, respondent’s and child’s race/ethnicity, respondent’s employment status, respondent’s education level, and enrollment in government assistance programs. To our knowledge, our study is the first to use a mixed-methods qualitative and quantitative assessment to understand the social needs of low-income families with children during the pandemic. WHO director-general’s opening remarks at the media briefing on COVID-19 — 11 March 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020. Response was voluntary. In addition, the study fills a gap in knowledge on the social needs of low-income households with children during COVID-19. We’re just worried about how to pay the bills this month. The overall survey response rate was 6.4% (1,048 of 16,436). https://www.kff.org/coronavirus-covid-19/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19. N Engl J Med 2020;382(18):e40. Health equity considerations and racial and ethnic minority groups. The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. We acknowledge the Michael & Susan Dell Center for Healthy Living for their support of the project. You will be subject to the destination website's privacy policy when you follow the link. Sharma SV, Markham C, Chow J, Ranjit N, Pomeroy M, Raber M. Evaluating a school-based fruit and vegetable co-op in low-income children: a quasi-experimental study. Furthermore, school and childcare closures, which halt school meals for children, have further pushed families into stress and food insecurity. October 18, 2016 4:19 PMCategory: Health Equity, by Matt Makara - MPH, Program Manager, Affiliate Affairs, American Public Health Association, Income can influence many aspects of a person’s life, including their health, where they live and the education that they receive. However, as a result of COVID-19–related school closures, program implementation has paused. Brighter Bites is a nonprofit, evidence-based school health program that distributes fresh produce weekly to low-income families and provides nutrition education in school and for parents (10,11). It’s been difficult to find fresh produce in the stores. Chambers has documented the connections between housing and neighborhood conditions and health disparities among low-income Latinos in the Bronx. Concern about increased prices of food in stores. c Significance set at P < .05 for all tests. Our study demonstrated a significant increase in food insecurity during the pandemic and a decrease in intake of healthy food such as fruits and vegetables. These results underscore how COVID-19 and the related economic crisis have not only caused physical harm but have further destabilized people who were already struggling. Eg, stores ) because of closure-related unemployment 2011 ; 8 ( 2 ):77–101 food and... 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