Published April 10, 2020. The survey was administered the survey electronically in April 2020 to 16,436 Brighter Bites families who were enrolled in the program during the 2019–2020 school year. My worry is that my husband can lose his job due to the pandemic that we’re going through. ICD-10-CM coding options include: Z59.5 extreme poverty; Z59.6 low income 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). Whitby B, Fitzpatrick K. Survey shows regions of elevated food insecurity due to COVID-19 pandemic. Overall, 93.5% of respondents reported being food insecure, a 22-percentage-point increase since fall 2019. My biggest worry is getting sick, or that my kids get sick, or ending up without food or money to pay the bills. Health Aff (Millwood) 2020;39(6):927–35. 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). Prev Chronic Dis 2011;8(2):A49. The other authors have no conflicts of interest relevant to this article to disclose. The COVID-19 pandemic is occurring in the context of a global economic crisis, both of which highlight health and social challenges for the most vulnerable people in our communities. 5 ICD-10-CM coding options include: Z59.5 extreme poverty Z59.6 low income The concerns were due to various reasons, such as lack of personal protective equipment and working in frontline jobs. Program staff members distributed survey links through text messages. I’m worried about my children’s food and about work. 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). 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. Public health workers have long been witness to the inextricable links between poor health and poverty. Medicaid benefi-ciaries are low-income by definition, and one-half of all Medicare beneficiaries had incomes below US$26,000 in 2016.6 Both groups are, therefore, key target populations for addressing social needs. A small proportion of respondents expressed concern about reliable transportation (6.4%) and childcare (8.2%). In addition, 41% of respondents said that their intake of fruits and vegetables decreased because of COVID-19, and 83% said their frequency of eating food from restaurants decreased because COVID-19. Four themes emerged from the analysis of write-in responses to the question about immediate concerns during the COVID-19 pandemic (Table 3): 1) fear of contracting COVID-19, 2) disruption of employment status, 3) financial hardship, and 4) exacerbated food insecurity. Suggested citation for this article: Sharma SV, Chuang R, Rushing M, Naylor B, Ranjit N, Pomeroy M, et al. 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. Finally, our cross-sectional descriptive study does not allow us to draw conclusions on cause and effect; our study is a snapshot at an early moment in the pandemic and serves as a baseline for examining patterns of change and causal associations in future studies. If a respondent answered “never true” to both questions, we considered the household food secure. Hager ER, Quigg AM, Black MM, Coleman SM, Heeren T, Rose-Jacobs R, et al. Coronavirus resource center COVID-19 map. Frequency of grocery shopping decreased and food pantry usage increased. 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 … Currently he is working in the areas of health inequalities, marginalization, political advocacy, health policy, and the social determinants of health… The Atlantic. Figure.COVID-19-related changes in food insecurity, eating out, and food shopping behavior among low-income households with children (N = 1,048), Brighter Bites. Accessed September 10, 2020. Transforming qualitative information: thematic analysis and code development. 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. Because demographic characteristics did not vary by site, our examination of COVID-19–related knowledge, risks, attitudes, and behaviors across racial/ethnic groups did not adjust for site differences. The survey also asked if, because of COVID-19, their consumption of fruits and vegetables had increased, decreased, or stayed the same. An open-ended question asked about their greatest concern. These resources include information on where to get tested for COVID-19, how to register for government assistance programs, COVID-19 prevention practices, and maintaining healthy eating, physical activity, and mental health. 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. https://www.theatlantic.com/family/archive/2020/04/two-pandemics-us-coronavirus-inequality/609622. Levitt L, Schwartz K, Lopez E. Estimated cost of treating the uninsured hospitalized with COVID-19. Addressing the social determinants of health has been highlighted by the U.S. government’s Healthy People 2020 initiative, National Partnership for Action to End Health Disparities, and National Prevention and Health Promotion Strategy as being integral to improving health for all. Methods We used data, from the World Health Survey in 48 low-income and middle-income … A greater proportion in Houston and Washington, DC, than in the other 2 locations received Medicaid or CHIP (P < .001), whereas a smaller proportion of children in Dallas than in the other 3 locations participated in free or reduced-price meals programs (P = .04). I’m worried about my husband getting sick and spreading it to me and my kids because he’s still working and his job doesn’t provide protection. RTI International. Finally, we thank Brighter Bites staff members, participating schools, and parents for their support of the project. Published May 10, 2018. Accessed September 8, 2020. Our study is a call to action for government and community agencies to deploy short- and long-term strategies to address the needs of our most vulnerable populations. Accessed August 27, 2020. One subtheme was lack of personal protective equipment among family members working in a high-risk environment. Precarity is an important social determinant of health with demonstrated physical and mental health consequences, which affects people in low-income, middle-income and high-income contexts. Blanck HM, Thompson OM, Nebeling L, Yaroch AL. Science consistently shows that low incomes are a significant risk factor in disease incidence and severity as well as life expectancy. Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. Development and validity of a 2-item screen to identify families at risk for food insecurity. Hunger in America 2014: national report. Our qualitative assessment also demonstrated that although most respondents reported following safety guidelines, some expressed fear of becoming infected in public spaces. Most (81.8%) respondents reported knowing a great deal about COVID-19 and were concerned about being infected themselves (87.3%) or their children being infected (87.0%) (Table 2). The survey provided a checklist for these 8 items, and respondents could check all that applied. https://www.kff.org/coronavirus-covid-19/issue-brief/estimated-cost-of-treating-the-uninsured-hospitalized-with-covid-19. Lack of seriousness about COVID-19 among other people. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health. Accessed September 8, 2020. Centers for Disease Control and Prevention. There’s no work, no money and bills don’t offer forgiveness. Respondents could check all that applied. Prev Chronic Dis 2017;14:E101. 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. https://www.rti.org/focus-area/coronavirus-united-states-survey. [A tabular version of this figure is also available.]. Food shopping frequency and behavior. Prev Med 2016;91:8–17. Breastfeeding is an issue of health equity. Income: Lower Wages Come at Cost to Public Health, Housing is a Social Determinant of Health, Education is a Social Determinants of Health, Get to Know Social Determinants of Health, Planners4Health: A new approach to advancing practice at the intersection of planning and public health, Plan4Health connects people to nutrition, recreation in rural Oregon. Chowkwanyun M, Reed AL Jr. Labor force statistics from the current population survey. As of September 2020, the United States is the epicenter of the pandemic, with more than 6.3 million confirmed cases and more than 189,000 fatalities (2). 32, 33, 34 In addition, social assistance programs are designed as a safety net for all U.S. citizens, but specifically benefit low-income individuals and families. The funder/sponsor did not participate in the work. We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. Quantitative data analysis. https://coronavirus.jhu.edu/map.html. g Stratified analysis showed significant differences (P < .05) in sociodemographic variables by city. J Nutr Educ Behav 2019;51(10):1202–1210.e1. COVID-19–related concerns. However, this issue has many layers. That we don’t have masks, gloves, or disinfectant wipes because you can’t find them at the stores. Published April 23, 2020. g χ2 test. Impact of a pilot school-based nutrition intervention on fruit and vegetable waste at school lunches. https://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity. Because survey completion was voluntary, not all respondents answered all questions; thus, values for each variable may not sum to value in column head. Our objective was to conduct a cross-sectional quantitative and qualitative descriptive analysis of a rapid-response survey among low-income households with children on social needs, COVID-19–related concerns, and diet-related behaviors. Also, 46.7% of families reported receiving Medicaid, and 74.4% of the children participated in free or reduced-price meals programs. [T]he fact that they can’t eat enough fruit or food that they like. 2 Birthing parents † who do not breastfeed are at higher risk of negative health outcomes, including cancer, cardiovascular disease, … The pandemic will cleave America in two. Yancy CW. World Health Organization. e χ2 test. In addition, 83.5% of respondents reported decreasing the frequency of eating out because of COVID-19, with a greater proportion of Hispanic families (84.9%) than families in other racial/ethnic groups reporting decreased frequency (P = .003). c Significance set at P < .05 for all tests. Your research has connected housing with cardiovascular health, depression, sleep disorders, asthma, and obesity. N Engl J Med 2020;382(18):e40. I am the only financial support for my family, so if anything happened to me, I don’t know what would happen to my loved ones. Brighter Bites developed a set of comprehensive resources to disseminate to their families via text, emailed newsletters, and the Brighter Bites website (www.brighterbites.org). This variation among individuals and groups due to income is referred to as the "social gradient. I feel worried because I’m not giving enough vegetables and fruit to my children since my husband only works 3 days, and I’m not working because my baby was just born, so there are 4 children and 2 adults and I’m short of food and diapers for my baby, but what I need is food for the family. Social determinants of health may influence the burden of disease on global health in many ways. Webb Hooper M, Nápoles AM, Pérez-Stable EJ. They’re largely responsible for health disparities and can, therefore, impact cancer patients’ chances of survival. Texas Health & Human Services Commission. 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