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. 2020 Oct 1:17:E119.
doi: 10.5888/pcd17.200322.

Social Determinants of Health-Related Needs During COVID-19 Among Low-Income Households With Children

Shreela V Sharma  1   2 , Ru-Jye Chuang  1 , Melinda Rushing  1 , Brittni Naylor  1 , Nalini Ranjit  3 , Mike Pomeroy  4 , Christine Markham  5
Affiliations

Social Determinants of Health-Related Needs During COVID-19 Among Low-Income Households With Children

Shreela V Sharma et al. Prev Chronic Dis. .

Abstract

Introduction: Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. 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.

Methods: We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. The survey asked families enrolled in a coordinated school-based nutrition program about their social needs, COVID-19-related concerns, food insecurity, and diet-related behaviors during the pandemic. An open-ended question asked about their greatest concern. We calculated descriptive statistics stratified by location and race/ethnicity. We used thematic analysis and an inductive approach to examine the open-ended comments.

Results: More than 80% of survey respondents were familiar with COVID-19 and were concerned about infection. Overall, 76.3% reported concerns about financial stability, 42.5% about employment, 69.4% about food availability, 31.0% about housing stability, and 35.9% about health care access. Overall, 93.5% of respondents reported being food insecure, a 22-percentage-point increase since fall 2019. Also, 41.4% reported a decrease in fruit and vegetable intake because of COVID-19. Frequency of grocery shopping decreased and food pantry usage increased. Qualitative assessment identified 4 main themes: 1) fear of contracting COVID-19, 2) disruption of employment status, 3) financial hardship, and 4) exacerbated food insecurity.

Conclusion: Our study highlights the compounding effect of the COVID-19 pandemic on households with children across the spectrum of social needs.

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Figures

Figure
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. All changes were significant at P < .001, except for shopping at a farmers market/food co-op/farm stand ≥1 time per week (P = .31).
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