Abstract
Objective: To compare rural and urban food insecurity in a high-risk obstetrics population prior to and during the COVID-19 pandemic. Methods: Utilizing convenience sampling of high-risk obstetrics patients, validated survey questions assessed self-reported food insecurity from March - October 2019 (pre-COVID-19) and March - October 2020 (COVID-19). Chi-squared analysis compared food insecurity between these two periods and among patients living in rural vs. urban counties.Results: A total of 1089 (pre-COVID-19) and 1246 (COVID-19) screenings were completed. Compared to 2019, the prevalence of food insecurity in 2020 was significantly higher from March-June only (7.8% pre-COVID-19 vs. 11.4 % COVID-19, p=0.04). Despite pre-COVID-19 similarity, rural patients reported significantly higher food insecurity prevalence during COVID-19 than urban counterparts (12.9% rural vs. 8.2% urban, p<0.01). Conclusions: The COVID-19 pandemic was associated with a disproportionate effect on food insecurity among rural patients with high-risk pregnancies. Rural health systems and agencies should explore proactive screening and intervention efforts to mitigate the adverse, downstream health effects of food insecurity.
Highlights
Food insecurity is a social determinant of health associated with higher risks of many chronic conditions including diabetes, cardiovascular disease, mental health disorders, as well as higher annual healthcare expenditures.[1,2] Among obstetrics patients, food insecurity is associated with adverse pregnancy outcomes including preterm birth, low birthweight, and gestational diabetes.[3]Rural, non-metropolitan communitiesPlease cite this paper as: Chen A, Merritt K, Greenwood A, Syrop CH, Haugsdal ML
In Iowa, the estimated food insecurity prevalence increased from 10.5% in 2019 to 24.5% in March-April 2020.6,7 Considering the numerous adverse effects of food insecurity on pregnancy and health outcomes, it is important that we examine and identify the effect of COVID-19 on food insecurity in vulnerable populations, including highrisk obstetrics (HROB) patients and rural communities
This study aims to characterize the prevalence of food insecurity in a highrisk obstetrics (HROB) population prior to and during the COVID-19 pandemic across rural and urban counties in Iowa
Summary
Food insecurity is a social determinant of health associated with higher risks of many chronic conditions including diabetes, cardiovascular disease, mental health disorders, as well as higher annual healthcare expenditures.[1,2] Among obstetrics patients, food insecurity is associated with adverse pregnancy outcomes including preterm birth, low birthweight, and gestational diabetes.[3]. Please cite this paper as: Chen A, Merritt K, Greenwood A, Syrop CH, Haugsdal ML. COVID-19 expands food insecurity disparities among rural, high-risk obstetrics patients. Available from: https://pubs.lib.uiowa.edu Free full text article
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