Pre-pandemic to early-pandemic changes in risk of household food insecurity among Maryland families with children.

Alysse J Kowalski,Helina Selam,Angela C B Trude,Ann Pulling Kuhn,Hannah G Lane,Maureen M Black,Erin R Hager

doi:10.1017/s136898002100481x

Abstract

The objective was to examine risk and protective factors associated with pre- to early-pandemic changes in risk of household food insecurity (FI). We re-enrolled families from two statewide studies (2017-2020) in an observational cohort (May-August 2020). Caregivers reported on risk of household FI, demographics, pandemic-related hardships, and participation in safety net programs (e.g. CARES stimulus payment, school meals). Maryland, United States. Economically, geographically, and racially/ethnically diverse families with preschool to adolescent-age children. Eligibility included reported receipt or expected receipt of the CARES stimulus payment or a pandemic-related economic hardship (n=496). Prevalence of risk of FI was unchanged (pre-pandemic: 22%, early-pandemic: 25%, p=0.27). Risk of early-pandemic FI was elevated for non-Hispanic Black (aRR=2.1 [95% CI 1.1, 4.0]) and Other families (aRR=2.6 [1.3, 5.4]) and families earning ≤300% federal poverty level. Among pre-pandemic food secure families, decreased income, job loss, and reduced hours were associated with increased early-pandemic FI risk (aRR=2.1 [1.2, 3.6] to 2.5 [1.5, 4.1]); CARES stimulus payment (aRR=0.5 [0.3, 0.9]) and continued school meal participation (aRR=0.2 [0.1, 0.9]) were associated with decreased risk. Among families at risk of FI pre-pandemic, safety net program participation was not associated with early-pandemic FI risk. The CARES stimulus payment and continued school meal participation protected pre-pandemic food secure families from early-pandemic FI risk but did not protect families who were at risk of FI pre-pandemic. Mitigating pre-pandemic FI risk and providing stimulus payments and school meals may support children's health and reduce disparities in response to pandemics.

Highlights

MethodsStudy population We recruited participants from two ongoing statewide childhood obesity prevention intervention trials in childcare or school settings, Creating Healthy Habits Among Maryland Preschoolers (CHAMP) and Wellness Champions for Change (WCC)(14,15)
Of 496 caregivers, 43 % were from Creating Healthy Habits Among Maryland Preschoolers (CHAMP) and 57 % were from Wellness Champions for Change (WCC) (Table 1)
Early-pandemic food insecurity (FI) among families with children was associated with disparities by race/ethnicity and socioeconomic status

Summary

Methods

Study population We recruited participants from two ongoing statewide childhood obesity prevention intervention trials in childcare or school settings, Creating Healthy Habits Among Maryland Preschoolers (CHAMP) and Wellness Champions for Change (WCC)(14,15). The CHAMP and WCC studies took place in fifty-four childcare centres and thirty-three schools (eighteen elementary and fifteen middle) serving low- and middleincome communities in thirteen counties. Elementary and middle schools were eligible if > 40 % of the student body was eligible for free or reduced-price school meals. In spring 2020, 1063 caregivers who had completed a pre-pandemic baseline survey were invited to re-enroll in the COVID-19 study and 593 (56 %) re-enrolled through email, text or phone (Fig. 2)

Results

Discussion

Conclusion