Master of Public Health Program, College of Liberal Arts and Social Sciences, DePaul University, 1 E. Jackson Blvd, Chicago, IL, 60604, USA.
Department of Pharmacy Administration and Public Health, St. John's University, Queens, NY, 11439, USA.
J Racial Ethn Health Disparities. 2023 Aug;10(4):1703-1720. doi: 10.1007/s40615-022-01355-x. Epub 2022 Jul 13.
COVID-19 revealed and broadened existing disparities in large cities. This article interprets the early impacts of COVID-19 on food insecurity (FI) in the Chicago and New York City (NYC) metropolitan areas for Black, Indigenous, and People of Color (BIPOC) and provides a study using a Social Determinants of Health (SDOH) framework.
A cross-sectional survey adapted from the National Food Access and COVID Research Team (NFACT) was deployed in Chicago (N = 680) and in NYC (N = 525) during summer 2020 and oversampled for race, ethnicity, and socioeconomic status. Multivariate binary logistic regression generated adjusted odds ratios (aOR) and 95% CIs for FI and select SDOH variables, which was conducted on each dataset.
The prevalence of FI in NYC increased to 66.8% (from 57.8%) and in Chicago to 44.8% (from 41.0%). While higher income protected against FI before, protection was diminished or eliminated since COVID-19. FI declined for households with children in NYC while odds increased and became significant in Chicago. Respondents with chronic health conditions experienced increased odds of FI since COVID. In Chicago, this variable had the highest odds of FI. Respondents with depression or anxiety had increased odds of FI. In NYC, depression had the highest odds of FI. Females in NYC were protected against FI. Hispanics in NYC lost protection against FI from before to since COVID-19.
Results support the observed rise of FI for BIPOC and its association with health status. The analysis has multifaceted, structural policy implications for reducing FI in urban centers.
COVID-19 揭示并扩大了大城市中现有的差距。本文解释了 COVID-19 对芝加哥和纽约市(NYC)大都市区黑人和有色人种(BIPOC)的粮食不安全(FI)的早期影响,并使用健康的社会决定因素(SDOH)框架进行了研究。
一项从国家食品获取和 COVID 研究团队(NFACT)改编的横断面调查在 2020 年夏季在芝加哥(N=680)和纽约市(N=525)进行,并对种族、族裔和社会经济地位进行了过采样。多元二项逻辑回归生成了 FI 和选择 SDOH 变量的调整优势比(aOR)和 95%置信区间(CI),分别对每个数据集进行了分析。
纽约市的 FI 患病率从 57.8%上升到 66.8%,而芝加哥从 41.0%上升到 44.8%。虽然较高的收入在 COVID-19 之前可以保护人们免受 FI 的影响,但这种保护现在已经减弱或消失了。在纽约市,有孩子的家庭的 FI 率下降,而在芝加哥,这种情况的几率增加并变得显著。患有慢性健康状况的受访者自 COVID 以来 FI 的几率增加。在芝加哥,该变量的 FI 几率最高。患有抑郁症或焦虑症的受访者患 FI 的几率增加。在纽约市,抑郁症的 FI 几率最高。在纽约市,女性免受 FI 的影响。纽约市的西班牙裔人失去了 COVID-19 之前对 FI 的保护。
结果支持 BIPOC 中观察到的 FI 增加及其与健康状况的关联。该分析对减少城市中心的 FI 具有多方面的、结构性的政策意义。