Department of Health, Behavior & Society, University of Kentucky, Lexington, KY 40506, USA.
Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY 40506, USA.
Int J Environ Res Public Health. 2024 May 4;21(5):594. doi: 10.3390/ijerph21050594.
The COVID-19 pandemic produced acute effects on health inequities, yet more enduring impacts in vulnerable populations in rural Appalachia are understudied. This qualitative study included three focus groups with thirty-nine adults (74% female, mean age 52.7 years) to obtain perspectives on the impact of the COVID-19 pandemic on well-being in Martin County, Kentucky, in fall 2022. Grounded Theory was employed using an iterative inductive-deductive approach to capture the lasting effects of the COVID-19 pandemic on health practices and status. Three prominent themes emerged: (1) increased social isolation; (2) household cost of living strains caused by inflation; and (3) higher food prices and diminished food availability causing shifts in food purchasing and consumption. Participants noted that the rising cost of living resulted in residents having to "choose between medication, food and utilities". Increased food prices resulted in residents "stretching" their food, modifying how they grocery shopped, and limiting meat consumption. Persistent food shortages were exacerbated by there being few grocery stores in the county. Lastly, increased social isolation was profoundly articulated as widely impacting mental health, especially among youth. Our findings underscore the ongoing deleterious effects of inflation and food supply chain disruptions in this rural, geographically isolated community, which resulted in difficult spending choices for residents.
COVID-19 大流行对健康不平等产生了急性影响，但在阿巴拉契亚农村地区的弱势群体中，更持久的影响仍未得到充分研究。本定性研究包括与 39 名成年人（74%为女性，平均年龄 52.7 岁）进行的三次焦点小组讨论，以了解 2022 年秋季肯塔基州马丁县 COVID-19 大流行对幸福感的影响。采用扎根理论，使用迭代归纳演绎方法捕捉 COVID-19 大流行对健康实践和状况的持久影响。出现了三个突出的主题：（1）社交隔离增加；（2）通货膨胀导致的家庭生活成本压力；（3）更高的食品价格和减少的食品供应导致食品购买和消费的转变。参与者指出，生活成本的上升导致居民不得不“在药物、食物和水电费之间做出选择”。食品价格上涨导致居民“节省”食物，改变了他们的购物方式，并限制了肉类消费。由于该县的杂货店很少，食品短缺问题更加严重。最后，人们深刻地表达了社交隔离的增加对心理健康的广泛影响，尤其是对年轻人的影响。我们的研究结果强调了通货膨胀和食品供应链中断在这个农村、地理位置偏远的社区持续产生的有害影响，这导致居民在支出方面面临艰难的选择。
