Background Food insecurity impacts nearly one-in-four Latinx households in the United States and has been exacerbated by the novel coronavirus or COVID-19 pandemic. Methods We examined the impact of COVID-19 on household and child food security in three preexisting, longitudinal, Latinx urban cohorts in the San Francisco Bay Area (N = 375 households, 1875 individuals). Households were initially recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff prior to the COVID-19 pandemic. For this COVID-19 sub-study, participants responded to a 15-min telephonic interview. Participants answered 18 questions from the US Food Security Food Module (US HFSSM) and questions on types of food consumption, housing and employment status, and history of COVID-19 infection as per community or hospital-based testing. Food security and insecurity levels were compared with prior year metrics. Results We found low levels of household food security in Latinx families (by cohort: 29.2%; 34.2%; 60.0%) and child food security (56.9%, 54.1%, 78.0%) with differences between cohorts explained by self-reported levels of education and employment status. Food security levels were much lower than those reported previously in two cohorts where data had been recorded from prior years. Reported history of COVID-19 infection in households was 4.8% (95% Confidence Interval (CI); 1.5–14.3%); 7.2% (95%CI, 3.6–13.9%) and 3.5% (95%CI, 1.7–7.2%) by cohort and was associated with food insecurity in the two larger cohorts (p = 0.03; p = 0.01 respectively). Conclusions Latinx families in the Bay Area with children are experiencing a sharp rise in food insecurity levels during the COVID-19 epidemic. Food insecurity, similar to other indices of poverty, is associated with increased risk for COVID-19 infection. Comprehensive interventions are needed to address food insecurity in Latinx populations and further studies are needed to better assess independent associations between household food insecurity, poor nutritional health and risk of COVID-19 infection.
BackgroundThe novel coronavirus (COVID-19) has disproportionately impacted the Latinx community in the United States. Environmental risk factors, including community level pollution burden and exposure to smoking and secondhand smoke, have not been evaluated in relation to risk for infection with COVID-19.MethodsWe evaluated self-reported infection rates of COVID-19 in three, preexisting, longitudinal, Latinx family cohorts in the San Francisco Bay Area from May through September 2020 (N=383 households, 1,875 people). All households were previously recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff before the pandemic. For the COVID-19 sub-study, participants responded to a 15-minute telephonic interview where we assessed food consumption patterns, housing and employment status, and history of COVID-19 infection based on community and hospital-based testing. We also evaluated secondhand smoke exposure based on previously collected self-reported data. Environmental pollution exposure was determined from census tract residence using California’s EnviroScreen 2.0 data. Non-parametric tests and multiple logistic regression were used to assess possible associations and independent predictors of COVID-19 infection.ResultsIn the combined Latinx, Eating and Diabetes Cohort (LEAD) and Hispanic, Eating and Nutrition (HEN) cohorts there was a 7.6% household infection rate (14/183) with a lower rate of 3.5% (7/200) in the Telomeres at Birth (TAB) cohort. Larger household size increased risk for infection (OR, 1.43 (95%CI 1.10-1.87)) in the combined LEAD/HEN cohorts and increasing number of children trended towards significance in the TAB cohort (OR 1.82, 95% CI 0.98-3.37). Any exposure to secondhand smoke in the household also trended towards increasing risk after adjusting for household size and other exposures (OR 3.20, 95%CI 0.80-12.73) and (OR 4.37, 95% CI 0.80-23.70). We did not find any associations between neighborhood pollution level based on census track location and risk of infection. Furthermore, we found weak evidence between dietary exposure and risk of COVID-19 infection after adjusting for possible confounders.ConclusionCrowding as indicated by household size increases risk for COVID-19 infection in Latinx families. Exposure to secondhand smoke may also increase risk for COVID-19 through increased coughing, respiratory impairment and increased travel of virus on smoke particles. Public policy and health interventions need to ensure that multiunit residential complexes prevent any exposure to secondhand smoke.
INTRODUCTION Environmental risk factors, including community level pollution burden and exposure to smoking and secondhand smoke, have not been evaluated in relation to risk for infection with COVID-19 in high risk, urban Latinx families. METHODS We evaluated risk factors for COVID-19 infection in three, preexisting, longitudinal, Latinx family cohorts in the San Francisco Bay Area from May through September 2020 (N=383 households, 1875 people). All households were previously recruited before the pandemic. For the COVID-19 sub-study, participants responded to a telephone interview where we assessed food consumption patterns, housing and employment status, and history of COVID-19 infection. Secondhand smoke exposure was based on previously collected selfreported data, and environmental pollution exposure was determined from census tract residence. Non-parametric tests and multiple logistic regression were used to assess independent predictors of COVID-19 infection. RESULTS Larger household size increased risk for infection (OR=1.58; 95% CI: 1.12-2.23, p<0.01) as did increasing number of children in household (OR=3.79; 95% CI: 1.51-9.56). Any exposure to secondhand smoke was also associated with increased risk for COVID infection (OR 4.69; 95% CI: 1.01-21.85) and having a greater number of family members eating at home was protective against infection (OR=0.10; 95% CI: 0.02-0.52, p<0.01). CONCLUSIONS Crowding, as indicated by larger household size, increases risk for COVID-19 infection in Latinx families, as does exposure to secondhand smoke. Public policy and health interventions need to ensure that multiunit residential complexes do not allow exposure to secondhand smoke between units, that individuals eat in the home environment, and that large households can safely separate individuals exposed to COVID-19.
Background Latinos have had higher case counts, hospitalization rates and deaths during the COVID-19 pandemic nationally and in the state of California. Meanwhile, Latino vaccination rates remain lower than those of non-Hispanic Whites. COVID-19 vaccine nonintent, defined as intent to not vaccinate against COVID-19, among Latino individuals continues to be an issue in the state of California. Methods Families from three Latino longitudinal mother–child cohorts previously recruited in the San Francisco Bay Area were surveyed telephonically from February to June 2021 to assess attitudes towards vaccination against COVID-19 and prior vaccination, in general, for themselves and their children. Risk for vaccine nonintent was assessed using the Mann–Whitney rank sum non-parametric test for continuous predictors and chi-squared tests for categorical ones. Results Three hundred and nineteen families were surveyed from the Telomere at Birth (TAB), Hispanic Eating and Nutrition (HEN) and Latino Eating and Diabetes Cohort (LEAD). Approximately 36% from TAB and 28% from HEN/LEAD indicated COVID-19 vaccine nonintent for themselves and/or their children. Risk factors for vaccine nonintent included lower maternal age (p = 0.01), concern about vaccine side effects (p < 0.01) and prior history of a household members being infected with SARS-CoV-2 (p < 0.01) and indexes of household crowding including number of people sharing a bathroom (p = 0.048). Vaccine intent was also associated with receiving vaccine input from friends (p = 0.03), family (p < 0.01) and/or coworkers (p = 0.02) compared with those who were not planning on getting vaccinated against COVID-19. Conclusions Latino families living in crowded living situations who may not have received any COVID-19 advice from family, coworkers or friends are at particular risk for nonintent for vaccinatation against COVID-19. Community-based grassroots or promotor/a based interventions centered on trusted individuals with close community ties and counseling concerning vaccination against COVID-19 could help boost vaccination rates in this population group.
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