The pandemic reveals; the novel coronavirus (COVID-19) pandemic has brought the historically rooted inequities of our society to the forefront. We argue that an intersectional analysis is needed to further help peel back the veil that the pandemic has begun to reveal. We identify structural gendered racism—the totality of interconnectedness between structural racism and structural sexism in shaping race and gender inequities—as a root cause of health problems among Black women and other women of color, which has been amplified during the pandemic. We show that women of color occupy disadvantaged positions within households, occupations, and health care institutions, and therefore face heightened risk for COVID-19 and lowered resources for mitigating the impact of the deadly virus. Intersectional analyses and solutions must be centered to also reveal, we hope, a new way forward.

Background There are significant health technology gaps between Latinos and non-Hispanic whites and between first- and second-generation Latinos. Objective This study aimed to examine disparities in Web-based health information–seeking behavior (HISB) and patient portal use among Latinos, taking into account nativity and subethnic affiliation. Methods We analyzed US-born, non-Hispanic whites and Latinos adults (N=49,259) and adult internet users (N=36,214) in the 2015 to 2016 National Health Interview Survey using a binary logistic regression controlling for individual difference level variables. Outcomes were internet use, HISB (health information-seeking online and using a chat group for health information), and patient portal use (using a computer to schedule an appointment, filling a prescription, and communicating with a provider). Results We found that US-born Mexicans (odds ratio [OR] 0.81, 95% CI 0.66-0.99), foreign-born Mexicans (OR 0.35, 95% CI 0.29-0.42), foreign-born Puerto Ricans (OR 0.62, 95% CI 0.44-0.87), foreign-born Central and South Americans (OR 0.42, 95% CI 0.33-0.53), and foreign-born other Latinos (OR 0.34, 95% CI 0.24-0.49) had lower odds of using the internet than US-born non-Hispanic whites. The relationship between subgroup affiliation and Web-based HISB varied by type of technology. US-born Mexicans (OR 0.77, 95% CI 0.66-0.9), foreign-born Mexicans (OR 0.51, 95% CI 0.43-0.61), foreign-born Central and South Americans (OR 0.53, 95% CI 0.43-0.64), and foreign-born other Latinos (OR 0.56, 95% CI 0.4-0.79) had lower odds of looking up health information online than US-born non-Hispanic whites. Controlling for age, sex, education, income to federal poverty level, and region, foreign-born Central and South Americans (OR 0.61, 95% CI 0.41-0.92) and foreign-born other Latinos (OR 0.26, 95% CI 0.1-0.68) had lower odds of filling a prescription using a computer than US-born non-Hispanic whites. Foreign-born Mexicans (OR 0.51, 95% CI 0.36-0.72) and foreign-born Central and South Americans (OR 0.7, 95% CI 0.5-0.99) have lower odds of emailing a health care provider than US-born non-Hispanic whites. Posthoc analyses were conducted among Mexican-Americans to see if age was significant in predicting Web-based HISB or other patient portal use. We found individuals aged 18 to 30 years had higher odds of using the internet (OR 3.46, 95% CI 2.61-4.59) and lower odds of looking up health information online (OR 0.75, 95% CI 0.58-0.96). A posthoc analysis was conducted among Mexican-Americans to see if nativity predicted Web-based HISB and patient portal use. We found that US-born individuals had higher odds (OR 52.9, 95% CI 1.2-1.93) of looking up health information online compared with foreign-born individuals. Conclusions We found Latino subgroups do not use health information channels equally, and attempts to target Latinos should take ethnicity and nativity into account. ...

The coronavirus disease 2019 (COVID-19) pandemic increased food insecurity among US households, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with US caregivers of infants under 2 years of age (N = 319) to assess how the COVID-19 pandemic impacted breastfeeding, formula-feeding and household ability to obtain infant-feeding supplies and lactation support (68% mothers; 66% White; 8% living in poverty). We found that 31% of families who used infant formula indicated that they experienced various challenges in obtaining infant formula, citing the following top three reasons: the formula was sold out (20%), they had to travel to multiple stores (21%) or formula was too expensive (8%). In response, 33% of families who used formula reported resorting to deleterious formula-feeding practices such as diluting formula with extra water (11%) or cereal (10%), preparing smaller bottles (8%) or saving leftover mixed bottles for later (11%).Of the families who fed infants human milk, 53% reported feeding changes directly as a result of the pandemic, for example, 46% increased their provisioning of human milk due to perceived benefits for the infant's immune system (37%), ability to work remotely/stay home (31%), concerns about money (9%) or formula shortages (8%).Fifteen percent of families who fed human milk reported that they did not receive the lactation support they needed and 4.8% stopped breastfeeding. To protect infant food and nutrition security, our results underscore the need for policies to support breastfeeding and ensure equitable and reliable access to infant formula.

The COVID-19 pandemic drastically increased food insecurity among U.S. households, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with U.S. caregivers of infants (<2 years) (N=319) to assess how the COVID-19 pandemic impacted breastfeeding, formula-feeding, and household ability to obtain infant-feeding supplies and lactation support (68% mothers; 66% white; 8% living in poverty). Results suggest that the COVID-19 pandemic had a greater negative impact on formula-feeding families, largely due to formula shortages and financial strain. We found 31% of formula-feeding families indicated they experienced various challenges to obtaining formula, citing the following top three reasons: formula was sold out (20%), had to travel to multiple stores (21%), or too expensive (8%). In response, 33% of formula-feeding families reported resorting to potentially harmful feeding practices such as diluting formula with extra water (12%) or cereal (10%), preparing smaller bottles (8%), or feeding left-over/expired formula (11%). Only 15% of breastfeeding families reported feeding difficulties directly as a result of the pandemic—15% were reluctant to obtain lactation support and 9% weaned early. In fact, 51% of breastfeeding families reported increased provision of human milk to infants due to perceived benefits for the infant’s immune system (37%), ability to work remotely/stay home (31%), or concerns about money (8%) or formula shortages (8%). To protect infants from malnutrition in future crises, our results underscore the need for policies to support breastfeeding families and ensure equitable access to infant formula.