Objective: The COVID-19 pandemic increased food insufficiency: a severe form of food insecurity. Drawing on an ecological framework, we aimed to understand factors that contributed to changes in food insufficiency from April to December 2020, in a large urban population hard hit by the pandemic. Design: We conducted internet surveys every 2 weeks in April–December 2020, including a subset of items from the Food Insecurity Experience Scale. Longitudinal analysis identified predictors of food insufficiency, using fixed effects models. Setting: Los Angeles County, which has a diverse population of 10 million residents. Participants: A representative sample of 1535 adults in Los Angeles County who are participants in the Understanding Coronavirus in America tracking survey. Results: Rates of food insufficiency spiked in the first year of the pandemic, especially among participants living in poverty, in middle adulthood and with larger households. Government food assistance from the Supplemental Nutrition Assistance Program was significantly associated with reduced food insufficiency over time, while other forms of assistance such as help from family and friends or stimulus funds were not. Conclusions: The findings highlight that during a crisis, there is value in rapidly monitoring food insufficiency and investing in government food benefits. 
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                            Socio-ecological factors linked with changes in adults’ dietary intake in Los Angeles County during the peak of the coronavirus 2019 pandemic
                        
                    
    
            Abstract Objective:Comprehensive studies examining longitudinal predictors of dietary change during the coronavirus disease 2019 pandemic are lacking. Based on an ecological framework, this study used longitudinal data to test if individual, social and environmental factors predicted change in dietary intake during the peak of the coronavirus 2019 pandemic in Los Angeles County and examined interactions among the multilevel predictors. Design:We analysed two survey waves (e.g. baseline and follow-up) of the Understanding America Study, administered online to the same participants 3 months apart. The surveys assessed dietary intake and individual, social, and neighbourhood factors potentially associated with diet. Lagged multilevel regression models were used to predict change from baseline to follow-up in daily servings of fruits, vegetables and sugar-sweetened beverages. Setting:Data were collected in October 2020 and January 2021, during the peak of the coronavirus disease 2019 pandemic in Los Angeles County. Participants:903 adults representative of Los Angeles County households. Results:Individuals who had depression and less education or who identified as non-Hispanic Black or Hispanic reported unhealthy dietary changes over the study period. Individuals with smaller social networks, especially low-income individuals with smaller networks, also reported unhealthy dietary changes. After accounting for individual and social factors, neighbourhood factors were generally not associated with dietary change. Conclusions:Given poor diets are a leading cause of death in the USA, addressing ecological risk factors that put some segments of the community at risk for unhealthy dietary changes during a crisis should be a priority for health interventions and policy. 
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                            - Award ID(s):
- 2125616
- PAR ID:
- 10545068
- Publisher / Repository:
- Cambridge University Press
- Date Published:
- Journal Name:
- Public Health Nutrition
- Volume:
- 27
- Issue:
- 1
- ISSN:
- 1368-9800
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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