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Home visiting programs (HVPs) provide services to pregnant individuals and parents of young children to improve families’ health and well-being. However, little is known about these families’ social contexts. This study explores the social networks and dietary intake of mothers enrolled in a HVP, focusing on health support and health undermining. Cross-sectional data from 76 mothers enrolled in a HVP in Los Angeles County were collected by interview, using validated measures. Almost all mothers (95.7%) had one or more health supporters, while 55.1% had one or more health underminers. Some key findings related to health support were that mothers with higher income had more health supporters in their network (b = 1.36,p = 0.03), and network members were more likely to be health supporters if they were a romantic partner (OR = 3.41,p < 0.001), a resource-based connection (OR = 3.46,p < 0.01), or if they lived in the same neighborhood as the mother (OR = 1.68,p < 0.05). Further, having a health supporter who lived in the same neighborhood was associated with consuming more (1 + daily servings) vegetables (OR = 3.0,p < 0.05) and no sugar-sweetened beverages (OR = 0.29,p < 0.05). There were fewer findings related to health undermining: network members more likely to be underminers were romantic partners (OR = 8.93,p < .0001), and those perceived as having overweight or obesity (OR = 3.98,p < 0.001), but health undermining did not predict dietary intake. Overall, a broad set of network features were linked with health support, and given that some types of support were linked with better diet, network-based diet interventions leveraging health support may be effective in this priority population.

 

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.

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.

Data were collected in October 2020 and January 2021, during the peak of the coronavirus disease 2019 pandemic in Los Angeles County.

903 adults representative of Los Angeles County households.

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.

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.

 

Food insecurity spiked in some U.S. regions during the COVID-19 pandemic, as did food access challenges. Concerns were raised that these food issues were more prominent in food deserts, or neighborhoods lacking access to a grocery store or supermarket. Using data collected from a representative sample of Los Angeles County adults between April and October 2020, this study examined relationships between self-reported food insecurity, perceived food access barriers, and residing in a food desert, and examined differences across key geographic regions of the county. There was little relationship between residing in a food desert and experiencing food insecurity. However, perceived grocery store closures/limited hours and not having access to a vehicle were commonly reported barriers to food access, which were associated with more food insecurity. These findings suggest that geographic disparities in food access impact food insecurity. Efforts to address food insecurity should center on achieving food justice and addressing disparities across geographic regions.

 

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.