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As of this writing, more than 177 000 Americans have died of COVID-19, and nearly 6 million cases have been confirmed in the United States. The pandemic has exposed and exacerbated serious disparities along racial/ethnic and socioeconomic lines with lowincome Americans and Black and Hispanic Americans being the most likely to get sick and die from COVID-19. But the case counts, infection rates, and deaths are just the tip ofthe iceberg. The economic downturn caused by the COVID-19 pandemic has already led to devastating consequences for millions of Americans who were struggling to make ends meet and will continue to exert lasting damages disproportionately felt by lowincome Americans and communities of color.As society shut down to curb the spread of the virus, tens of millions of Americans lost their jobs or saw their incomes dramatically reduced, likely increasing poverty rates.1 As a consequence, Americans struggled to afford food, shelter, and other basic needs, widening existing disparities that will result in long-term health consequences. One immediate consequence of the economic downturn has been apparent since the start ofthe pandemic. Since mid-March 2020, numerous surveys have documented unprecedented levels of food insecurity that eclipse anything seen in recent decades in the United States, including during the Great Recession. Over the past five years, US Department of Agriculture (USDA) estimates of food insecurity in the United States have hovered around 11% to 12%. As of March and April 2020, national estimates of food insecurity more than tripled to 38%.3 In a national survey we fielded in March 2020 among adults with incomes less than 250% of the 2020 federal poverty level (based on thresholds from the US Census), 44% of all households were food insecure including 48% of Black households, 52% ofHispanic households, and 54% of households with children.

Converging research indicates that household food insecurity impedes children from reaching their full physical, cognitive, and psychosocial potential. This state-of-the-art review examines the last decade of research to: (1) describe the impact of the severity and persistence of food insecurity on child development; (2) use a socio-ecological framework to examine significant proximal and distal factors which may interplay; and (3) outline directions for future research. We conducted a systematic review of six databases of published papers from 2011 to June 2021. The search was limited to high-income countries and children aged from birth to 12 years. From 17,457 papers, 17 studies were included in the final review. Transitioning between food security and food insecurity had a significant and lasting effect on academic/cognitive function and behavior (i.e., externalizing), however less clear relationships were seen for psychosocial outcomes and other behaviors examined (i.e., internalizing). There was significant variation in the measurement and thresholds used to define both food insecurity and child development outcomes. Subsequently, comparisons across studies are difficult. Several future recommendations, including incorporation of socio-ecological factors, is provided. In conclusion, this review supports the link between food insecurity and sub-optimal child development; however, there is an imperative to improve and extend current understanding to ameliorate the causes of food insecurity.

In response to the rapid spread of COVID-19, governments across the globe have implemented local lockdowns that have led to increased unemployment and have disrupted local and international transport routes and supply chains. Whilst such efforts aim to slow or stop the spread of the SARS-CoV-2 virus, they have also resulted in increased food insecurity, whether due to reduced incomes or increased food prices. This is the first paper to track food insecurity and its determinants during the pandemic using multi-country and multi-wave evidence. Using data from 11 countries and up to 6 waves of High-Frequency Phone Survey data (household-level surveys) on COVID-19 and its impacts, we use a fixed-effects linear probability model to investigate the socioeconomic determinants of food insecurity during the pandemic for each country using household-level data over multiple waves. We control for socioeconomic characteristics including gender and education of the household head; income and poverty status of the households during the pandemic; safety nets in the form of cash and food assistance; coping strategies adopted by households; and price effects of major food items. Our findings suggest that cash safety nets appear to have been more effective than food in terms of reducing food insecurity during the pandemic; and that those particularly hard hit are female headed-households (highest in Malawi: 0.541, 95% CI 0.516, 0.569; lowest in Cambodia: 0.023, 95% CI 0.022, 0.024), the less educated (highest in Djibouti: − 0.232, 95% CI − 0.221, − 0.244; lowest in Nigeria: 0.006, 95% CI − 0.005, − 0.007), and poorer households (highest in Mali: 0.382, 95% CI 0.364, 0.402; lowest in Chad: 0.135, 95% CI 0.129, 0.142). In line with the existing literature, our results show that, even controlling for income loss and poverty status, those households who had to borrow rather than rely on savings had a higher probability of suffering from food insecurity. Distinct differences in the efficacy of safety nets across the 11 countries, and the differential impact of the pandemic on different groups within societies, suggest in-depth country-specific studies are needed to understand why some countries have coped better than others. Our paper highlights the importance of improving household resilience to future systemic crises, and using evidence-based best practice in the design of relevant policy instruments.

Poor dietary patterns leading to poorer health and increased health care use have affected people living in disadvantaged economic circumstances in the UK for decades, which many fear will be exacerbated due to the UK's current so-called ‘cost of living crisis’. The voices of experts by experience of those health and social inequalities are not routinely included in health improvement intervention development in relation to obesity prevention policy and programmes. Obesity is highly correlated with food insecurity experience in high-income country contexts (where food insecurity data are routinely collected) and is similarly socially patterned. Using a health equity lens, this review paper highlights qualitative research findings that have revealed the perspectives and direct experiences of people living with food insecurity, or those others supporting food-insecure households, that shed light on the role and influence of the socio-economic contextual factors food-insecure people live with day-to-day. Insights from qualitative research that have focused on the granular detail of day-to-day household resource management can help us understand not only how food insecurity differentially impacts individual household members, but also how behavioural responses/food coping strategies are playing into pathways that lead to avoidable ill health such as obesity, diabetes and other chronic health conditions, including mental health problems. This review paper concludes by discussing research and policy implications in relation to food-insecure households containing people with chronic health conditions, and for pregnant women and families with infants and very young children living in the UK today.

•While significant differences were found between males and females, the effect size was small indicating both genders were equally affected.•Approximately 71% of the sample was moderately to severely food insecure.•Members of the LGBTQI community were more likely to experience food insecurity.•First generation students were also more likely to experience food insecurity.•Public private partnerships are crucial to addressing food insecurity among distance education students. Food insecurity is a widely studied phenomenon; however, studies documenting food insecurity among Open Distance and e-Learning students are sadly lacking. This paper aim of this paper is to study the prevalence of food insecurity among Open Distance and e-Learning students in South Africa. The purpose is to test the common assumption that Open Distance and e-Learning students do not struggle with food insecurity as they are typically living at home or employed. The method used in this paper was an online anonymous version of the Food Insecurity Experience Scale and was administered through Qualtrics. Only 27.9% (n = 2084) of respondents were food secure and mildly food insecure (score of 1 to 4), while those who were moderately food insecure constituted 16.7% (n = 1250) of the sample (score of 5 to 6) and those with severe food insecurity constituted 55% (n = 4130). The dependent variable was not normally distributed and therefore nonparametric measures were used to test for differences in groups, namely, the Kruskal–Wallis and the Mann–Whitney U tests. The results show that African students are more likely to experience food insecurity compared to their counterparts, while there were no substantive differences in gender. Members of the LGBTQI community were also shown to be at higher risk of food insecurity. Those whose primary income was either grants or income from an informal business were at higher risk of food insecurity than those who worked full time. The findings of this study underscore the pervasive nature of food insecurity among students in South African Open, Distance and e-Learning education

The COVID-19 public health crisis has led to a historic increase in food insecurity throughout the United States. Long lines of people-some on foot, some in cars-waiting to receive food assistance have made headlines since March 2020. Photographs of these lines, reminiscent of photographs of the bread lines of the Great Depression, have highlighted the need for stronger coordination between government and the charitable food system to adequately address food insecurity.In 2020, Feeding America conservatively projected a 36% growth in national food insecurity rates: from 11.5% in 2018 to 15.6%.1,2 The proportion of disadvantaged adults receiving charitable food rose 61%: from 9.0% in December 2019 to 14.5% in June 20203 To address this increased need, the charitable food assistance system has quickly adapted. However, the charitable system alone cannot meet this staggering hunger crisis. Federal and state government assistance must be expanded to support the charitable food system, as the repercussions of the pandemic are likely to continue for years to come.

Background From 2014–2019, Latin America and the Caribbean had the fastest growth of moderate-to-severe food insecurity than any other region, rising from 22.9% to 31.7%. While the prevalence of food insecurity is higher among women than men in every continent, Latin America has the largest food insecurity gender gap. Factors contributing to this gender inequity include underrepresentation of women in formal employment, heightened burden of dependent care on women, and unequal compensation of labor for women vs. men. The objective of this study was to investigate the association between the gender of the head of the household, employment status of household members, and food insecurity in households with children in a low-income district of Lima, Peru. Methods This cross-sectional study was carried out in Villa El Salvador, the fifth largest district in Metropolitan Lima, Peru, where over 20% of the population lives in poverty. Data were collected on a stratified random sample ( n  = 329) using a household questionnaire, including a validated food security tool (HFIAS). We ran multivariate logistic regression models predicting household food insecurity, with independent variables including gender of household head, education of household head, employment of household head, household-level employment status, age, and weekly food expenses per person. Results In fully adjusted models, woman-headed households had almost thrice the odds of being food insecure compared to man-headed households. Education also had a significant effect size: a household whose household head did not complete high school was 3.4 times more likely to be food insecure than if they had some post-secondary education. Woman-headed households had a significantly higher proportion of members not formally employed, compared to man-headed households, but employment status was not associated with food insecurity. Conclusions Gender of the household head was a major contributing factor to household food insecurity in Villa el Salvador. Gender dynamics affecting opportunities for employment, education, and non-remunerated work should inform national food security policies and interventions with the goal to not only lower food insecurity, but also reduce gender inequities in food insecurity and other nutritional outcomes.

Household food insecurity (HFI) is a powerful stressor negatively associated with early childhood development (ECD). However, no comprehensive review has examined the association of HFI and ECD. Therefore, this systematic review and meta‐analysis investigated the association between HFI and ECD domains and subdomains in children under 5 years old. Peer‐reviewed and grey literature were systematically searched in electronic databases with no year or language restrictions. Studies were eligible if they assessed the association between HFI and one or more ECD domains. Data were extracted using a standard predefined protocol. Meta‐analysis was performed, and the heterogeneity across studies was explored. Nineteen studies were included in the systematic review and 14 in the meta‐analysis. Of the studies, 15 were from high income countries (HICs) and four from low–middle income countries (LMICs). For developmental risk and the cognitive/math and cognitive/school readiness and reading subdomains, the only studies available were conducted in HICs. The meta‐analysis showed that HFI was associated with developmental risk (OR 1.28; 95% CI [1.14, 1.45]), cognitive/vocabulary (OR 0.94; 95% CI [0.90, 0.98]), and cognitive/math (OR 0.84; 95% CI [0.73, 0.96]). HFI was marginally associated with cognitive/school readiness and reading (OR 0.91; 95% CI [0.82, 1.00]) and motor development (OR; 0.91, 95% CI [0.80, 1.04]). HFI was associated with poor ECD in children under 5 years old. Specifically, HFI was associated with developmental risk and poor math skills in studies conducted in HICs and with poor vocabulary skills in studies conducted in both HICs and LMICs. Prospective studies examining HFI and ECD are needed in LMICs.

This study aimed to identify and rank the different aspects of households' vulnerability to food insecurity. The data were collected by a standard online questionnaire. The Household Food Insecurity Access Scale was used to assess food insecurity levels, and first-order structural equation modelling was applied to determine factors that affect food insecurity. Seven dimensions of vulnerability were measured: economic, social, cultural, human, physical, psychology and information, using thirty-seven items extracted from the related literature review. This study was implemented in Tehran province in Iran. The sample included 392 families residing in Tehran province which was determined using random sampling. About 61 % of the total sample faced food insecurity, at marginal, moderate and severe levels. Economic, psychological and human aspects of vulnerability had the highest effect on food insecurity during the initial COVID-19 lockdown. Authorities and policymakers must provide economic and financial support to vulnerable households. Abolition of US economic and financial sanctions imposed on Iran must be implemented to battle with COVID-19 in this country.

Background Due to the relatively low numbers of households in high income countries experiencing food insecurity most studies conflate the levels of severity, which masks between- and within-country differences. This study aims to describe the characteristics of individuals living in high income countries who were moderately or severely food insecure and investigates temporal trends in prevalence. It assesses these characteristics in comparison to those who were food secure. Methods This is a secondary analysis of data collected by the FAO Voices of the Hungry between 2014–2018. The data were collected during the annual Gallup World Polls of nationally representative samples using the Food Insecurity Experience Scale. Data from 34 highly developed, wealthy countries were analysed. The age, gender, income, education, area of residence and household structure of individuals experiencing moderate/severe food insecurity (FI), and severe FI, were compared using ANOVA, Welch’s F, Pearson’s Chi-square, and Linear-by-Linear Association, dependent on the variable of interest. Hierarchical cluster analysis was used to group countries according to their prevalence of moderate/severe FI, and severe FI. Results Overall, 6.5% of the weighted sample were moderately/severely food insecure (M-SFI), while 1.6% were severely food insecure. M-SFI individuals were present in all 34 countries, in all years and across all education levels and income quintiles. The proportion of individuals experiencing moderate/severe FI varied between years and countries. Fifteen countries showed a significant downward temporal trend in prevalence of moderate/severe FI ( p  < 0.001), while three countries demonstrated an increasing temporal trend driven by increasing prevalence in those aged 65 years or less ( p  < 0.001). Comparing individuals experiencing moderate versus severe FI showed over-representation of males, single adult households and lower household income in the severe FI group. Conclusions Individuals across all income, education and age categories living in high income countries are experiencing moderate/severe food insecurity, but with higher prevalence in those experiencing more disadvantage. Over the study period some countries experienced escalating while others demonstrated decreasing moderate/severe FI trends. This comparison of countries with similar economic and human development indices highlights an opportunity to investigate subtle variations in social, economic and education policy that could have profound impacts on food insecurity.