Social inequities in a psychological domain of food insecurity among mothers from southern brazil during the covid-19 pandemic

We aimed to investigate the social inequalities in the fear of not having enough food for the household, a psychological domain of food insecurity, during the COVID-19 pandemic among mothers from the 2019 Rio Grande birth cohort. In 2019 we invited all mothers who gave birth to a singleton liveborn in the municipality of Rio Grande (southern Brazil) to respond to a standardized questionnaire. In 2020, we followed these mothers twice. In wave I we located 1,077 of all eligible mothers and 1,033 in wave II (follow-up rate of 52.1% and 50.4%). We estimated the absolute and relative inequalities of food insecurity according to the number of people living in the household, maternal education, family income, and income change during the pandemic using the slope index of inequalities (SII) and the concentration index (CIX), respectively. 1,021 mothers reported having food insecurity, and the prevalence was 42.8% and 44.7% for waves I and II, respectively. In wave I we observed inequities in the distribution of food insecurity, being higher among mothers living with ≥3 people (SII:-17.3; 95%CI[-29.6;-5.0]), with a lower education (SII:-36.7; 95%CI[-47.0;-26.4]), lower income (SII-48.9; 95%CI[-58.0;-39.7]), and with an income that decreased during the pandemic (SII:-47.1; 95%CI[-57.3;-36.9]). These inequities widened from wave I to wave II. This study describes the impact of the COVID-19 pandemic on maternal and family food insecurity and the increased social disparities during the pandemic, especially among the most vulnerable populations. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), grant number 433426/2018-7, and the Rio Grande Municipal Department of Health. The study was conducted within a graduate program supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES finance code 001). Moreover, this research was funded in whole, or part, by the Wellcome Trust [Grant number 210735\_Z\_18_Z]. For the purpose of open access, the author has applied for a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the Ethics Committee of the Universidade Federal do the Rio Grande, under protocol number 15724819.6.0000.5324. An informed consent form was signed by all participants during the baseline study. For WebCovid-19 follow-up, a digital acceptance of terms and conditions was obtained from the mothers before the start of the survey. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data are available by the research group entitled "Grupo de Pesquisa e Inovação em Saúde (GPIS)" (contact via coorteriogrande2019{at}gmail.com) for researchers who meet the criteria for access to confidential data.