Social predictors of food insecurity during the stay-at-home order due to the COVID-19 pandemic in Peru. Results from a cross-sectional web-based survey

BackgroundStay-at-home orders and social distancing have been implemented as the primary tools to reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, this approach has indirectly lead to the unemployment of 2{middle dot}3 million Peruvians, in Lima, Peru alone. As a result, the risk of food insecurity may have increased, especially in low-income families who rely on a daily wage. This study estimates the prevalence of moderate or severe food insecurity (MSFI) and identifies the associated factors that explain this outcome during the stay-at-home order. MethodsA cross-sectional web-based survey, with non-probabilistic sampling, was conducted between May 18 and June 30, 2020, during the stay-at-home order in Peru. We used social media advertisements on Facebook to reach 18-59-year-olds living in Peru. MSFI was assessed using the Food Insecurity Experience Scale (FIES). Rasch model methodology requirements were considered, and factors associated with MSFI were selected using stepwise forward selection. A Poisson generalized linear model (Poisson GLM), with log link function, was employed to estimate adjusted prevalence ratios (aPR). FindingsThis analysis is based on 1846 replies. The prevalence of MSFI was 23{middle dot}2%, and FIES proved to be an acceptable instrument with reliability 0{middle dot}72 and infit 0{middle dot}8-1{middle dot}3. People more likely to experience MSFI were those with low income (less than 255 US$/month) in the pre-pandemic period (aPR 3{middle dot}77; 95%CI, 1{middle dot}98-7{middle dot}16), those whose income was significantly reduced during the pandemic period (aPR 2{middle dot}27; 95%CI, 1{middle dot}55-3{middle dot}31), and those whose savings ran out in less than 21 days (aPR 1{middle dot}86; 95%CI, 1{middle dot}43-2{middle dot}42). Likewise, heads of households (aPR 1{middle dot}20; 95%CI, 1{middle dot}00-1{middle dot}44) and those with probable SARS-CoV2 cases as relatives (aPR 1{middle dot}29; 95%CI, 1{middle dot}05-1{middle dot}58) were at an increased risk of MSFI. Additionally, those who perceived losing weight during the pandemic (aPR 1{middle dot}21; 95%CI, 1{middle dot}01-1{middle dot}45), and increases in processed foods prices (aPR 1{middle dot}31; 95%CI, 1{middle dot}08-1{middle dot}59), and eating less minimally processed food (aPR 1{middle dot}82; 95%CI, 1{middle dot}48-2{middle dot}24) were more likely to experience MSFI. InterpretationPeople most at risk of MSFI were those in a critical economic situation before and during the pandemic. Social protection policies should be reinforced to prevent or mitigate these adverse effects. FundingNone.