SNAP participation among low-income US households stays stagnant while food insecurity escalates in the months following the COVID-19 pandemic.
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SUBMITTER: Ohri-Vachaspati P
PROVIDER: S-EPMC8437829 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:This paper makes several contributions to the literature regarding the measurement of food insecurity and implications for estimating factors that affect this outcome. First, we show that receipt of benefits from the Supplemental Nutrition Assistance Program (SNAP) has a systematic effect on responses to questions in the 12-month food security module (FSM). We find that the probability of affirming more severe food hardships items, and the probability of being classified as having very low food security (VLFS), is higher just before and just after households receive their benefits. This leads to an under-estimate of VLFS by 3.2 percentage points for the SNAP sample (about 17 percent of prevalence). We also provide informative bounds on the relationship between SNAP and VLFS and show that the treatment effect of SNAP on VLFS is also likely underestimated.
| S-EPMC7906471 | biostudies-literature
Project description:The burden of obesity disproportionately influences poor health outcomes in rural communities in the United States. Various social and environmental factors contribute to inadequate food access and availability in rural areas, influencing dietary intakes and food insecurity rates. This study aims to identify patterns related to food insecurity and fruit and vegetable consumption within a SNAP-eligible and low-income, highly obese rural Appalachian community. A prospective cohort was implemented to identify gaps in resources addressing obesity and food insecurity challenges. SAS 9.4 software was used to examine differences in dietary intakes and shopping practices among SNAP participants. Among participants (n = 152), most reported an annual household income less than USD 20,000 (n = 90, 60.4%), 29.1% reported food insecurity, and 39.5% reported receiving SNAP benefits within the last month. The overall mean FV intake was 3.46 daily servings (95% CI: 3.06-3.91) among all participants. SNAP participation was associated with food insecurity (p = 0.007) and those participating in SNAP were two times more likely to report being food insecure (OR = 2.707, 95% CI: 1.317, 5.563), relative to non-participants. These findings further depict the need for intervention, as the burden of food insecurity persists. Tailoring health-promoting initiatives to consider rurality and SNAP participation is vital for sustainable success among these populations.
| S-EPMC7504289 | biostudies-literature
Project description:Many low-income college students are barred from food assistance for no reason other than the fact that they are pursuing a college education. Based on 22 interviews that capture the experiences of food insecure college students as they attempt to navigate SNAP, this study shows how low enrollment in the program and food insecurity are the predictable outcomes of policy decisions intended to restrict access to both free public higher education and public assistance in the 1980's and 1990's and were shaped by the racialized politics of deservingness. By documenting the barriers students encounter attempting to access food assistance, this study shows how these policies play out in the lives of students at the City University of New York (CUNY) today. Ultimately, the politics of deservingness create significant direct and indirect barriers to SNAP enrollment for students and limit policy makers' and advocates' attempts to expand SNAP and address food insecurity on college campuses.Supplementary informationThe online version contains supplementary material available at 10.1007/s10460-021-10273-3.
| S-EPMC8515333 | biostudies-literature
Project description:ImportanceHouseholds with children and minoritized racial and ethnic groups experience a disproportionate burden of food hardship. During the COVID-19 pandemic, the US federal government implemented emergency allotments in the Supplemental Nutrition Assistance Program (SNAP), increasing the amount of food purchasing assistance received by many participating households.ObjectiveTo examine the association of implementing emergency allotments in SNAP with food hardship among households with children overall and for households with Black, Hispanic, and White children by comparing income-eligible households that did and did not participate in SNAP.Design, setting, and participantsThis ecologic cross-sectional study used 2016-2022 National Survey of Children's Health data and a difference-in-differences approach to compare changes in the risk of food hardship from before implementation of emergency allotments in SNAP (2016-2019) to during implementation (2020-2022). Households with children younger than 18 years and incomes 130% or less of the federal poverty level (FPL) in all 50 states and Washington, DC, were included.ExposureImplementation of emergency allotments in SNAP.Main outcome and measuresThe primary outcome was caregiver report of household food hardship during the past 12 months.ResultsOf 44 753 households with incomes 130% or less of the FPL, a weighted 23.4% had Black children, 56.7% had White children, and 19.9% had children of other races. More than one-third of households (37.8%) had Hispanic children, and 31.8% had young children aged 0 to 5 years. The percentage of households that experienced food hardship decreased from 2016 to 2021 (from 62.9% to 48.2% among SNAP-participating households and from 44.3% to 38.9% among income-eligible nonparticipating households) but increased in 2022 (to 58.0% among SNAP-participating households and to 47.5% among nonparticipating households). Adjusting for confounders, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating compared with nonparticipating households (risk ratio [RR], 0.88; 95% CI, 0.81-0.96). Implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating households with Hispanic (RR, 0.86; 95% CI, 0.72-1.02) and White (RR, 0.85; 95% CI, 0.76-0.94) children compared with nonparticipating households but not among households with Black children (RR, 1.04; 95% CI, 0.87-1.23).Conclusions and relevanceIn this ecologic cross-sectional study, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among households with children. Efforts are needed to ensure that all populations benefit from economic policies.
| S-EPMC11329880 | biostudies-literature
Project description:IntroductionThe Special Supplemental Nutrition Program for Women, Infants and Children (WIC) required major revisions to food packages in 2009; effects on nationwide low-income household purchases remain unexamined.MethodsThis study examines associations between WIC revisions and nutritional profiles of packaged food purchases from 2008 to 2014 among 4,537 low-income households with preschoolers in the U.S. (WIC participating versus nonparticipating) utilizing Nielsen Homescan Consumer Panel data. Overall nutrients purchased (e.g., calories, sugar, fat), amounts of select food groups with nutritional attributes that are encouraged (e.g., whole grains, fruits and vegetables) or discouraged (e.g., sugar-sweetened beverages, candy) consistent with dietary guidance, composition of purchases by degree of processing (less, moderate, or high), and convenience (requires preparation, ready to heat, or ready to eat) were measured. Data analysis was performed in 2016. Longitudinal random-effects model adjusted outcomes controlling for household composition, education, race/ethnicity of the head of the household, county quarterly unemployment rates, and seasonality are presented.ResultsAmong WIC households, significant decreases in purchases of calories (-11%), sodium (-12%), total fat (-10%), and sugar (-15%) occurred, alongside decreases in purchases of refined grains, grain-based desserts, higher-fat milks, and sugar-sweetened beverages, and increases in purchases of fruits/vegetables with no added sugar/fats/salt. Income-eligible nonparticipating households had similar, but less pronounced, reductions. Changes were gradual and increased over time.ConclusionsWIC food package revisions appear associated with improved nutritional profiles of food purchases among WIC participating households compared with low-income nonparticipating households. These package revisions may encourage WIC families to make healthier choices among their overall packaged food purchases.
| S-EPMC5820777 | biostudies-literature
Project description:ImportanceFood insecurity is associated with high health care expenditures, but the effectiveness of food insecurity interventions on health care costs is unknown.ObjectiveTo determine whether the Supplemental Nutrition Assistance Program (SNAP), which addresses food insecurity, can reduce health care expenditures.Design, setting, and participantsThis is a retrospective cohort study of 4447 noninstitutionalized adults with income below 200% of the federal poverty threshold who participated in the 2011 National Health Interview Survey (NHIS) and the 2012-2013 Medical Expenditure Panel Survey (MEPS).ExposuresSelf-reported SNAP participation in 2011.Main outcomes and measuresTotal health care expenditures (all paid claims and out-of-pocket costs) in the 2012-2013 period. To test whether SNAP participation was associated with lower subsequent health care expenditures, we used generalized linear modeling (gamma distribution, log link, with survey design information), adjusting for demographics (age, gender, race/ethnicity), socioeconomic factors (income, education, Social Security Disability Insurance disability, urban/rural), census region, health insurance, and self-reported medical conditions. We also conducted sensitivity analyses as a robustness check for these modeling assumptions.ResultsA total of 4447 participants (2567 women and 1880 men) were enrolled in the study, mean (SE) age, 42.7 (0.5) years; 1889 were SNAP participants, and 2558 were not. Compared with other low-income adults, SNAP participants were younger (mean [SE] age, 40.3 [0.6] vs 44.1 [0.7] years), more likely to have public insurance or be uninsured (84.9% vs 67.7%), and more likely to be disabled (24.2% vs 10.6%) (P?<?.001 for all). In age- and gender-adjusted models, health care expenditures between those who did and did not participate in SNAP were similar (difference, $34; 95% CI, -$1097 to $1165). In fully adjusted models, SNAP was associated with lower estimated annual health care expenditures (-$1409; 95% CI, -$2694 to -$125). Sensitivity analyses were consistent with these results, also indicating that SNAP participation was associated with significantly lower estimated expenditures.Conclusions and relevanceSNAP enrollment is associated with reduced health care spending among low-income American adults, a finding consistent across several analytic approaches. Encouraging SNAP enrollment among eligible adults may help reduce health care costs in the United States.
| S-EPMC5710268 | biostudies-literature
Project description:Few studies have investigated food security, dietary quality, or unfavorable food intake through self-reports among children and adolescents in Asia. This study assessed the association of perceived food insecurity with dietary quality and unfavorable food intake among 1111 children and 538 adolescents from economically disadvantaged families in Taiwan. Food security status was collected by a validated questionnaire. Dietary quality was examined using a dietary diversity score (DDS). Unfavorable food intake was defined as fried food, bread/cake/pastries, sugar-sweetened beverages, and biscuits/chips. Food-insecure participants had lower DDS, whole grains and protein-rich food intake than food-secure participants. Furthermore, food-insecure children had a higher frequency of unfavorable food consumption. The level of children's food insecurity was inversely associated with DDS (β: -0.047, 95% CI: -0.085 to -0.009) but positively with bread/pastry (β: 0.103, 95% CI: 0.022-0.184) and sugar-sweetened beverages (β: 0.117, 95% CI: 0.018-0.215) intake. Adolescents who reported food insecurity and not enough money for household expenses had an odds ratio of 2.85 (95% CI: 1.15-7.10) for poor DDS relative to their food-secure and financially able counterparts. We recommended that health policy needs to include diversifying food and nutrition education for vulnerable children and adolescents to improve dietary quality.
| S-EPMC8540399 | biostudies-literature
Project description:To determine whether food insecurity--the inability to reliably afford safe and nutritious food--is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes.We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of 711 patients with diabetes in safety net health clinics. We then examined whether difficulty following a diabetic diet, self-efficacy, or emotional distress related to diabetes mediated the relationship between food insecurity and glycemic control.The food insecurity prevalence in our sample was 46%. Food-insecure participants were significantly more likely than food-secure participants to have poor glycemic control, as defined by hemoglobin A(1c) ?8.5% (42 vs. 33%; adjusted odds ratio 1.48 [95% CI 1.07-2.04]). Food-insecure participants were more likely to report difficulty affording a diabetic diet (64 vs. 49%, P < 0.001). They also reported lower diabetes-specific self-efficacy (P < 0.001) and higher emotional distress related to diabetes (P < 0.001). Difficulty following a healthy diet and emotional distress partially mediated the association between food insecurity and glycemic control.Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. This risk may be partially attributable to increased difficulty following a diabetes-appropriate diet and increased emotional distress regarding capacity for successful diabetes self-management. Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting.
| S-EPMC3263865 | biostudies-other
Project description:Despite the increasing global concern of improving food security, the determinants of food insecurity at household level in the rural areas have been poorly known. Therefore, the aim of this study was to analyze determinants of food insecurity at household level. A total of 383 households were selected using multistage sampling techniques. The logistic regression model was used to analyze the data. The result revealed that odds of illiterate households were 2.376 times more likely than educated households to experience food insecurity in the rural areas (ref. (Coef. = 0.865, OR = 2.376, P = 0.006)). Households with landholdings of more than half hectare were less likely to experience food insecurity. (ref. (Coef. = 1.982, OR = 7.260, P = 0.000)). Odds of households who engaged in off-farm activities were 0.204 times less likely to experience food insecurity. (ref. (Coef. = −1.588, OR = 0.204, P = 0.000)). Households who adopt farm technologies were less likely to experience food insecurity than those who do not adopt farm technology (ref. (Coef. = −1.086, OR = 0.337, P = 0.001)). Odds of higher-aged household heads were 6.141 times more likely to experience food insecurity than younger-aged household heads (ref. (Coef. = 1.815, OR = 6.141, P = 0.000)). Larger household sizes were less likely to experience food insecurity (ref. (Coef. = −2.423, OR = 0.089, P = 0.000)). In conclusion, understanding determinants of food insecurity at household level is essential to achieve food security in rural areas. Results suggest implementation of the effective developmental programs are needed to reduce food insecurity in rural areas.
| S-EPMC9849972 | biostudies-literature
Project description:Pregnancy, infancy, and toddlerhood are sensitive times in which families are particularly vulnerable to household food insecurity and when disparities in child obesity emerge. Understanding obesity-promoting infant-feeding beliefs, styles, and practices in the context of food insecurity could better inform both food insecurity and child obesity prevention interventions and policy guidelines. We performed purposive sampling of low-income Hispanic mothers (n = 100) with infants in the first 2 years of life, all of whom were participants in a randomized controlled trial of an early child obesity prevention intervention called the Starting Early Program. Bilingual English-Spanish interviewers conducted semistructured qualitative interviews, which were audio recorded, transcribed, and translated. By using the constant comparative method, transcripts were coded through an iterative process of textual analysis until thematic saturation was reached. Three key themes emerged: (1) contributors to financial strain included difficulty meeting basic needs, job instability, and high vulnerability specific to pregnancy, infancy, and immigration status; (2) effects on infant feeding included decreased breastfeeding due to perceived poor maternal diet, high stress, and limiting of healthy foods; and (3) coping strategies included both home- and community-level strategies. Stakeholders in programs and policies to prevent poverty-related disparities in child obesity should consider and address the broader context by which food insecurity is associated with contributing beliefs, styles, and practices. Potential strategies include addressing misconceptions about maternal diet and breast milk adequacy, stress management, building social support networks, and connecting to supplemental nutrition assistance programs.
| S-EPMC6564052 | biostudies-literature