scholarly journals Is participation in food and income assistance programmes associated with obesity in California adults? Results from a state-wide survey

2010 ◽  
Vol 14 (4) ◽  
pp. 645-652 ◽  
Author(s):  
Cindy W Leung ◽  
Eduardo Villamor

AbstractObjectivePublic assistance programmes may increase risk of obesity among adults. The current study assessed whether participation in the Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamp Program), Supplemental Security Income (SSI) or California Work Opportunities and Responsibilities to Kids (CalWorks) was associated with obesity, independent of socio-economic status and food insecurity.DesignA cross-sectional analysis of the 2007 Adult California Health Interview Survey. Outcome measures included BMI and obesity. Distribution of BMI and prevalence of obesity were compared by participation in each programme, using weighted linear and binomial regression models in which BMI or obesity was the outcome, respectively, and programme participation was the predictor.SettingA population survey of various health measures.SubjectsNon-institutionalized adults (n 7741) whose household income was ≤130 % of the federal poverty level.ResultsThe prevalence of obesity was 27·4 %. After adjusting for sociodemographic characteristics, food insecurity and participation in other programmes, the prevalence of obesity was 30 % higher in SNAP participants (95 % CI 6 %, 59 %; P = 0·01) than in non-participants. This association was more pronounced among men than women. SSI participation was related to an adjusted 50 % higher prevalence of obesity (95 % CI 27 %, 77 %; P < 0·0001) compared with no participation. SNAP and SSI participants also reported higher soda consumption than non-participants of any programme. CalWorks participation was not associated with obesity after multivariable adjustment.ConclusionsParticipation in SNAP or SSI was associated with obesity independent of food insecurity or socio-economic status. The suggestion that these associations may be mediated by dietary quality warrants further investigation among low-income populations.

2015 ◽  
Vol 19 (6) ◽  
pp. 1103-1111 ◽  
Author(s):  
Victoria L Mayer ◽  
Kevin McDonough ◽  
Hilary Seligman ◽  
Nandita Mitra ◽  
Judith A Long

AbstractObjectiveTo examine the relationship between food insecurity and coping strategies (actions taken to manage economic stress) hypothesized to worsen glucose control in patients with diabetes.DesignUsing a cross-sectional telephone survey and clinical data, we compared food-insecure and food-secure individuals in their use of coping strategies. Using logistic regression models, we then examined the association between poor glucose control (glycated Hb, HbA1c≥8·0 %), food insecurity and coping strategies.SettingAn urban medical centre, between June and December 2013.SubjectsFour hundred and seven adults likely to be low income (receiving Medicaid or uninsured and/or residing in a zip code with >30 % of the population below the federal poverty level) with type 2 diabetes.ResultsOf respondents, 40·5 % were food insecure. A significantly higher percentage of the food-insecure group reported use of most examined coping strategies, including foregone medical care, participation in the Supplemental Nutrition Assistance Program (SNAP)) and use of emergency food programmes. Food insecurity was associated with poor glucose control (OR=2·23; 95 % CI 1·22, 4·10); coping strategies that were more common among the food insecure were not associated with poor glucose control. Among the food insecure, receipt of SNAP was associated with lower risk of poor glucose control (OR=0·27; 95 % CI 0·09, 0·80).ConclusionsWhile food insecurity was associated with poor glucose control, most examined coping strategies did not explain this relationship. However, receipt of SNAP among food-insecure individuals was associated with better diabetes control, suggesting that such programmes may play a role in improving health.


2012 ◽  
Vol 15 (12) ◽  
pp. 2228-2236 ◽  
Author(s):  
Cindy W Leung ◽  
David R Williams ◽  
Eduardo Villamor

AbstractObjectiveA high prevalence of food insecurity has persisted in the USA for the past two decades. Previous studies suggest that the association between food insecurity and obesity may vary by gender and race/ethnicity. We examined whether food insecurity was associated with BMI and obesity within gender and racial/ethnic groups in a large, diverse sample of low-income adults.DesignA cross-sectional analysis of a large population-based health survey. We compared the distribution of BMI and obesity by food security levels within gender and racial/ethnic categories.SettingData were derived from the 2003–2009 waves of the California Health Interview Survey.SubjectsThe study sample included 35 747 non-elderly adults with households ≤200 % of the federal poverty level.ResultsAmong Hispanic men, very low food security was associated with a 1·0 kg/m2 higher BMI (95 % CI 0·3, 1·7 kg/m2) and a 36 % higher prevalence of obesity (95 % CI 17, 58 %) after multivariate adjustment. Among Hispanic women, very low food security was associated with a 1·1 kg/m2 higher BMI (95 % CI 0·4, 1·9 kg/m2) and a 22 % higher prevalence of obesity (95 % CI 8, 38 %). Positive associations were also observed for Asian women and multi-racial men. No significant associations were observed for non-Hispanic whites, African Americans, Asian men or multi-racial women.ConclusionsOur results suggest that the association of food insecurity and obesity is limited to individuals of certain low-income, minority racial/ethnic groups. Whether targeted interventions to address food insecurity in these individuals may also decrease obesity risk deserves further investigation.


2017 ◽  
Vol 3 (2) ◽  
pp. 320-323
Author(s):  
Samar Hossain ◽  
Sharma Priyanka ◽  
Talib Hossain ◽  
Surendra Mohan Mathur

Objective: The last two decades have witnessed an increase in health care costs due to obesity and related issues among children and adolescents. Childhood obesity is a global phenomenon affecting all socio-economic groups, irrespective of age, sex or ethnicity. The study was done to find the the prevalence of obesity and overweight and their association with socioeconomic status (SES) and the risk factors. Materials and Methods: School based cross sectional study carried out over a period of 4 months in three schools of East Delhi. The study was carried out in 629 school children of 10–18 years of age and belonging to different socioeconomic statuses in schools in East Delhi. The obesity and overweight were considered using an updated body mass index reference. A pre-tested questionnaire was used to determine the Socio-economic status and life style factors. Results: The prevalence of overweight among children was higher in middle socioeconomic status groups as compared to high socioeconomic class in both boys and girls whereas the prevalence of obesity was higher in high Socio economic status group as compared to middle socioeconomic group. The prevalence of obesity as well as overweight in low SES group was the lowest as compared to other group. Conclusion: The findings of this study suggest that the prevalence of overweight and obesity varies remarkably with different socioeconomic development levels.


2020 ◽  
Vol 23 (17) ◽  
pp. 3226-3235
Author(s):  
Reece Lyerly ◽  
Pasquale Rummo ◽  
Sarah Amin ◽  
Whitney Evans ◽  
Eliza Dexter Cohen ◽  
...  

AbstractObjective:Mobile produce markets (MPM) offering Supplemental Nutrition Assistance Program (SNAP) incentive programmes have the potential to provide accessible and affordable fruits and vegetables (FV) to populations at risk of food insecurity. The objective of this study is to characterise the customer base of an MPM and describe their participation at twelve market sites serving low-income seniors.Design:In 2018, customers from an MPM in Rhode Island (RI) participated in a cross-sectional survey (n 330; 68 % response rate), which measured dietary patterns, food security and food shopping behaviours. We compared the shopping habits and market experiences of customers who currently received SNAP benefits with those who did not currently receive SNAP benefits.Setting:An MPM in RI which offers a 50 % discount for FV purchased with SNAP benefits.Participants:This study describes current market customers at twelve market sites serving low-income seniors.Results:Market customers were mostly low-income, female, over the age of 50 years and Hispanic/Latino. Most customers received SNAP benefits, and almost half were food insecure. In addition, three quarters of SNAP customers reported their SNAP benefits last longer since shopping at the markets. Mixed logistic regression models indicated that SNAP customers were more likely to report buying and eating more FV than non-SNAP customers.Conclusions:MPM are critical resources of affordable produce and have been successful in improving access to FV among individuals of low socio-economic status in RI. This case study can inform policy and programme recommendations for MPM and SNAP incentive programmes.


2019 ◽  
Vol 23 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Fred Molitor ◽  
Celeste Doerr ◽  
John Pugliese ◽  
Lauren Whetstone

AbstractObjective:To examine trends from 2015 to 2017 in dietary behaviours and diet quality among low-income mothers, teenagers and children.Design:Cross-sectional telephone surveys using a validated 24 h dietary assessment.Setting:Randomly sampled households with incomes ≤185 % of the US federal poverty level across California.Participants:Survey participants were 13 247 mothers (≥18 years), 3293 teenagers (12–17 years) and 6043 children (5–11 years). Respondents were mostly Latino.Results:Over the 3-year study period, consumption of fruits and vegetables with and without 100 % fruit juice increased (P ≤ 0·05) by at least 0·3 cups/d for mothers, teenagers and children. Intake of water also increased (P ≤ 0·001) by more than 1 cup/d for mothers and children and 2 cups/d for teenagers. Sugar-sweetened beverage (SSB) consumption was unchanged over the 3 years. Overall diet quality, as assessed by the Healthy Eating Index-2015, improved (P ≤ 0·01) for mothers, teenagers and children. Covariates for the fifteen regression models (three age groups by five outcome variables) included race/ethnicity, age, education for mothers, and gender for teenagers and children.Conclusions:The observed increases in fruit and vegetable intake and improvements in overall diet quality during the 3-year period suggest that low-income Californians may have lowered their risk of preventable diseases. However, more intense or strategic SSB-reduction interventions are required. Regional- or state-level, population-based surveillance of dietary behaviours is useful for public health nutrition policy and programme decision making, and can be used to assess potential trends in future negative health outcomes and related costs associated with poor dietary behaviours within at-risk populations.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257879
Author(s):  
Aviva A. Musicus ◽  
Anne N. Thorndike ◽  
Jason P. Block ◽  
Eric B. Rimm ◽  
Sara N. Bleich

Background The dual burden of poor diet quality and food insecurity makes free food—food acquired at no cost—a very important part of the nutrition safety net for low-income families. The goal of this study was to determine the national prevalence and nutritional quality of free food acquired separately in two settings: 1) by children at school; and 2) by employees at work; both stratified by participation in the Supplemental Nutrition Assistance Program (SNAP). Methods Using National Household Food Acquisition and Purchase Survey data (2012; n = 4,826 U.S. households containing 5,382 employed adults and 3,338 school-aged children), we used survey-weighted proportions to describe free food acquisition and linear regression to compare the 2010 Healthy Eating Index (HEI-2010) for free/non-free food acquisition events (i.e., meals) by SNAP status. Analyses were conducted in 2019–2020. Results SNAP households had more free acquisition events (29.6%) compared to non-SNAP households (<185% federal poverty level (FPL) = 22.3%; ≥185%FPL = 21.0%, p’s<0.001). For SNAP-participant children, free acquisition events at school had a higher mean HEI-2010 compared to non-free acquisition events at school (50.3 vs. 43.8, p = 0.033) and free acquisition events by SNAP-non-participant children ≥185%FPL at school (50.3 vs. 38.0, p = 0.001). Free and non-free acquisition events at work had relatively low HEI-2010s, with no differences by SNAP status. Conclusions Over one fifth of all food acquisition events were free, but free food acquisitions at school and work were relatively unhealthy. For children participating in SNAP, free food acquired at school had higher nutritional quality. Improving the dietary quality of free foods could improve the health of families, especially those participating in SNAP.


2016 ◽  
Vol 19 (18) ◽  
pp. 3337-3348 ◽  
Author(s):  
Arezoo Rezazadeh ◽  
Nasrin Omidvar ◽  
Hassan Eini-Zinab ◽  
Mahmoud Ghazi-Tabatabaie ◽  
Reza Majdzadeh ◽  
...  

AbstractObjectiveTo identify major dietary patterns and their association with socio-economic status (SES) and food insecurity in two major ethnic groups living in Urmia, north-west Iran.DesignA cross-sectional study.SettingAll four geographical zones of Urmia city.SubjectsParticipants (n 723; 427 women and 296 men), aged 20–64 years, from two ethnic groups (445 Azeri Turks and 278 Kurds).ResultsThree major dietary patterns were extracted: ‘Traditional High SES’ (THS), ‘Traditional Low SES’ (TLS) and ‘Transitional’. After adjusting for confounders, the THS pattern was positively associated with education level and negatively associated with moderate or severe food insecurity in Azeri Turks; whereas, among Kurds, it was more common in women and positively associated with age. The TLS pattern was more common among men and negatively associated with educational level and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men, positively associated with being married and negatively associated with household income/capita. The ‘Transitional’ pattern was positively associated with being employed and negatively associated with age and all levels of food insecurity in Azeris; while, among Kurds, it was more common among men and negatively associated with age, being married and physical activity level.ConclusionsFindings suggest that household SES and food insecurity are associated with detrimental dietary patterns and that this effect may be stronger than cultural and ethnic background. These patterns differ by age and gender. Therefore, such characteristics should be considered in planning and formulating diet-related policies and programmes.


2021 ◽  
pp. 003335492097466
Author(s):  
Jennifer A. Pooler ◽  
Mithuna Srinivasan ◽  
Zachary Miller ◽  
Paula Mian

Objective Ensuring access to sufficient foods at all times is critical to veterans’ health and well-being. Food insecurity has not been well explored in the veteran population. We examined the prevalence and predictors of food insecurity among low-income veterans, because the highest rates of food insecurity are among low-income households. We also examined rates of Supplemental Nutrition Assistance Program (SNAP) participation among subgroups at the highest risk of food insecurity. Methods We used univariate analyses and 2011-2017 National Health Interview Survey (NHIS) data on veterans aged ≥21 with family incomes <200% of the federal poverty level to estimate the prevalence of food insecurity. We used bivariate analyses to identify correlates of food insecurity and estimate SNAP participation rates among subgroups of low-income veterans. Percentages were weighted using NHIS survey weights. Results Of 5146 low-income veterans, 22.5% reported being food insecure in the previous month. Food insecurity was significantly associated with being aged <65 (33.0% aged 45-64 and 29.7% aged 21-44) compared with 15.0% and 6.4% among veterans aged 65-74 and ≥75, respectively ( P < .001); unemployed compared with employed or not in the labor force (39.4%, 22.7%, and 20.2%, respectively; P < .001); in fair or poor health compared with good, very good, or excellent heath (31.8% vs 18.2%; P < .001); and having experienced serious psychological distress in the past month (56.3%) compared with not having experienced such distress (19.7%; P < .001). Although overall SNAP participation among low-income veterans was estimated to be 27.0%, participation rates were highest among veterans who had experienced serious psychological distress (44.1%), were unemployed (39.2%), and were renting their home (39.0%). Conclusions Some low-income veterans are at greater risk of food insecurity than other veterans. Postseparation programs, civilian support services, and veterans’ health providers should be aware of the characteristics that place veterans at highest risk of food insecurity.


Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1574 ◽  
Author(s):  
Matthew J. Landry ◽  
Alexandra E. van den Berg ◽  
Fiona M. Asigbee ◽  
Sarvenaz Vandyousefi ◽  
Reem Ghaddar ◽  
...  

Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention. A sample of 598 children completed two 24-h dietary recalls and a questionnaire including an adapted version of the 5-item Child Food Security Assessment (CFSA). Food security was categorized as food secure or FI based on summed CFSA scores. Dietary quality was assessed using the Health Eating Index-2015 (HEI-2015). Mixed effects linear regression models examined associations between FI and dietary quality. Children were 64% Hispanic, 55% female, and were 9.2 years old on average. Adjusting for sociodemographic characteristics, BMI percentile, and energy intake, FI was associated with lower HEI-2015 total scores (β = −3.17; 95% CI = −5.28, −1.06; p = 0.003). Compared to food secure children, FI children had lower greens and beans (2.3 vs. 1.9, p = 0.016), seafood and plant protein (2.0 vs. 1.6, p = 0.006), and added sugar (7.4 vs. 8.0, p = 0.002) component scores. Interventions targeting low-income and FI children should investigate ways to improve dietary quality.


Author(s):  
Lee Smith ◽  
Laurie Butler ◽  
Mark A Tully ◽  
Louis Jacob ◽  
Yvonne Barnett ◽  
...  

The objectives were to (1) assess the prevalence of hand-washing practices across 80 countries and (2) assess frequency of hand-washing practice by economic status (country income and severe food insecurity), in a global representative sample of adolescents. Cross-sectional data from the Global School-based Student Health Survey 2003–2017 were analyzed. Data on age, sex, hand-washing practices in the past 30 days, and severe food insecurity (i.e., proxy of socioeconomic status) were self-reported. Multivariable logistic regression and meta-analysis with random effects based on country-wise estimates were conducted to assess associations. Adolescents (n = 209,584) aged 12–15 years [mean (SD) age 13.8 (1.0) years; 50.9% boys] were included in the analysis. Overall, the prevalence of hand-washing practices were as follows: never/rarely washing hands before eating (6.4%), after using toilet (5.6%), or with soap (8.8%). The prevalence of never/rarely washing hands after using the toilet (10.8%) or with soap (14.3%) was particularly high in low-income countries. Severe food insecurity was associated with 1.34 (95%CI = 1.25–1.43), 1.61 (95%CI = 1.50–1.73), and 1.44 (95%CI = 1.35–1.53) times higher odds for never/rarely washing hands before eating, after using the toilet, and with soap, respectively. A high prevalence of inadequate hand washing practices was reported, particularly in low-income countries and those with severe food insecurity. In light of the present COVID-19 pandemic and the rapid expansion being observed in low- and middle-income locations, interventions that disseminate good hand-washing practices are urgently required. Such interventions may also have cross-over benefits in relation to other poor sanitation-related diseases.


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