Food Choice With Economic Scarcity and Time Abundance: A Qualitative Study

2021 ◽  
pp. 109019812110459
Author(s):  
Sara C. Folta ◽  
Oyedolapo Anyanwu ◽  
Jennifer Pustz ◽  
Jennifer Oslund ◽  
Laura Paige Penkert ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Low Income ◽  
Food Choice ◽  
Resource Constraints ◽  
Low Cost ◽  
The United States ◽  
Photo Elicitation ◽  
Semistructured Interview ◽  
Relative Time ◽  
Multiple Resource

Consumers with low income in the United States have higher vulnerability to unhealthy diets compared with the general population. Although some literature speculates that scarcity is an explanation for this disparity, empirical evidence is lacking. We conducted a qualitative study of food choice to explore whether scarcity-related phenomena, such as tunneling and bandwidth tax, may contribute to unhealthy dietary choices. We used participant-driven photo elicitation ( n = 18) to investigate the food choice behaviors of individuals living in the greater Boston area who met the federal guidelines for poverty. Participants took photos at the point of food acquisition for 1 month, after which we interviewed them using a semistructured interview guide with the photos as prompts. Thematic coding was used for analysis. Respondents had relative time abundance. Two major themes emerged: participants used a set of strategies to stretch their budgets, and they highly prioritized cost and preference when making food choices. The extreme focus on obtaining food at low cost, which required time and effort, was suggestive of tunneling. We found no evidence of the bandwidth tax. Our findings raise the hypothesis of scarcity as a continuum: when individuals experience multiple resource constraints, they experience scarcity; whereas people with very limited finances and relative time abundance may instead be in a prescarcity condition, with a hyperfocus on a scarce resource that could lead to tunneling as constraints increase. Additional studies are needed to understand whether and how tunneling and bandwidth tax emerge, independently or together, as people face different levels and types of scarcity.

scholarly journals A positive deviance-based qualitative study of stress, coping, and feeding practices among low-income, Hispanic mothers whose children do versus do not meet guidelines for fruit and vegetable intake

2020 ◽  
Vol 35 (6) ◽  
pp. 584-604
Author(s):  
Eleanor Shonkoff ◽  
Sara C Folta ◽  
Theodore Fitopoulos ◽  
Cynthia N Ramirez ◽  
Ricky Bluthenthal ◽  
...  
Keyword(s):  
Physical Activity ◽  
Qualitative Study ◽  
Low Income ◽  
Comparison Group ◽  
Vegetable Intake ◽  
Feeding Practices ◽  
The United States ◽  
Positive Deviance ◽  
Healthy Weight ◽  
Hispanic Mothers

Abstract Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being ‘high-risk’ for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one’s attention away from stressors; comparison group mothers tended to report stress about managing their child’s eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.

scholarly journals 662 PAP Therapy: A Review of Resources for the Uninsured during COVID-19

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A259-A259
Author(s):  
Melissa Malinky ◽  
Abigail Oberla ◽  
Meena Khan ◽  
M Melanie Lyons
Keyword(s):  
Low Income ◽  
Web Search ◽  
Low Cost ◽  
Wait Time ◽  
The United States ◽  
Fixed Cost ◽  
United States Census ◽  
Lower Socioeconomic ◽  
Increased Risk ◽  
Available Resources

Abstract Introduction In 2019, the United States Census estimated 8% (26.1 million) people were without health insurance. Further, an estimated 3.5 million people became/remained uninsured from COVID-19-related job losses. Patients with OSA that belong to a lower socioeconomic status (SES) are less likely to have access to healthcare and may be under or uninsured. Untreated OSA can lead to increased risk of symptoms and associated co-morbidities. Resources to help the uninsured to obtain PAP therapy were available pre-COVID, including two main sources, American Sleep Apnea Association (ASAA) and our local branch serving central Ohio, The Breathing Association. However, the COVID pandemic limited access or closed these programs. Our Sleep Medicine clinics saw 148 uninsured OSA patients between March-December, 2020. Given these difficulties, we re-evaluated available resources for the uninsured. Methods We conducted a search for current low cost ($100 or less) PAP therapy options for the uninsured, March 15, 2020-December 3, 2020, by: (1) contacting pre-COVID-19 resources, including Durable Medical Equipment (DME) providers, (2) consulting social work, and (3) completing a librarian assisted web-search not limited to PubMed, Embase, CINAHL for academic related articles and electronic searches using a combination of English complete word and common keywords: OSA, PAP, uninsured, no insurance, cheap, medically uninsured, resources, self-pay, low-income, financial assistance, US. Resources such as private sellers were not investigated. Results During COVID-19, assistance for PAP machines/supplies have closed or required a protracted wait-time. Options including refurbished items range from low, one-time fixed cost or income-based discounts from: one local charity (Joint Organization for Inner-City Needs) and DME (Dasco), and four national entities (ASAA, Second Wind CPAP, Reggie White Foundation, CPAP Liquidators). An Electronic Health Record-based tool was developed and distributed to increase provider awareness of pandemic available resources. Conclusion Untreated OSA is associated with increased risk of cardiovascular co-morbidities. Access and cost may limit treatment in OSA patients from a lower SES. The COVID-19 pandemic has shuttered programs providing discount PAP and supplies, leaving fewer resources for these patients, thus further widening this health care disparity. Alternatives are needed and current resources are not easily accessible for providers and patients. Support (if any):

Abstract 17385: CPR Education in High-need Schools to Increase Student Knowledge and Comfort Performing CPR

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Debra Heard ◽  
Comilla Sasson
Keyword(s):  
Low Income ◽  
Classroom Teacher ◽  
Low Cost ◽  
The United States ◽  
Training Data ◽  
Paired Data ◽  
School Students ◽  
Chi Square ◽  
Bystander Cpr ◽  
Cpr Training

Introduction: Low-income neighborhoods are important targets for CPR trainings as they typically have high incidence of out-of-hospital cardiac arrest and low prevalence of bystander CPR. Training middle school students in these neighborhoods is a novel intervention to increase CPR awareness. Objective: Conduct a school-based CPR intervention using classroom teachers as facilitators at 1131 middle schools across the United States with a high proportion of students from lower-income families. Methods: Population: 1131 public middle and high schools in 34 states (including the District of Columbia) were selected for the 2014-2015 school year to participate based on close proximity to sponsor’s U.S. store locations and 50% or more student eligibility for free or reduced-price lunch. Intervention: Participants completed a pre-test survey to assess baseline knowledge of CPR and comfort performing CPR. A classroom Hands-Only CPR training lasting one class period was conducted with the CPR in Schools Training Kit™, which includes an educational DVD, 10 manikins and resources for any classroom teacher to conduct trainings. Participants then completed post-training knowledge and comfort survey. McNemar’s tests on paired data and chi square and t-tests on aggregated unpaired data were conducted to assess for differences in CPR knowledge and comfort performing CPR pre- and post-training. Results: Training data were returned by 563 (49.8%) participating schools training a total of 150,409 students in Hands-Only CPR. Using a sample of returned data, the mean number of questions answered correctly on CPR knowledge increased from 2.5 to 4.2 (out of 5). The majority of participants (75.8%) felt comfortable performing Hands-Only CPR after the intervention. Conclusion: A total of 150,409 students from 563 schools were trained in Hands-Only CPR (average 267 students/CPR in Schools Training Kit). At $625 per CPR in Schools Training Kit (with 10 manikins and materials), training cost $4.70 for each student trained. Participants demonstrated increased knowledge of and comfort performing CPR. The CPR in Schools Training Kit is a low cost and promising method for increasing bystander CPR awareness in the student population in low-income neighborhoods.

Is Cost of Living Related to Living Alone Among Older Persons? Evidence From the Elder Economic Security Standard Index

2015 ◽  
Vol 38 (17) ◽  
pp. 2495-2511
Author(s):  
Jan E. Mutchler ◽  
Jiyoung Lyu ◽  
Ping Xu ◽  
Jeffrey A. Burr
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Metropolitan Areas ◽  
Low Cost ◽  
The United States ◽  
Economic Security ◽  
Living Alone ◽  
Cost Of Living ◽  
Standard Index ◽  
Security Standard

This study examines whether the cost of living is related to the probability of living alone among unmarried persons age 65 years and older in the United States. Cost of living is measured at the metropolitan area level by the Elder Economic Security Standard Index, which takes into account geographic variability in cost of housing, food, transportation, and medical care. Using multilevel modeling, we find that higher cost of living is related to a lower likelihood of living alone net of personal resources. Results also show that the gap in the likelihood of living alone between high- and low-income older adults is slightly lessened in low-cost metropolitan areas. We conclude that the price of “purchasing privacy” is substantially higher in some metropolitan areas than in others. These findings inform policies designed to help older adults age in place.

scholarly journals Parents' views on human papillomavirus vaccination for sexually transmissible infection prevention: a qualitative study

Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 274 ◽  
Author(s):  
Linda M. Niccolai ◽  
Caitlin E. Hansen ◽  
Marisol Credle ◽  
Sheryl A. Ryan ◽  
Eugene D. Shapiro
Keyword(s):  
Human Papillomavirus ◽  
Qualitative Study ◽  
Cancer Prevention ◽  
Low Income ◽  
Hpv Vaccination ◽  
The United States ◽  
Care Providers ◽  
Sti Prevention ◽  
Sexually Transmissible Infection ◽  
Transmissible Infection

Background Human papillomavirus (HPV) is the most common sexually transmissible infection (STI) in the United States (US) and an important cause of several cancers. Vaccines that prevent HPV infections are now recommended for routine use in adolescents but coverage remains suboptimal in the US. Because they are often promoted as cancer prevention vaccines, little is known about parents’ views on vaccination for prevention of an STI. Methods: In this qualitative study, parents and caregivers of children ages 10–18 years completed an in-depth interview. Participants (n = 38) were recruited from an urban hospital-based primary care centre serving a low-income population in the north-eastern US during May 2013–February 2014. Interviews were transcribed and coded using a thematic content approach. Results: Five major themes emerged with relevance to the topic of HPV vaccination for STI prevention: (1) low awareness of HPV as an STI; (2) favourable opinions about STI prevention messages for vaccination, including at young ages; (3) salience of sexual mode of transmission, given the unpredictability of adolescent sexual behaviour and high rates of other STIs and teen pregnancy; (4) recognition that sexual health is a topic of conversation between adolescents and health care providers; and(5) relevance of personal experience. Conclusions: Discussing STI prevention in the context of HPV vaccination appears to be well accepted by urban, low-income minority families. In addition to providing information on cancer prevention, these messages may help to raise awareness, acceptability and uptake of HPV vaccines.

Immigrant Small Business and International Economic Linkage: A Case of the Korean Wig Business in Los Angeles, 1968–1977

1996 ◽  
Vol 30 (2) ◽  
pp. 485-510 ◽  
Author(s):  
Ku-Sup Chin ◽  
In-Jin Yoon ◽  
David Smith
Keyword(s):  
United States ◽  
Los Angeles ◽  
South Korea ◽  
Low Income ◽  
Low Cost ◽  
Economic Restructuring ◽  
The United States ◽  
Korean Immigrants ◽  
Asian Immigrants ◽  
Economic Linkages

This article investigates factors that have contributed to the growth of the import-export business among Asian immigrants. The central argument is that the development of Asian immigrants’ import-export business has been closely related to the increasing economic linkages between Asian countries and their countrymen in the United States. Such economic linkages are a product of the global economic restructuring whereby some developing countries of Asia have become major exporters of low cost/low price consumer goods to the United States. The Korean immigrants’ wig business in Los Angeles is studied as a case of contemporary import-export trade among Asian immigrants, with major findings summarized as follows: first, the increased reliance of the United States on imported goods by the 1970s led to a rapid growth of the export-oriented industry in South Korea; second, wigs became the major export item of South Korea due to its cheap labor force and government-aid loans to the wig industry, third, a strong vertical integration developed between Korean wig manufacturers in South Korea and Korean importers, wholesalers, and retailers in the United States – that integration provided Korean immigrants with initial business opportunities in the U.S. economy, particularly in the low-income minority areas.

Using Ethnography to Assess Barriers to Services in a Washington DC Community Clinic

2005 ◽  
Vol 27 (2) ◽  
pp. 5-9
Author(s):  
Michelle Goodman
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Services ◽  
Low Cost ◽  
Strong Predictor ◽  
The United States ◽  
Washington Dc ◽  
Kaiser Family Foundation ◽  
Community Clinic ◽  
Care Services

There are over 42 million uninsured people living in the United States today. Even though a small percent of these 42 million are immigrants, they are more likely to be uninsured because of limited access to low-cost insurance. This is particularly true for those who are low-income, unemployed or under-employed (Kaiser Family Foundation, April 2001). Low-income immigrants may face a number of barriers to accessing health care services, which, in turn, can cause disparity in health outcomes compared to individuals who have health insurance. Latinos represent about 12% of the population, but make up 25% of the Nation's uninsured (American College of Physicians 2000). Newly immigrant Latinos are almost three times less likely to have a consistent source of medical care, which is a strong predictor of obtaining preventative health care screening (American College of Physicians 2000). Since each community experiences the health care system in different ways and because political, economic and social conditions influence the availability and accessibility of services, it is important to identify these barriers for each individual community cohort that a community clinic and/or program may be working with.

scholarly journals Tolerable Suboptimization: Racial Consequences of Defunding Public Universities

2020 ◽  
Author(s):  
Laura T. Hamilton ◽  
Kelly Nielsen ◽  
Veronica Lerma
Keyword(s):  
Higher Education ◽  
Low Income ◽  
Public Universities ◽  
Resource Constraints ◽  
Underrepresented Students ◽  
The United States ◽  
Public Higher Education ◽  
Student Body ◽  
Student Activists ◽  
University Services

The defunding of public higher education has dramatically impacted public universities in the United States, and schools with racially marginalized student bodies are most likely to feel the crunch. Yet, scholars have directed little attention to the on-the-ground racial consequences of limited public postsecondary funding for students. In this article we ask: How is the defunding of public higher education reflected in the organizational practices of a university serving historically underrepresented students? And how do resource constraints affect racially (and often economically) marginalized students’ access to core university services? We draw on a year-long case study of a University of California campus serving a majority Latinx and low-income student body, including ethnographic observations and interviews with administrators, student-facing staff, student activists and organizers, and Black and Latinx students. Our findings identify defunding as a contemporary mechanism through which racial disparities in postsecondary educational experiences are maintained.

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