scholarly journals Physical Disabilities and Food Access Among Limited Resource Households

2007 ◽  
Vol 27 (3) ◽  
Author(s):  
Caroline B. Webber ◽  
Jeffery Sobal ◽  
Jamie S. Dollahite
Keyword(s):  
New York ◽  
Low Income ◽  
Food Choice ◽  
Food Access ◽  
Physical Disabilities ◽  
Limited Resource ◽  
Health And Illness ◽  
Limited Food ◽  
Physical Abilities ◽  
The Impact

Food is a basic need of all people. The degree to which people have access to food influences food choice, quality of life, health, and illness. We examined how physically impaired and disabled food shoppers from low-income households managed food provision for their families and the impact health and physical disabilities had on family food choice among those with limited resources. This qualitative study examined food access among 28 low-income rural, village, and inner city families in upstate New York selected by purposive and theoretical sampling. An unanticipated finding emerged that nearly one-half of participants, all primary grocery shoppers for their families, had a variety of health conditions and disabilities that limited food access and, in turn, healthy, affordable food. These findings suggest that physical abilities, agency, and context interact in food access.

scholarly journals A modified choice experiment to examine willingness to participate in a Community Supported Agriculture (CSA) program among low-income parents

2018 ◽  
Vol 35 (2) ◽  
pp. 140-157 ◽  
Author(s):  
Jared T. McGuirt ◽  
Stephanie B. Jilcott Pitts ◽  
Karla L. Hanson ◽  
Molly DeMarco ◽  
Rebecca A. Seguin ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Rural Areas ◽  
Choice Experiment ◽  
Limited Resource ◽  
Community Supported Agriculture ◽  
Willingness To Participate ◽  
Healthy Foods ◽  
Food Quantity ◽  
Access To Healthy Foods

AbstractThere is a need to improve geographical and financial access to healthy foods for limited resource populations in rural areas. Community Supported Agriculture (CSA) programs can improve access to healthy foods in rural and limited-resource populations. However, research is needed to discern the most appealing conditions for a CSA (e.g. price, frequency, food quantity) among rural, low-income customers. The goal of this study was to understand low-income consumers' preferences related to participation in a CSA program, considering price, frequency, food quantity and accessibility (e.g. distance) conditions. A modified exploratory choice experiment exercise was embedded within in-depth interviews to examine willingness to participate in CSA under a variety of conditions among 42 low-income adults with at least one child in the household in North Carolina, New York, Vermont and Washington. Willingness to participate in a CSA under each condition was summed and compared across conditions. Results were stratified by race, number of children and household members and McNemar's test and Student's t-test were used to examine differences in willingness between conditions. Salient quotes were extracted to support themes related to each condition. Our analysis suggests that the ideal CSA would be a full-sized share of eight to nine items of mixed variety, distributed every other week, priced at less than US$15, no more than 10 min further than the supermarket (SM) from their home and preferably less expensive but no more than 20% more expensive than SM prices. CSAs interested in reaching rural low-income populations may benefit from considering these consumer-level preferences.

Effect of Electronic Health Record Reminders for Routine Immunizations and Immunizations Needed for Chronic Medical Conditions

2021 ◽  
Vol 12 (05) ◽  
pp. 1101-1109
Author(s):  
Ashley B. Stephens ◽  
Chelsea S. Wynn ◽  
Annika M. Hofstetter ◽  
Chelsea Kolff ◽  
Oscar Pena ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Age Groups ◽  
Clinical Decision ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Chi Square ◽  
Control And Prevention ◽  
Electronic Health ◽  
The Impact

Abstract Background Immunization reminders in electronic health records (EHR) provide clinical decision support (CDS) that can reduce missed immunization opportunities. Little is known about using CDS rules from a regional immunization information system (IIS) to power local EHR immunization reminders. Objective This study aimed to assess the impact of EHR reminders using regional IIS CDS-provided rules on receipt of immunizations in a low-income, urban population for both routine immunizations and those recommended for patients with chronic medical conditions (CMCs). Methods We built an EHR-based immunization reminder using the open-source resource used by the New York City IIS in which we overlaid logic regarding immunizations needed for CMCs. Using a randomized cluster-cross-over pragmatic clinical trial in four academic-affiliated clinics, we compared captured immunization opportunities during patient visits when the reminder was “on” versus “off” for the primary immunization series, school-age boosters, and adolescents. We also assessed coverage of CMC-specific immunizations. Up-to-date immunization was measured by end of quarter. Rates were compared using chi square tests. Results Overall, 15,343 unique patients were seen for 26,647 visits. The alert significantly impacted captured opportunities to complete the primary series in both well-child and acute care visits (57.6% on vs. 54.3% off, p = 0.001, and 15.3% on vs. 10.1% off, p = 0.02, respectively), among most age groups, and several immunization types. Captured opportunities for CMC-specific immunizations remained low regardless of alert status. The alert did not have an effect on up-to-date immunization overall (89.1 vs. 88.3%). Conclusion CDS in this population improved captured immunization opportunities. Baseline high rates may have blunted an up-to-date population effect. Converting Centers for Disease Control and Prevention (CDC) rules to generate sufficiently sensitive and specific alerts for CMC-specific immunizations proved challenging, and the alert did not have an impact on CMC-specific immunizations, potentially highlighting need for more work in this area.

scholarly journals Mobility, Targeting, and Private-School Vouchers

2000 ◽  
Vol 90 (1) ◽  
pp. 130-146 ◽  
Author(s):  
Thomas J Nechyba
Keyword(s):  
New York ◽  
School District ◽  
School Districts ◽  
Residential Mobility ◽  
Low Income ◽  
Private School ◽  
School Vouchers ◽  
School Voucher ◽  
The Impact

This paper uses general-equilibrium simulations to explore the role of residential mobility in shaping the impact of different private-school voucher policies. The simulations are derived from a three-district model of low-, middle-, and high-income school districts (calibrated to New York data) with housing stocks that vary within and across districts. In this model, it is demonstrated that school-district targeted vouchers are similar in their impact to nontargeted vouchers but vastly different from vouchers targeted to low-income households. Furthermore, strong migration effects are shown to significantly improve the likely equity consequences of voucher programs. (JEL I22, I28, H73)

scholarly journals Assessment of a government-subsidized supermarket in a high-need area on household food availability and children’s dietary intakes

2015 ◽  
Vol 18 (15) ◽  
pp. 2881-2890 ◽  
Author(s):  
Brian Elbel ◽  
Alyssa Moran ◽  
L Beth Dixon ◽  
Kamila Kiszko ◽  
Jonathan Cantor ◽  
...  
Keyword(s):  
New York ◽  
Dietary Intake ◽  
Food Availability ◽  
Low Income ◽  
Dietary Habits ◽  
Dietary Intakes ◽  
Household Food ◽  
Household Food Availability ◽  
One Year ◽  
The Impact

AbstractObjectiveTo assess the impact of a new government-subsidized supermarket in a high-need area on household food availability and dietary habits in children.DesignA difference-in-difference study design was utilized.SettingTwo neighbourhoods in the Bronx, New York City. Outcomes were collected in Morrisania, the target community where the new supermarket was opened, and Highbridge, the comparison community.SubjectsParents/caregivers of a child aged 3–10 years residing in Morrisania or Highbridge. Participants were recruited via street intercept at baseline (pre-supermarket opening) and at two follow-up periods (five weeks and one year post-supermarket opening).ResultsAnalysis is based on 2172 street-intercept surveys and 363 dietary recalls from a sample of predominantly low-income minorities. While there were small, inconsistent changes over the time periods, there were no appreciable differences in availability of healthful or unhealthful foods at home, or in children’s dietary intake as a result of the supermarket.ConclusionsThe introduction of a government-subsidized supermarket into an underserved neighbourhood in the Bronx did not result in significant changes in household food availability or children’s dietary intake. Given the lack of healthful food options in underserved neighbourhoods and need for programmes that promote access, further research is needed to determine whether healthy food retail expansion, alone or with other strategies, can improve food choices of children and their families.

Food Sovereignty, Food Access, and the Local Food Movement in Southeastern North Carolina

2017 ◽  
Vol 41 (4) ◽  
pp. 446-460 ◽  
Author(s):  
Leslie Hossfeld ◽  
E. Brooke Kelly ◽  
Erin O’Donnell ◽  
Julia Waity
Keyword(s):  
North Carolina ◽  
Healthy Eating ◽  
Low Income ◽  
Food Access ◽  
Local Food ◽  
Food Sovereignty ◽  
Limited Resource ◽  
Healthy Food ◽  
Local Food Movement ◽  
The Right

Food sovereignty is about the right to healthy food and the right to have control over one’s food. This article examines opportunities and challenges in the efforts of Feast Down East (FDE), a local food systems movement in Southeastern North Carolina, to develop a food sovereignty program linking limited resource consumers and growers in an effort to provide access to healthy, affordable, and culturally appropriate foods in a low-income community. Several FDE initiatives attempt to address common problems in limited resource communities, such as food insecurity, food access, and knowledge about healthy food preparation. “Fresh markets,” which are run by low-income consumers and sell affordable produce, link limited resource farmers to urban, low-income public housing neighborhoods. Nutrition and cooking classes are offered at the market sites, and recipes are distributed at the point of sale. FDE’s Food Sovereignty Program also partners with other organizations, such as Food Corps to raise awareness about healthy eating in schools, and two local nonprofits to provide fresh produce boxes to low-income residents. Surveys of 16 program participants conducted by extension leaders indicate increases in food security, healthy eating habits, and physical activity among participants. Semistructured interviews with four community resident leaders illuminate some of the barriers of neighborhood effects and other challenges in cultivating food sovereignty, such as living conditions, politics of place, and broader inequalities. Additional initiatives that address food sovereignty in limited resource communities are needed as a means of expanding access and gaining additional knowledge about challenges in doing so.

scholarly journals Outcomes of a Weight Loss Intervention to Prevent Diabetes Among Low-Income Residents of East Harlem, New York

2019 ◽  
Vol 46 (6) ◽  
pp. 1073-1082 ◽  
Author(s):  
Victoria L. Mayer ◽  
Nita Vangeepuram ◽  
Kezhen Fei ◽  
Emily A. Hanlen-Rosado ◽  
Guedy Arniella ◽  
...  
Keyword(s):  
New York ◽  
Weight Loss ◽  
Low Income ◽  
Diabetes Prevention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Oral Glucose ◽  
East Harlem ◽  
The Impact

There is a need for diabetes prevention efforts targeting vulnerable populations. Our community–academic partnership, the East Harlem Partnership for Diabetes Prevention, conducted a randomized controlled trial to study the impact of peer led diabetes prevention workshops on weight and diabetes risk among an economically and racially diverse population in East Harlem, New York. We recruited overweight/obese adults from more than 50 community sites and conducted oral glucose tolerance testing and completed other clinical assessments and a health and lifestyle survey. We randomized prediabetic participants to intervention or delayed intervention groups. Intervention participants attended eight 90-minute peer-led workshop sessions at community sites. Participants in both groups returned for follow-up assessments 6 months after randomization. The main outcomes were the proportion of participants who achieved 5% weight loss, percentage weight loss, and change in the probability of developing diabetes over the next 7.5 years according to the San Antonio Diabetes Prediction Model. We enrolled 402 participants who were mainly female (85%), Latino (73%) or Black (23%), foreign born (64%), and non-English speaking (58%). At 6 months, the intervention group lost a greater percentage of their baseline weight, had significantly lower rise in HbA1c (glycated hemoglobin), decreased risk of diabetes, larger decreases in fat and fiber intake, improved confidence in nutrition label reading, and decrease in sedentary behavior as compared with the control group. Thus, in partnership with community stakeholders, we created an effective low-resource program that was less intensive than previously studied programs by incorporating strategies to engage and affect our priority population.

Finding Relief in Action: The Intersection of Youth-Led Community Organizing and Mental Health in Brooklyn, New York City

2018 ◽  
Vol 52 (4) ◽  
pp. 618-638 ◽  
Author(s):  
Anna Ortega-Williams ◽  
Laura J. Wernick ◽  
Jenny DeBower ◽  
Brittany Brathwaite
Keyword(s):  
Mental Health ◽  
New York ◽  
Low Income ◽  
Community Organizing ◽  
Multiple Stressors ◽  
Historical Trauma ◽  
Well Being ◽  
Youth Of Color ◽  
The Impact ◽  
Health And Well Being

Youth of Color, especially those in households with low income, experience multiple stressors and trauma that affect their well-being. Few studies examine the impact of youth engagement in leadership and organizing to address systemic inequity on their mental health and well-being. In a community-based participatory action research design, three organizations which train youth of Color in organizing in Brooklyn, New York, held four focus groups ( n = 43, ages 14-24 years) to examine the impact of organizing on youth mental health and well-being. Key emergent themes of youth organizing include (a) storytelling as therapeutic; (b) group leadership as strengthening personal and collective power, hopefulness, and a sense of protection; and (c) the strain of navigating their hopes and current reality. This study has important implications for actions programs can take who seek to engage youth of Color in organizing in communities and institutions impacted by historical trauma and current day systemic inequity.

scholarly journals Virtual Empowerment Training: Reaching Grandparent Caregivers During COVID19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 835-836
Author(s):  
Carole Cox
Keyword(s):  
United States ◽  
New York ◽  
Low Income ◽  
Computer Training ◽  
The United States ◽  
Community Empowerment ◽  
Severe Illness ◽  
Grandparent Caregivers ◽  
Loss And Grief ◽  
The Impact

Abstract COVID-19 has had a devastating impact on minority populations in the United States who have disproportionately been at risk of getting the virus, having severe illness, and dying from it, with these risks most pronounced for older adults. The impact has been particularly severe on the more than on the more than 2, 7 million grandparents raising their grandchildren in the United States. Covid-19 has added profound strains to these families as they struggle with resources and isolation, frequently without assistance as well as the challenge of helping children to navigate online learning. The Virtual Empowerment Training Project, developed as a 7 session pilot program for low income grandparent caregivers in New York includes classes that strengthen parenting, communication, coping with loss and grief, and community empowerment. Participants were given ipads and computer training prior to classes, all conducted through Zoom. Initial data from the 56 participants (M age = 62, Race/ethnicity=Black, 79%, Hispanic, 16%, Income annual 41%<$15,K ) indicate improvement, i.e. a lessening of Negative Affect regarding the grandchild (p < .01) in the quality of their relationships with their grandchildren while also experiencing a decline (p < .01) in their sense of parental efficacy, possibly reflecting their becoming more critical of their own parental skills. Participant evaluations of the course were overwhelmingly positive, with more than 90% finding it extremely helpful, valuable, and eager to share it with others and to become more involved in improving the lives of grandfamilies.

The Introduction of a Supermarket via Tax-Credits in a Low-Income Area

2016 ◽  
Vol 31 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Brian Elbel ◽  
Tod Mijanovich ◽  
Kamila Kiszko ◽  
Courtney Abrams ◽  
Jonathan Cantor ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Race And Ethnicity ◽  
Vegetable Consumption ◽  
Ordinary Least Squares ◽  
Dietary Quality ◽  
South Bronx ◽  
Appreciable Change ◽  
Logistic Regression Models ◽  
The Impact

Purpose. Interest and funding continue to grow for bringing supermarkets to underserved areas, yet little is known about their impact. Design. A quasi-experimental study was used to determine the impact of a new supermarket opening as a result of tax and zoning incentives. Setting. The study took place in the South Bronx, New York City, New York. Subjects: Studied were residents of two South Bronx neighborhoods deemed high need. Measures. Food purchasing and consumption were examined via surveys and 24-hour dietary recalls before and at two points after the supermarket opened (1–5, 13–17 months). Analysis. Data were analyzed using difference-in-difference models controlling for gender, race and ethnicity, age, education, marital status, and self-reported income. Ordinary least squares and logistic regression models were estimated for continuous and binary outcomes, respectively. Results. At baseline, 94% to 97% of consumers shopped at a supermarket. There was a 2% increase in this behavior in the intervention community ( p < .05) not seen in the comparison community. One year later there was a 7% net increase in eating at home ( p < .1) and a 20% decrease in drinking sugary beverages ( p < .05), but no appreciable change in fruit/vegetable consumption or overall dietary quality. Conclusion. The new supermarket did not result in substantial or broad changes in purchasing patterns or nutritional quality of food consumed, though smaller, positive changes were observed over a 1-year period. Future work should examine different contexts and a broader set of outcomes, including economic development.

How Low-Income Smokers in New York Access Cheaper Cigarettes

2018 ◽  
Vol 33 (4) ◽  
pp. 558-565
Author(s):  
Laurel Curry ◽  
Carol L. Schmitt ◽  
Amy Henes ◽  
Christina Ortega-Peluso ◽  
Haven Battles
Keyword(s):  
New York ◽  
Native American ◽  
Focus Group ◽  
Low Income ◽  
New York State ◽  
Group Discussions ◽  
Cigarette Taxes ◽  
Interview Guide ◽  
The Impact ◽  
Cigarette Prices

Purpose: To understand the tobacco acquisition practices of low-income smokers in New York State in light of high cigarette prices due to high cigarette taxes. Design: Eight focus groups with low-income smokers were conducted in spring 2015 and 2016 (n = 74). Setting: New York City (NYC) and Buffalo, New York. Participants: Low-income adults aged 18 to 65 who smoke cigarettes regularly. Method: Qualitative analysis of focus group transcripts that explored differences and similarities by region. We used the interview guide—which covered the process of acquiring cigarettes and the impact of cigarette prices—as a framework for analysis to generate themes and subthemes (deductive coding). We also generated themes and subthemes that emerged during focus group discussions (inductive coding). Results: Some smokers in Western New York have switched to untaxed cigarettes from Native American reservations, whereas low-income smokers in NYC described convenient sources of bootlegged cigarettes (packs or loosies) in their local neighborhood stores, through acquaintances, or on the street. Familiarity with the retailer was key to accessing bootlegged cigarettes from retailers. Conclusions: Smokers in this study could access cheaper cigarettes, which discouraged quit attempts and allowed them to continue smoking. The availability of lower priced cigarettes may attenuate public health efforts aimed at reducing smoking prevalence through price and tax increases.

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