Prevalence and Predictors of Household Food Insecurity and Supplemental Nutrition Assistance Program Use in Youth and Young Adults With Diabetes: The SEARCH for Diabetes in Youth Study

<a>OBJECTIVES: To assess the prevalence of household food insecurity (HFI) and Supplemental Nutrition Assistance Program (SNAP) participation in youth and young adults (YYA) with diabetes overall, by type, and sociodemographic characteristics.</a> RESEARCH DESIGN AND METHODS: The study included participants with youth-onset type 1 diabetes and type 2 diabetes from the SEARCH for Diabetes in Youth study. HFI was assessed using the 18-item U.S. Household Food Security Survey Module (HFSSM) administered from 2016-2019; ³3 affirmations on the HFSSM were considered indicative of HFI. Participants were asked about SNAP participation. Chi-square tests were used to assess whether the prevalence of HFI and SNAP participation differed by diabetes type. Multivariable logistic regression models were used to examine differences in HFI by participant characteristics. RESULTS: Of 2561 respondents (age range 10-35 years; 79.6% ≤ 25 years), 2177 had type 1 diabetes (mean age 21.0 years, 71.8% non-Hispanic white, 11.8% non-Hispanic black, 13.3% Hispanic, 3.1% other) and 384 had type 2 diabetes (mean age 24.7 years, 18.8% non-Hispanic white, 45.8% non-Hispanic black, 23.7% Hispanic, 18.7% other). The overall prevalence of HFI was 19.7% (95% CI 18.1, 21.2). HFI was more prevalent in type 2 diabetes than type 1 diabetes (30.7% vs. 17.7%, p< 0.01). In multivariable regression models, YYA on Medicaid/Medicare or without insurance, with lower parental education, and with lower household income had greater odds of experiencing HFI. SNAP participation was 14.1% (95% CI 12.7, 15.5) with higher participation among those with type 2 diabetes compared to type 1 diabetes (34.8% vs. 10.7%; p<0.001). CONCLUSIONS: Almost 1 in 3 YYA with type 2 diabetes and more than 1 in 6 with type 1 diabetes reported HFI in the past year, a significantly higher prevalence than the general U.S. population.

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1115-P: Household Food Insecurity and Cognitive Function in Youth and Young Adults with Type 1 Diabetes

Diabetes ◽

10.2337/db21-1115-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 1115-P

Author(s):

ANGELA D. LIESE ◽

ANDREA D. BROWN ◽

ALLISON SHAPIRO ◽

EDWARD A. FRONGILLO ◽

GRETA WILKENING ◽

...

Keyword(s):

Type 1 Diabetes ◽

Young Adults ◽

Cognitive Function ◽

Food Insecurity ◽

Household Food Insecurity ◽

Household Food ◽

Youth And Young Adults

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Prevalence and Predictors of Household Food Insecurity and Supplemental Nutrition Assistance Program Use in Youth and Young Adults With Diabetes: The SEARCH for Diabetes in Youth Study

10.2337/figshare.16873354.v1 ◽

2021 ◽

Author(s):

Faisal S. Malik ◽

Angela D. Liese ◽

Beth A. Reboussin ◽

Katherine A. Sauder ◽

Edward A. Frongillo ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Assistance Program ◽

Household Food ◽

Youth And Young Adults ◽

Nutrition Assistance ◽

Youth Study ◽

Hispanic White

<a>OBJECTIVES: To assess the prevalence of household food insecurity (HFI) and Supplemental Nutrition Assistance Program (SNAP) participation in youth and young adults (YYA) with diabetes overall, by type, and sociodemographic characteristics.</a> RESEARCH DESIGN AND METHODS: The study included participants with youth-onset type 1 diabetes and type 2 diabetes from the SEARCH for Diabetes in Youth study. HFI was assessed using the 18-item U.S. Household Food Security Survey Module (HFSSM) administered from 2016-2019; ³3 affirmations on the HFSSM were considered indicative of HFI. Participants were asked about SNAP participation. Chi-square tests were used to assess whether the prevalence of HFI and SNAP participation differed by diabetes type. Multivariable logistic regression models were used to examine differences in HFI by participant characteristics. RESULTS: Of 2561 respondents (age range 10-35 years; 79.6% ≤ 25 years), 2177 had type 1 diabetes (mean age 21.0 years, 71.8% non-Hispanic white, 11.8% non-Hispanic black, 13.3% Hispanic, 3.1% other) and 384 had type 2 diabetes (mean age 24.7 years, 18.8% non-Hispanic white, 45.8% non-Hispanic black, 23.7% Hispanic, 18.7% other). The overall prevalence of HFI was 19.7% (95% CI 18.1, 21.2). HFI was more prevalent in type 2 diabetes than type 1 diabetes (30.7% vs. 17.7%, p< 0.01). In multivariable regression models, YYA on Medicaid/Medicare or without insurance, with lower parental education, and with lower household income had greater odds of experiencing HFI. SNAP participation was 14.1% (95% CI 12.7, 15.5) with higher participation among those with type 2 diabetes compared to type 1 diabetes (34.8% vs. 10.7%; p<0.001). CONCLUSIONS: Almost 1 in 3 YYA with type 2 diabetes and more than 1 in 6 with type 1 diabetes reported HFI in the past year, a significantly higher prevalence than the general U.S. population.

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Does Supplemental Nutrition Assistance Program Reduce Food Insecurity among Households with Children? Evidence from the Current Population Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063178 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3178

Author(s):

Jun Zhang ◽

Yanghao Wang ◽

Steven T. Yen

Keyword(s):

Food Security ◽

Food Insecurity ◽

Current Population Survey ◽

Population Survey ◽

Supplemental Nutrition Assistance Program ◽

Supplemental Nutrition ◽

Assistance Program ◽

Current Population ◽

Households With Children ◽

Nutrition Assistance

The Supplemental Nutrition Assistance Program (SNAP) is designed to improve household diet and food security—a pressing problem confronting low-income families in the United States. Previous studies on the issue often ignored the methodological issue of endogenous program participation. We revisit this important issue by estimating a simultaneous equation system with ordinal household food insecurity. Data are drawn from the 2009–2011 Current Population Survey Food Security Supplement (CPS-FSS), restricted to SNAP-eligible households with children. Our results add to the stocks of empirical findings that SNAP participation ameliorates food insecurity among adults only, but increases the probabilities of low and very low food security among children. These contradictory results indicate that our selection approach with a single cross section is only partially successful, and that additional efforts are needed in further analyses of this complicated issue, perhaps with longitudinal data. Socio-demographic variables are found to affect food-secure households and food-insecure households differently, but affect SNAP nonparticipants and participants in the same direction. The state policy tools, such as broad-based categorical eligibility (BBCE) and simplified reporting, can encourage SNAP participation and thus ameliorate food insecurity. Our findings can inform policy deliberations.

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Association Between Household Food Security and Disordered Eating Behaviors Among Young Adults with Diabetes: The SEARCH for Diabetes in Youth Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_047 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1419-1419

Author(s):

Emahlea Jackson ◽

Angela Liese ◽

Catherine Pihoker ◽

Faisal Malik ◽

Jessica Jones-Smith ◽

...

Keyword(s):

Young Adults ◽

Food Security ◽

Disordered Eating ◽

Eating Behaviors ◽

Household Food Security ◽

Disordered Eating Behaviors ◽

Household Food ◽

Significant Difference ◽

Youth Study ◽

Diabetes In Youth

Abstract Objectives Examine the relationship between household food insecurity (HFS; i.e., access to nutritionally adequate and safe food) and disordered eating behaviors (i.e., restriction, bingeing, insulin manipulation, etc.) among a sample of young adults with youth-onset type 1 (T1D) or type 2 diabetes (T2D). Methods We used cross-sectional data from the SEARCH for Diabetes in Youth Study. Individuals (n = 792) ages ≥18 years completed the U.S. Household Food Security Survey Module and the Diabetes Eating Problem Survey-Revised (DEPS-R) between 2016 and 2019. We converted HFS scores to a 10-point scale and dichotomized scores into food secure (HFS ≤ 2.2) vs. food insecure (HFS > 2.2). Multivariable linear regression was used to evaluate the association of HFS with continuous DEPS-R score (i.e., 0–80, with a greater score indicating greater symptoms of disordered eating), adjusting for potential confounders (i.e., sex, age, race/ethnicity, education, household income, insurance, depressive symptoms, and duration of diabetes). We further stratified analyses by diabetes type. Results Participants were on average 23.8 ± 3.7 years, 59.6% female, 49.6% non-Latino white, and had a mean diabetes duration of 11.5 ± 3.1 years. The overall mean DEPS-R score was 17.3 ± 10.0 points. Mean DEPS-R scores in individuals living in food secure households (n = 709) and food insecure households (n = 83) were 16.6 ± 9.45 and 23.4 ± 12.4, respectively. The adjusted DEPS-R scores were 3.6 points (95% CI = 1.5, 5.7; P < 0.001) higher in food insecure compared to food secure households. In individuals with T1D (n = 600), the adjusted DEPS-R scores were 5.0 points (95% CI = 2.6, 7.4; P < 0.001) higher in food insecure (n = 55) compared to food secure (n = 545) households. In individuals with T2D (n = 192), there was no significant difference in mean DEPS-R scores between food insecure (n = 28) versus food secure (n = 164) households in unadjusted or adjusted models (P > 0.05). Conclusions Lower household food security in young adults with T1D, but not T2D, is associated with increased disordered eating scores. These results may allow clinicians and other public health professionals to target individuals with low household food security as being at higher risk for potential disordered eating, particularly those with T1D. Funding Sources NIDDK & CDC.

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An Examination of the Adequacy of Supplemental Nutrition Assistance Program (SNAP) Benefit Levels: Impacts on Food Insecurity

Agricultural and Resource Economics Review ◽

10.1017/age.2019.30 ◽

2019 ◽

Vol 48 (3) ◽

pp. 433-447 ◽

Cited By ~ 6

Author(s):

Craig Gundersen ◽

Elaine Waxman ◽

Amy S. Crumbaugh

Keyword(s):

Food Insecurity ◽

Low Income ◽

The United States ◽

Food Prices ◽

Supplemental Nutrition Assistance Program ◽

Supplemental Nutrition ◽

Assistance Program ◽

The Difference ◽

Nutrition Assistance ◽

The Cost

The Supplemental Nutrition Assistance Program (SNAP) serves as the primary tool to alleviate food insecurity in the United States. Its effectiveness has been demonstrated in numerous studies, but the majority of SNAP recipients are still food insecure. One factor behind this is the difference in food prices across the country—SNAP benefits are not adjusted to reflect these differences. Using information from Feeding America's Map the Meal Gap (MMG) project, we compare the cost of a meal by county based on the Thrifty Food Plan (TFP)—which is used to set the maximum SNAP benefit—with the cost of the average meal for low-income food-secure households. We find that the cost of the latter meal is higher than the TFP meal for over 99 percent of the counties. We next consider the reduction in food insecurity if, by county, the maximum SNAP benefit level was set to the cost of the average meal for low-income food-secure households. We find that if this approach were implemented, there would be a decline of 50.9 percent in food insecurity among SNAP recipients at a cost of $23 billion.

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