Federal Food Program Participation and Beverage Intake Among Families With Low Household Income.

OBJECTIVE: Examine beverage intake among families with low income by household participation in federal food assistance programs. DESIGN: Cross-sectional study conducted in fall/winter 2020 via an online survey. PARTICIPANTS: Mothers of young children insured by Medicaid at the time of the child's birth (N = 493). VARIABLES MEASURED: Mothers reported household federal food assistance program participation, later categorized as Supplementation Nutrition Program for Women, Infants, and Children (WIC) only, Supplemental Nutrition Assistance Program-Education (SNAP) only, both WIC and SNAP, and neither. Mothers reported beverage intake for themselves and their children aged 1-4 years. ANALYSIS: Negative binomial and ordinal logistic regression. RESULTS: After accounting for sociodemographic differences between groups, mothers from households participating in WIC and SNAP consumed sugar-sweetened beverages (incidence rate ratio, 1.63; 95% confidence interval [CI], 1.14-2.30; P = 0.007) and bottled water (odds ratio, 1.76; 95% CI, 1.05-2.96; P = 0.03) more frequently than mothers from households in neither program. Children from households participating in WIC and SNAP also consumed soda (incidence rate ratio, 6.07; 95% CI, 1.80-20.45; P = 0.004) more frequently than children in either program. Few differences in intake were observed for mothers or children participating in only WIC or SNAP vs both programs or neither program. CONCLUSION AND IMPLICATIONS: Households participating in both WIC and SNAP may benefit from additional policy and programmatic interventions to limit sugar-sweetened beverage intake and reduce spending on bottled water.

Experiences of the Flint Water Crisis Among Reproductive-Age Michigan Women in Communities Outside of Flint: Differences by Race and Ethnicity.

We sought to understand how women in Michigan communities outside of Flint experienced the Flint water crisis, an avoidable public health disaster widely attributed to structural racism. Using survey data from 950 Michigan women aged 18-45 from communities outside of Flint, we examined racial and ethnic differences in personal connections to Flint, perceived knowledge about the water crisis, and beliefs about the role of anti-Black racism in the water crisis factors that could contribute to poor health via increased psychological stress. We found that White (OR = 0.32; 95% CI: 0.22, 0.46) and Hispanic (OR = 0.21; 95% CI: 0.09, 0.49) women had lower odds than Black women of having family or friends who lived in Flint during the water crisis. Compared to Black women, White women were less likely to be moderately or very knowledgeable about the water crisis (OR = 0.58; 95% CI: 0.41, 0.80). White women (OR = 0.26; 95% CI: 0.18, 0.37), Hispanic women (OR = 0.38; 95% CI: 0.21, 0.68), and women of other races (OR = 0.28; 95% CI: 0.15, 0.54) were less likely than Black women to agree that the water crisis happened because government officials wanted to hurt Flint residents. Among those who agreed, White women (OR = 0.47; 95% CI: 0.30, 0.74) and women of other races (OR = 0.33; 95% CI: 0.12, 0.90) were less likely than Black women to agree that government officials wanted to hurt people in Flint because most residents are Black. We conclude that the Flint water crisis was a racialized stressor, with potential implications for the health of reproductive-age Black women.

Perceptions of tap water associated with low-income Michigan mothers' and young children's beverage intake.

OBJECTIVE: To quantify perceptions of tap water among low-income mothers with young children residing in Michigan and examine associations between perceptions of tap water, mothers' and young children's beverage intake, and mothers' infant feeding practices. DESIGN: Cross-sectional study. SETTING: Online survey. PARTICIPANTS: Medicaid-insured individuals who had given birth at a large Midwestern US hospital between fall 2016 and fall 2020 were invited by email to complete a survey in winter 2020 (N 3881); 15·6 % (N 606) completed eligibility screening, 550 (90·8 %) were eligible to participate, and 500 (90·9 %) provided valid survey data regarding perceptions of tap water, self and child beverage intake, and infant feeding practices. RESULTS: Two-thirds (66·2 %) of mothers reported that their home tap water was safe to drink without a filter, while 21·6 % were unsure about the safety of their home tap water. Mothers' perceptions of their home tap water were associated with their own tap and bottled water intake and their young children's tap water and bottled water intake. Mothers with more negative perceptions of tap water in general, independent of their perceptions about their home tap water, consumed more bottled water and sugar-sweetened beverages, and their young children drank bottled water and fruit drinks more frequently. Few associations were observed between mothers' perceptions of tap water and infant feeding practices. CONCLUSIONS: Uncertainty about tap water safety and negative perceptions of tap water are common among low-income Michigan mothers. These beliefs may contribute to less healthful and more costly beverage intake among mothers and their young children.

FOOT INJURIES IN MICHIGAN, USA, GRAY WOLVES (CANIS LUPUS), 1992-2014.

The range of gray wolves (Canis lupus) in the contiguous US is expanding. Research and monitoring to support population recovery and management often involves capture via foothold traps. A population-level epidemiologic assessment of the effect of trap injuries on wolf survival remains needed to inform management. We describe the baseline rate, type, and severity of foot injuries of wolves born 1992-2013 in Michigan's Upper Peninsula, evaluate the reliability of field-scoring trap-related injuries, and the effect of injuries on wolf survival. We assessed foot injuries by physical and radiographic exam at postmortem and/or time of capture for 351 wolves using the International Organization for Standardization 10990-5 standard and the effects of injuries, sex, age, previous capture and body condition on survival using proportional hazards regression. We used ordinal regression to evaluate epidemiologic associations between sex, age, previous capture, body condition, cause of death and injury severity. Most wolves (53%) experienced no physically or radiographically discernable foot injuries over their lifetimes. Among those wolves that did experience injuries, 33% scored as mild. Foot injuries had little epidemiologically discernable effect on survival rates. Wolves with higher foot trauma scores did experience an increased risk of dying, but the magnitude of the increase was modest. Most limb injuries occurred below the carpus or tarsus, and scoring upper-limb injuries added little predictive information to population-level epidemiologic measures of survival and injury severity. There was little association between injury severity and cause of death. Based on necropsy exams, previous trap injuries likely contributed to death in only four wolves (1.1%). Our results suggest that injuries resulting from foothold traps are unlikely to be a limiting factor in recovery and ongoing survival of the Michigan gray wolf population.