Food Insecurity Transitions and Changes in Employment and Earnings.

INTRODUCTION: Many low-income U.S. households experience food security changes over time, but little is known about how labor market transitions contribute to these changes. This paper uses longitudinal survey data collected from 2017 to 2020 to explore how changes in employment and earnings are associated with changes in food security status. METHODS: Analyses were conducted in the spring of 2022 and include nearly 3,500 individuals who participated in the Supplemental Nutrition Assistance Program Employment and Training program. Individuals responded to surveys at 2 points in time-12 months and 36 months after study enrollment-which asked for employment, earnings, and food security information. Logistic regression models were used to estimate the associations between food security transitions and employment and earnings changes. Analyses also were conducted to assess whether these associations differed on the basis of individuals' previous employment and earnings volatility. RESULTS: Individuals who experienced a job loss 2 months before the second survey interview had higher odds of becoming food insecure (OR=2.67; 95% CI=1.24, 5.75); those who experienced an earnings reduction in the month before the interview also had higher odds of becoming food insecure (OR=1.89; 95% CI=1.03, 3.47). The association between experiencing a job loss and becoming food insecure was greater among those who had experienced past earnings changes. There were no statistically significant associations between changes in earnings and employment and the likelihood of becoming food secure. CONCLUSIONS: Employment losses and earnings reductions are associated with becoming food insecure among Supplemental Nutrition Assistance Program Employment and Training participants. Providing additional support to individuals who experience these losses and reductions may reduce their risk of becoming food insecure.

Continued Participation in Congregate Meal Programs: The Role of Geographic Access to Food.

The Nutrition Services Program is the largest program that provides prepared meals to older adults in need. However, little is known about the factors associated with participants' continued receipt of meals. This study uses longitudinal nationally representative survey data and residential location information to examine the factors associated with continuing to receive congregate meals (N = 383). 71.6% of participants in a given month continued to receive program meals in all of the next 12 months. Participants with geographic access to food proximate to their home were significantly more likely to stop receiving meals than those with more limited access (OR = 0.37, CI 0.16, 0.85); this was true among participants who lived alone, were older, had lower income, or lived in an urban area. Understanding the factors associated with continuing to receive congregate meals will ensure that older adults can meet their food needs and have a primary access point for community services.

Randomized Controlled Trial of Healthy Harlem's Get Fit Program: An After-School Intervention for Childhood Overweight and Obesity in the Harlem Children's Zone.

Background: Although the increases in overweight and obesity observed for several decades have appeared to have leveled off, the prevalence of overweight and obesity remains exceptionally high among children of color. This article estimates the effect of Healthy Harlem's Get Fit-a 12-week after-school program aimed at helping students improve physical activity and eating habits-on BMI and weight status of adolescents. Methods: Participants were 436 students who had overweight or obesity in 12 Harlem Children's Zone after-school programs in New York. The evaluation was a randomized controlled trial where students were assigned to an intervention group that received Get Fit plus Prevention services or a control group that only received Prevention services in 2013 or 2014. Impacts were assessed on BMI z-score, percentage with overweight or obesity, and percentage with obesity using regression analysis. Results: Relative to the control group, students randomized to Get Fit experienced a decrease in BMI z-score (mean difference = -0.04; p = 0.02). The percentage of students with overweight or obesity was also lower (mean difference = -5.3; p = 0.02), but there was no effect on the percentage of students with obesity. Get Fit had an impact on BMI for girls, but not boys. Conclusions: Get Fit improved middle- and high-school students' BMI outcomes and weight status. Schools continue to face pressure to allocate time for physical education and activity while meeting their academic demands, underscoring the importance of after-school student-level interventions like Get Fit.

Food Insecurity is Directly Associated with the Use of Health Services for Adverse Health Events among Older Adults.

BACKGROUND: In 2018, 14.3 million US households experienced food insecurity, which has been linked to negative health outcomes such as depression and anxiety, diabetes, and hypertension. This connection is particularly important for older adults, who are at greater risk than younger adults for developing certain health conditions. OBJECTIVE: We estimated the association between food insecurity and the use of health services for adverse health events over a 12-mo observation period following survey interview for a nationally representative group of older adults participating in the congregate meal (CM) and home-delivered meal (HDM) programs. METHODS: We analyzed data from the Nutrition Services Program (NSP) Outcomes Survey matched to Medicare claims and enrollment data in 2015-2016 for a nationally representative sample of 626 CM or HDM recipients ages 67 y and older. We used logistic regression analysis controlling for demographic characteristics, prior health events, and geography to estimate the association between food insecurity and use of health services, including emergency department visits, inpatient stays, skilled nursing facility stays, and home healthcare episodes. We used ordinary least squares regression analysis to estimate the association between food insecurity and Medicare spending. RESULTS: Food insecurity was associated with an average increased likelihood of using health services for adverse health events of 16% (95% CI: 1%, 32%) for HDM participants. Food insecurity was associated with an average increased likelihood of emergency department visits of 24% (95% CI: 6%, 41%) for CM participants and 20% (95% CI: 5%, 36%) for HDM participants. There was no observed increase in likelihood of using the other health services. Food-insecure participants were less likely to have a skilled nursing facility stay. CONCLUSIONS: Food insecurity is associated with an increased likelihood of use of health services for adverse health events in older adult participants in meal service programs.

Supplemental Nutrition Assistance Program Participation and Emergency Food Pantry Use.

OBJECTIVE: To determine the association between Supplemental Nutrition Assistance Program (SNAP) participation and pantry use. DESIGN: A pretest-posttest design that compared pantry use at program enrollment and after 6 months of participation while controlling for household, economic, and geographic characteristics. SETTING: Supplemental Nutrition Assistance Program Food Security Survey: a national telephone survey of SNAP new-entrant households conducted in 2011-2012. PARTICIPANTS: A total of 3,191 households that completed baseline interviews and were still participating in SNAP approximately 6 months later. MAIN OUTCOME MEASURE: Received emergency food from pantries in the past 30 days. ANALYSIS: Logistic regression analysis of pantry use with SNAP participation and time-varying household characteristics as independent variables. Statistical significance was assessed using t tests. The authors applied a Bonferroni adjustment to account for multiple comparisons performed. RESULTS: Participating in SNAP for 6 months was associated with a decrease in pantry use by 5.2 percentage points (P < .001), representing a 24% reduction (from 21.8% to 16.6%). CONCLUSIONS AND IMPLICATIONS: Supplemental Nutrition Assistance Program benefit allotments are sufficient for some households, but 76% of SNAP households that enter the program while using pantries continue to do so about 6 months later, which underscores the need to assess the adequacy of SNAP benefit allotments in ensuring access to sufficient food for a healthy, active life.

Association of participation in the supplemental nutrition assistance program and psychological distress.

OBJECTIVES: We assessed whether households' participation in the Supplemental Nutrition Assistance Program (SNAP) was associated with improvements in well-being, as indicated by lower rates of psychological distress. METHODS: We used longitudinal data for 3146 households in 30 states, collected between October 2011 and September 2012 for the SNAP Food Security survey, the largest longitudinal national survey of SNAP participants to date. Analyses compared households within days of program entry to the same households approximately 6 months later. We measured psychological distress in the past 30 days on a 6-item Kessler screening scale and used multivariable regression to estimate associations between SNAP participation and psychological distress. RESULTS: A smaller percentage of household heads exhibited psychological distress after 6 months of participation in SNAP than at baseline (15.3% vs 23.2%; difference = -7.9%). In adjusted models, SNAP participation was associated with a decrease in psychological distress (adjusted relative risk = 0.72; 95% confidence interval = 0.66, 0.78). CONCLUSIONS: Continuing support for federal nutrition programs, such as SNAP, may reduce the public health burden of mental illness, thus improving well-being among vulnerable populations.

Supplemental Nutrition Assistance Program participation is associated with an increase in household food security in a national evaluation.

BACKGROUND: The Supplemental Nutrition Assistance Program (SNAP) provides nutrition assistance benefits to low-income families in an effort to reduce hunger and improve health and well-being. Because 1 in 7 Americans participate in the program each month, policymakers need to know whether the program is meeting these objectives effectively. OBJECTIVE: The objective of this study was to estimate the association between SNAP participation and household food security using recent data from the largest national survey of the food security of SNAP participants to date. METHODS: The analysis used a survey of nearly 6500 households and a quasi-experimental research design that consisted of 2 sets of comparisons. Using a cross-sectional sample, we compared information collected from SNAP households within days of program entry with information collected from a contemporaneous sample of SNAP households that had participated for ∼6 mo. Next, using a longitudinal sample, we compared baseline information collected from new-entrant SNAP households with information from those same households 6 mo later. Multivariate logistic regression analysis was used to estimate associations between SNAP and household food security. RESULTS: SNAP participation decreased the percentage of SNAP households that were food insecure in both samples by 6-17%. SNAP participation also decreased the percentage of households experiencing severe food insecurity--designated very low food security--by 12-19%. Findings were qualitatively robust to different empirical specifications. CONCLUSION: SNAP serves a vital role in improving the health and well-being of households by increasing food security. Given recent legislation to reduce program size and limit program eligibility, this study underscores SNAP's continued importance in affecting households' well-being. Future research is needed to determine whether specific groups of households experience differential improvements in food security.

Supplemental nutrition assistance program participation and child food security.

OBJECTIVE: This article investigates the association between Supplemental Nutrition Assistance Program (SNAP) participation and child food security by using data from the largest national survey of the food security of SNAP participants to date. METHODS: The analysis used a survey of nearly 3000 households with children and a quasi-experimental research design that consisted of 2 sets of comparisons. Using a cross-sectional sample, we compared information collected from SNAP households within days of program entry with information collected from a contemporaneous sample of SNAP households that had participated for ∼6 months. Next, by using a longitudinal sample, we compared baseline information collected from new-entrant SNAP households with information from those same households 6 months later. Multivariate logistic regression analysis was used to estimate associations between SNAP and child food security. RESULTS: SNAP participation was associated with an approximately one-third decrease in the odds of children being food insecure in both samples. In the cross-sectional analysis only, SNAP was also associated with a decrease in the odds of children experiencing severe food insecurity (designated very low food security). Findings were qualitatively robust to different empirical specifications. CONCLUSIONS: After controlling for other possible confounders, we found children in households that had participated in SNAP for 6 months experienced improvements in food security. On the basis of these findings, we conclude SNAP serves a vital role in improving the health and well-being of low-income children by increasing food security. Future research is needed to determine whether specific groups of children experience differential improvements in food security.