Participation in the Supplemental Nutrition Assistance Program and Dietary Behaviors: Role of Community Food Environment

Abstract

Program (SNAP) is the country's largest nutrition assistance program for low-income populations. While SNAP has been shown to reduce food insecurity, research on the diet quality of program participants is inconsistent. Objective: This study examined if the community food environment is a potential moderator of the association between SNAP participation and eating behaviors. Design: This cross-sectional study utilized participant data from a telephone survey of 2,211 households in four cities in New Jersey. Data were collected from two cross-sectional panels from 2009-10 and 2014. Food outlet data were purchased from commercial sources and classified as supermarkets, small grocery stores, convenience stores, or limited service restaurants. Participants/setting: Analysis is limited to 983 respondents (588 SNAP participants) with household incomes below 130% of the Federal Poverty Level. Main outcome measures: Eating behaviors assessed as frequency of consum ption of fruit, vegetables, salad, and sugar sweetened beverages (SSB). Statistical analysis performed: Interaction and stratified analyses using gamma regression determined the differences in the association between SNAP participation and eating behaviors by the presence or absence of food outlets adjusted for covariates. Results: SNAP participation was associated with a higher frequency of consuming SSB (p<0.05) when respondents lived within ¼-½ mile of a small grocery store, supermarket, and limited service restaurant. SNAP participants who did not live close to a convenience store reported a lower frequency of SSB consumption (p=0.01), while those living more than ½ mile away from a supermarket reported a lower frequency of fruit consumption (p=0.03). Conclusions: This study suggests that the community food environment may play a role in moderating the association between SNAP participation and eating behaviors. While SNAP participation is associated with some unhealthy behaviors, this association may only hold true when respondents live in certain food environments.

The neighborhood food environment modifies the effect of the 2009 WIC food package change on childhood obesity in Los Angeles County, California

“…However, previous research has found that individuals who live closer to outlets that sell fresh produce consume more fruits and vegetables [37] and individuals who live in proximity to unhealthy food outlets consume fewer fruits and vegetables [38]. Living in a neighborhood with an abundance of food outlets providing unhealthy items may encourage the consumption of high calorie and low nutritional value items, like sugar-sweetened beverages, among nutrition assistance program participants [39]. Similarly, living further from supermarkets or other food outlets that sell fresh fruits and vegetables may contribute to lower consumption of produce among food assistance program participants compared to non-participating individuals [39].…”

“…Living in a neighborhood with an abundance of food outlets providing unhealthy items may encourage the consumption of high calorie and low nutritional value items, like sugar-sweetened beverages, among nutrition assistance program participants [39]. Similarly, living further from supermarkets or other food outlets that sell fresh fruits and vegetables may contribute to lower consumption of produce among food assistance program participants compared to non-participating individuals [39].…”

Inequity in access to healthy foods

“…However, for those who are limited to food shopping near where they live, studies confirm a nearby store does improve access (350) and affordability (321). Other studies have found that decreased distance to a supermarket or grocery store improves food security, consumption of fruits and vegetables, or redemption of benefits, but increased purchase of unhealthy foods and beverages has also been observed (108,(351)(352)(353)(354). Even if physical proximity is at best weakly related to diet quality, decreasing distance could reduce disparities in the time burden to acquire food and disproportionately benefit people with disabilities and other mobility limitations who largely need or prefer to shop nearby (355).…”