Supplemental Nutrition Assistance Program Examining the Evidence to Define Benefit Adequacy (2013) / Chapter Skim
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4 Individual, Household, and Environmental Factors Affecting Food Choices and Access
4 Individual, Household, and Environmental Factors Affecting Food Choices and Access
Pages 97-146
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From page 97... ...
This chapter presents evidence on indi vidual, household, and environmental factors that affect food purchasing and consumption decisions and their impact on food choices and access and ultimately on the adequacy of SNAP allotments for achieving those goals. First, however, the chapter describes household food production theory as a framework for the discussion of these factors.
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From page 98... ...
. In the context of food choices, food consumption requires not only money expenditures for purchasing food but also time expenditures for purchasing, preparing, and consuming food and for cleaning up after preparation and consumption.
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From page 99... ...
Thus, the broader context of the theory of household production must address the various factors that influence the theory's application to actual food choices. INDIVIDUAL AND HOUSEHOLD FACTORS This section describes individual and household factors affecting the adequacy of SNAP allotments: food choices; the time available for food purchasing and preparation; knowledge, skills, and abilities related to food preparation; and the availability of personal, nonpublic transportation for individuals and households.
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From page 100... ...
, food choices are strongly influenced by events and experiences beginning early in life and continuing throughout the life course. The following discussion focuses on components of this model that are potentially related to the ability of SNAP participants to achieve the program goals: taste preferences, personal and social factors, employment status, acculturation, and access to personal transportation (which is also considered later in this section as a potential constraint on the access of SNAP participants to healthy foods)
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From page 101... ...
examining the "spillover" of work into food choices among low- and moderate-wage workers revealed that long hours, inflexible schedules, shift work, and multiple jobs have an impact on the time and energy available for food procurement and preparation. Strategies used by workers for acquiring food under these conditions involved compromises viewed as unsatisfactory for maintaining a healthy diet, such as skipping meals, eating take-out meals, eating away from home, and limiting time to meet family needs and skipping family meals.
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From page 102... ...
A bivariate analysis found positive associations between food insecurity and being unemployed, not owning a car, having older children, speaking Spanish only, planning to return to Puerto Rico, not attending Latino church or cultural events, receiving SNAP benefits that did not last the entire month, and accessing emergency food assistance. Likewise, a multivariate analysis showed positive associations between being unemployed, single, born in the United States, speaking Spanish only, planning to return to Puerto Rico, not attending Latino church or cultural events, and having SNAP benefits that did not last the entire month.
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From page 103... ...
. Although there were similarities between the two groups, including time and money constraints on food choices, those born in the United States were more likely to buy prepared foods, including fast foods, and were less likely to travel to shop for foods they wanted.
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included a sensitivity analysis of 8 hours per week to account for different food choices and recipe combinations, consistent with the Economic Research Service (ERS) publication Who Has Time to Cook?
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From page 105... ...
points to several government policies that have specifically promoted employment among low-income women over the last two decades, such as increases in the earned income tax credit. This trend, as well as the increasing number of single-parent households among SNAP participants, has altered the allocation of time resources, decreasing the amount available to spend on food preparation (Mancino and Newman, 2007)
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From page 106... ...
SNAP participants need to be especially skillful in making choices within the constraints of available resources so they can maximize the purchasing power of their SNAP benefits. The committee found limited research directly documenting a lack of nutrition and resource management knowledge and skills among lowincome populations generally, or among SNAP participants specifically.
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From page 107... ...
aim to enhance participants' ability to meet the recommendations of the DGA. Both use theoryguided interventions that take into account participants' existing strengths and emphasize building skills for resource management through planning meals and shopping wisely so as to use both nutrition assistance program benefits and cash to make healthy food choices (FNS, 2012; NIFA, 2009a)
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From page 108... ...
SNAP-Ed The Supplemental Nutrition Assistance Program-Education (SNAP-Ed) is a federal-state partnership program, sponsored by USDA, that supports nutrition educaion for SNAP participants.
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The first was an intensive school-based intervention (kindergarten through eighth grade) that included 50 hours of classroom nutrition education plus changes in school food policy, social marketing, and parent outreach (Foster et al., 2008)
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From page 110... ...
Access to Personal, Nonpublic Transportation Access to transportation was discussed above as a factor to consider for its impact on individual food choice decisions. Personal transportation is considered here as an individual/household factor that could have an impact on the purchasing power of SNAP allotments by constraining the ability of SNAP participants to access healthy foods.
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From page 111... ...
found that neighborhood residents with better access to supermarkets and limited access to convenience stores tend to have healthier diets and reduced risk for obesity. On the other hand, those residing in "food deserts"2 -- especially those without transportation -- may be limited to shopping at small neighborhood convenience and corner stores, where fresh produce, low-fat food items, and other healthy foods are often limited and of poor quality ( ndreyeva et al., 2008)
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From page 112... ...
This was the case both for distance to the nearest food source and number of opportunities to get there. Taken together, the evidence reviewed by the committee suggests that among low-income households, greater distances to major food outlets are more likely than shorter distances to be associated with limited food choices and fewer purchases of healthy foods.
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From page 113... ...
The committee notes that relevant data collection is ongoing but the data are not yet available through the ERS National Household Food Acquisition and Purchase Survey. When completed, this survey will provide detailed information on household food purchases and acquisitions, including foods purchased for consumption at and away from home and foods acquired through public and private food and nutrition assistance programs.
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From page 114... ...
. The ERS Quarterly Food at Home Price Database is based on 2006 Nielsen Homescan data and can be used to examine differences in food prices across regions.
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analysis, these differ i ences in prices across regions have substantial implications for the purchasing power of benefits provided by nutrition assistance programs.
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116 SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM TABLE 4-2 Price Variations Across Market Groups, Full Sample Versus Low-Income Sample, Low-Fat Milk (Food Group 23) , 2006 Nielsen Homescan Data Full Sample Low-Income Sample Price Price Relative Relative to to National National Mean Mean Market Group (%)
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INDIVIDUAL, HOUSEHOLD, AND ENVIRONMENTAL FACTORS 117 TABLE 4-3 Market Prices for the 20 Most Popular Fruits and Vegetables, with Deviation of Their Minimum and Maximum Prices from the National Average, 2004-2006 National Difference Difference Difference Average of Minimum Maximum from from from Market Market Market Minimum National National Prices per Price per Price per to Average to Average to Fruit/Vegetable Pound Pound Pound Maximum Minimum Maximum $ % Tomatoes 1.66 1.42 1.98 39 –15 19 Onions 1.33 0.95 1.68 77 –29 26 Lettuce 1.01 0.89 1.17 30 –11 16 Green beans 0.96 0.59 1.31 12 –38 36 Corn 0.89 0.74 1.11 50 –17 25 Carrots 1.18 0.99 1.38 39 –16 17 Broccoli 1.34 1.10 1.61 46 –18 20 Cucumbers 1.02 0.81 1.33 64 –21 30 Peppers 1.72 1.18 2.35 100 –32 37 Cabbage 0.52 0.42 0.70 68 –20 34 Bananas 0.49 0.40 0.62 55 –19 26 Apples 1.10 0.98 1.24 27 –12 12 Watermelon 0.87 0.49 1.19 140 –43 37 Oranges 0.85 0.72 1.25 73 –15 47 Grapes 1.51 1.31 1.70 30 –14 12 Strawberries 2.41 2.15 2.86 33 –11 19 Peaches 1.13 0.95 1.40 47 –15 25 Pineapples 1.29 0.99 1.63 65 –23 26 Pears 1.06 0.94 1.18 26 –11 12 Grapefruit 0.98 0.78 1.24 60 –21 27 SOURCE: Leibtag and Kumcu, 2011. Urban Versus Rural Food Prices The data in Table 4-2 also provide evidence of differences in prices by urban versus rural areas.
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From page 118... ...
found similar results using data from the Nielsen Homescan panel for 2006, which showed that prices paid by households in urban areas for fresh vegetables and salty snacks were significantly higher than those in non-urban areas. Food Prices by Store Type Households acquire food for use at home from a broad variety of stores and outlets (see Box 4-2)
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. This type of store may sell items ineligible for purchase with SNAP benefits as well, but its primary stock is food items.
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. Prices vary across types of stores, and thus the types of stores accessible to households affect their total food budgets and ability to acquire healthy foods.
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Thus, Figure 4-1 shows that comparisons of the costs of healthy versus unhealthy foods can be misleading if expressed on the basis of 100 calories
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because many healthy foods have fewer calories per serving (and per 100 grams) than unhealthy foods.
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Rising food prices may reduce the purchasing power of benefits received through federal nutrition assistance programs, depending on how and whether the benefits are adjusted for inflation over time (Hanson and Andrews, 2008)
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. Because SNAP benefits are adjusted annually in October using the prior year TFP price index, the food purchasing power of the benefits may decline to the extent that the adjustments do not fully account for the potential monthly rise in the cost of the TFP.
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In light of this evidence, the committee examined additional evidence for an impact of the ability of low-income populations to access affordable healthy foods on the purchasing power of SNAP allotments under the assumptions of the TFP. Access to Food Outlets and Purchasing Behavior The committee identified a number of observational studies showing correlations between various means of access to food outlets and purchasing behavior.
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From page 126... ...
This community was found to be lacking not in the number of food stores but in an accessible high-impact super produce store. By contrast, such stores were available in a higher-income urban mixed neighborhood in the same locale, illustrating that disparity in access to fresh produce was associated with a single disadvantaged area within a larger locale.
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From page 127... ...
These studies are important because they suggest a link between purchasing power and access to food. A general conclusion that can be drawn from this work is that although associated with income, access to food outlets and healthy foods needs to be considered in the context of how certain factors within the food environment affect the cost of healthier food options.
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From page 128... ...
Disparities in Access by Type of Food Outlet Apart from the question of distance from a food store is that of where SNAP participants are more likely to shop.
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Disparities in the Quality of Food Available for Purchase In a cross-sectional study of 25 stores in South San Diego County, C alifornia, Emond and colleagues (2012) examined associations between the availability, quality, and cost of healthy and unhealthy food items and store location -- specifically, non-ethnically based supermarkets and Latino grocery stores (tiendas)
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From page 130... ...
Disparities in Access to and Availability of Public Transportation Residents in many urban areas have few transportation options to reach supermarkets. To examine whether access to transportation plays a role in risk factors for food insecurity and access to food outlets, Bjorn and colleagues (2008)
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. Impact of Disparities in Access on Health Outcomes The committee identified a number of studies examining associations between disparities in access to healthy foods and food insecurity, obesity, and obesity-related chronic disease.
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Economic Research Service (ERS) analysis based on data from Census of Population, 2000, and the ERS-compiled supermarket directory for the contiguous United States in 2006.
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ERS analysis based on data from Census of Population, 2000, and the ERS-compiled supermarket directory for the contiguous United States in 2006. collected on more than 21,000 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
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Therefore, it is possible that the availability of food outlets and costs of food items may impact the purchasing power of SNAP allotments for healthy foods under the assumptions of the TFP, which in turn may affect diet-related health outcomes for SNAP participants. Effectiveness of Addressing Environmental Challenges to Food Access Environmental interventions to address challenges to food access show some promise.
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From page 135... ...
on the ability of some SNAP participants to pur chase a variety of healthy foods at reasonable cost. Evaluation and assessment of barriers to access should include the degree to which, and for whom, limitations in access to food outlets constrain the SNAP allotment.
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From page 136... ...
Data gaps exist for prices, quantities, and types of foods purchased by SNAP participants using SNAP benefits or other resources by type of food outlet. If these data could be linked to information on basic household factors such as ages of SNAP recipients, numbers of children, region of the country, and rural or urban setting, analyses could be carried out to assess which individual, household, and environmental factors are most important in defining the adequacy of SNAP allotments.
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From page 137... ...
The evidence points further to a lack of data on the magnitude of the impact of differences in food prices across locales on the ability of SNAP participants to purchase sufficient quantities of healthy foods based on household composition assumptions (Gundersen et al., 2011)
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However, evidence on the influence of nutrition knowledge and skills on the ability of SNAP participants to purchase and prepare healthy foods consistent with the assumptions of the TFP is insufficient to support a conclusion about the relevance of these factors to an evidence-based definition of the adequacy of SNAP allotments. Assessing the nutrition skills of the SNAP population directly (i.e., through direct observation)
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2011. Benefit redemption patterns in the Supplemental Nutrition Assistance Programs.
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2007. The food insecurity-obesity paradox: A r eview of the literature and the role food stamps may play.
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2012. Supplemental Nutrition Assistance Program: Nutrition education.
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2008. Rising food prices take a bite out of food stamp ben efits, EIB-41.
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2011. Associations be tween food insecurity, Supplemental Nutrition Assistance Program (SNAP)
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Reexamining the relation between food price and energy density. American Journal of Clinical Nutrition 90(5)
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2007. Food stamps, the Thrifty Food Plan, and meal preparation: The importance of the time dimension for U.S.
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2009. The art of grocery shopping on a food stamp budget: Factors influencing the food choices of low-income women as they try to make ends meet.
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