Welcome to the Neighborhood: Does Where you Live Affect the Use of Nutrition, Health, and Welfare Programs?

Despite the recent upsurge in neighborhood effects research, few studies have examined the impact of neighborhood characteristics on the use of nutrition, health, and welfare programs. To explore these issues, this study used data from Welfare, Children, and Families: A Three-City Study, a longitudinal dataset comprised of low-income neighborhoods in Boston, San Antonio, and Chicago (n=1,712). Using hierarchical linear models, the results indicated that both individual (education, employment, and marriage) and perceived neighborhood disorder factors were related to social service use

Can People Experiencing Homelessness Acquire Financial Assets?

Through an innovative Individual Development Account (IDA) program run by the Community Empowerment Fund (CEF), individuals at risk for or experiencing homelessness receive financial education, access matched savings accounts, and have saved a total of $89,831.55. This is notable as low-income individuals often lack access to the means to build assets, which can moderate financial distress. In this mixed-method study we examine the program\u27s impact through administrative data, surveys, and qualitative interviews. Of the 17 interview participants, 15 opened an account, saving an average of$1,356.24 toward housing, emergency savings, cars, education, and computers. Few U.S. IDA programs have served those experiencing homelessness, although the results demonstrate they can save, which is remarkable considering the U.S. saving rate has been steadily declining to close to zero. Our findings suggest that this model is effective in working with the most disadvantaged populations to successfully acquire financial assets

The relationship between income and food insecurity : the role of social support in rural and urban Oregonians

Millions of U.S. households experienced hunger in 2005 and millions more experienced food insecurity. Previous research indicates that low-wage work and little social support contribute to food insecurity. Research also suggests that individuals cope by finding alternate food sources and drawing on social support. Further, researchers have found that rural residents face difficulties that many urbanites do not, including lack of living-wage jobs, transportation, and nutrition assistance. However, rural dwellers may possess support they can leverage in difficult times. This study used mixed methods (i.e., quantitative and qualitative) to examine whether social support moderates the relationship between income and food insecurity and whether place of residence affects social support. First, a mail survey was conducted with a stratified random sample of Oregonians (n=343, 34.4% response rate). Subsequently, qualitative interviews (n = 25) were conducted with low-income or food insecure survey respondents to provide insight into these issues. Quantitative results indicate that lower income respondents were more likely to experience food insecurity. In general, social support did not moderate the relationship between income and food insecurity. When income was categorized using poverty guidelines, however, results suggested that emotional support, social network support, and organization membership may moderate this relationship. Specifically, respondents with incomes of ≤$19,999 were less likely to experience food insecurity in the presence of this support. However, small sample sizes in the ≤$19,999 income category resulted in unstable estimates of odds ratios (e.g., 4136.79). When income was recategorized to remedy this, the moderation disappeared. Additionally, place of residence had a significant association with only one social support measure, social network density. Rural respondents had less dense social networks than urban respondents. Place of residence was not a significant predictor of amount of social support via multivariate analysis. Several food insecurity contributors emerged from the qualitative study phase including ill health, unemployment, and having other expenses. Participants cited coping strategies such as use of alternate food sources, use of nutrition assistance, and drawing on social support. Although few significant quantitative results were found, qualitative findings suggest that developing nutrition interventions that build social support may lead to reduced food insecurity

The relationship between income and food insecurity among Oregon residents: does social support matter?

Millions of US households experienced food insecurity in 2005. Research indicates that low wages and little social support contribute to food insecurity. The present study aimed to examine whether social support moderates the relationship between income and food insecurity. Using a mail survey, we collected data on social support sources (social network, intimate partner and community) and social support functions from a social network (instrumental, informational and emotional). We used hierarchical logistic regression to examine the potential moderation of various measures of social support on the relationship between income and food insecurity, adjusting for potential confounding variables. Oregon, USA. A stratified random sample of Oregonians aged 18–64 years (n 343). We found no evidence of an association between social support and food insecurity, nor any evidence that social support acts as a moderator between income and food insecurity, regardless of the measure of social support used. Although previous research suggested that social support could offset the negative impact of low income on food security, our study did not find support for such an effect

The relationship between income and food insecurity among Oregon residents: does social support matter?

Objective: Millions of US households experienced food insecurity in 2005. Research indicates that low wages and little social support contribute to food insecurity. The present study aimed to examine whether social support moderates the relationship between income and food insecurity. Design: Using a mail survey, we collected data on social support sources (social network, intimate partner and community) and social support functions from a social network (instrumental, informational and emotional). We used hierarchical logistic regression to examine the potential moderation of various measures of social support on the relationship between income and food insecurity, adjusting for potential confounding variables. Setting: Oregon, USA. Subjects: A stratified random sample of Oregonians aged 18–64 years (n 343). Results: We found no evidence of an association between social support and food insecurity, nor any evidence that social support acts as a moderator between income and food insecurity, regardless of the measure of social support used. Conclusions: Although previous research suggested that social support could offset the negative impact of low income on food security, our study did not find support for such an effect.Keywords: Moderation analysis, Food insecurity, Oregon, Social suppor

“I Think That’s the Most Beneficial Change That WIC Has Made in a Really Long Time”: Perceptions and Awareness of an Increase in the WIC Cash Value Benefit

During the COVID-19 pandemic, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash Value Benefit (CVB) for fruits and vegetables increased by roughly USD 25/month/person. We sought to understand WIC participant perceptions of this change and barriers and facilitators to using the CVB. We conducted 10 virtual focus groups (5 rural, 5 urban/suburban) with WIC participants (n = 55) in North Carolina in March 2022. Focus groups were recorded and transcribed. We open-coded the content and used thematic analysis to uncover consistencies within and between sampled groups. Participants expressed favorable perceptions of the CVB increase and stated the pre-pandemic CVB amount was insufficient. Barriers to using the increased CVB were identifying WIC-approved fruits and vegetables in stores and insufficient supply of fruits and vegetables. Barriers were more pronounced in rural groups. Facilitators of CVB use were existing household preferences for fruits and vegetables and the variety of products that can be purchased with CVB relative to other components of the WIC food package. Participants felt the CVB increase allowed their families to eat a wider variety of fruits and vegetables. The CVB increase may improve fruit and vegetable intake, particularly if made permanent, but barriers to CVB and WIC benefit use may limit the potential impact

Early Results of a Natural Experiment Evaluating the Effects of a Local Minimum Wage Policy on the Diet-Related Health of Low-Wage Workers, 2018-2020

ABSTRACT Objective: This study presents results of a midpoint analysis of an ongoing natural experiment evaluating the diet-related effects of the Minneapolis Minimum Wage Ordinance, which incrementally increases the minimum wage to $15/hr. Design: A difference-in-difference (DiD) analysis of measures collected among low-wage workers in two U.S. cities (one city with a wage increase policy and one comparison city). Measures included employment-related variables (hourly wage, hours worked, and non-employment assessed by survey questions with wages verified by paystubs), body mass index measured by study scales and stadiometers, and diet-related mediators (food insecurity, Supplemental Nutrition Assistance Program (SNAP) participation, and daily servings of fruits and vegetables, whole-grain rich foods, and foods high in added sugars measured by survey questions). Setting: Minneapolis, Minnesota and Raleigh, North Carolina Participants: A cohort of 580 low-wage workers (268 in Minneapolis, 312 in Raleigh) who completed three annual study visits between 2018 and 2020. Results: In DiD models adjusted for time-varying and non-time-varying confounders, there were no statistically significant differences in variables of interest in Minneapolis compared with Raleigh. Trends across both cities were evident, showing a steady increase in hourly wage, stable body mass index, an overall decrease in food insecurity, and non-linear trends in employment, hours worked, SNAP participation, and dietary outcomes. Conclusion: There was no evidence of a beneficial or adverse effect of the Minimum Wage Ordinance on health-related variables during a period of economic and social change. The COVID-19 pandemic and other contextual factors likely contributed to the observed trends in both cities

Assessing the Readiness of Black Churches to Engage in Health Disparities Research

We assessed church readiness to engage in health disparities research using a newly developed instrument, examined the correlates of readiness, and described strategies that churches used to promote health. We pilot tested the instrument with churches in a church-academic partnership (n = 12). We determined level of readiness to engage in research and assessed correlates of readiness. We also conducted interviews with participating pastors to explore strategies they had in place to support research engagement. Churches scored fairly high in readiness (average of 4.04 out of 5). Churches with a pastor who promoted the importance of good nutrition in a sermon or had a budget for health-related activities had significantly higher readiness scores than churches without such practices. Having a tool to evaluate church readiness to engage in research will inform targeted technical assistance and research projects that will strengthen church-academic partnerships and improve capacity to address health disparities

Consensus-based care recommendations for adults with myotonic dystrophy type 1

Purpose of review Myotonic dystrophy type 1 (DM1) is a severe, progressive genetic disease that affects between 1 in 3,000 and 8,000 individuals globally. No evidence-based guideline exists to inform the care of these patients, and most do not have access to multidisciplinary care centers staffed by experienced professionals, creating a clinical care deficit. Recent findings The Myotonic Dystrophy Foundation (MDF) recruited 66 international clinicians experienced in DM1 patient care to develop consensus-based care recommendations. MDF created a 2-step methodology for the project using elements of the Single Text Procedure and the Nominal Group Technique. The process generated a 4-page Quick Reference Guide and a comprehensive, 55-page document that provides clinical care recommendations for 19 discrete body systems and/or care considerations. Summary The resulting recommendations are intended to help standardize and elevate care for this patient population and reduce variability in clinical trial and study environments. Described as “one of the more variable diseases found in medicine,” myotonic dystrophy type 1 (DM1) is an autosomal dominant, triplet-repeat expansion disorder that affects somewhere between 1:3,000 and 1:8,000 individuals worldwide.1 There is a modest association between increased repeat expansion and disease severity, as evidenced by the average age of onset and overall morbidity of the condition. An expansion of over 35 repeats typically indicates an unstable and expanding mutation. An expansion of 50 repeats or higher is consistent with a diagnosis of DM1. DM1 is a multisystem and heterogeneous disease characterized by distal weakness, atrophy, and myotonia, as well as symptoms in the heart, brain, gastrointestinal tract, endocrine, and respiratory systems. Symptoms may occur at any age. The severity of the condition varies widely among affected individuals, even among members of the same family. Comprehensive evidence-based guidelines do not currently exist to guide the treatment of DM1 patients. As a result, the international patient community reports varied levels of care and care quality, and difficulty accessing care adequate to manage their symptoms, unless they have access to multidisciplinary neuromuscular clinics. Consensus-based care recommendations can help standardize and improve the quality of care received by DM1 patients and assist clinicians who may not be familiar with the significant variability, range of symptoms, and severity of the disease. Care recommendations can also improve the landscape for clinical trial success by eliminating some of the inconsistencies in patient care to allow more accurate understanding of the benefit of potential therapies