Supermarket Shopping and The Food Retail Environment among SNAP Participants

<p>Much of the research on food deserts has focused on the relationship between the food retail environment and nutrition and health outcomes. Intermediary differences in food shopping patterns are often implicitly assumed to drive these relationships (environment hypothetically affects shopping, which hypothetically affects consumption). Research is limited, though, on whether these food shopping discrepancies exist. This article investigates whether a number of food shopping outcomes and the food retail environment are in fact associated and in which kinds of neighborhoods, using the Electronic Benefit Transfer (EBT) records of over 40 000 households receiving Supplemental Nutrition Assistance Program (SNAP) benefits in western Massachusetts. In some, though not all, food retail environments, we find a small but statistically significant negative association between continuous distance and both the percentage of SNAP redemptions spent at supermarkets and the number of benefit-spending trips taken to supermarkets. Nonetheless, SNAP households located in neighborhoods with what would be considered poor access to supermarkets still spent, on average, more than 75% of their redemptions at these retailers, only 5 percentage points lower than households located one block from a supermarket. These results suggest that SNAP participants’ inability to reach healthy food retailers is at most a minor driver of geographic disparities in nutrition and health outcomes.</p

Nutrition Knowledge Is Related to Food Security, Literacy, and Nutrition Education in Cambodian Refugee and Asylee Women in Lowell, Massachusetts

Refugees experience elevated risk of chronic disease post-resettlement. Understanding contributors to refugee knowledge of the connection between food and health may help promote healthful resettlement. A random survey was conducted with Cambodian refugee and asylee women in Lowell, MA (n = 160). Knowledge of the connection between health and food categories (meat with fat, soda, fast food, high-sodium sauces, salt, vegetables, fruit, and whole grains) was assessed. High food security, literacy, and having participated in nutrition education were related to higher knowledge. Approaches to refugee health should include improving food security and should be tailored to varied literacy levels.</p

The US IMPACT Food Policy Model data sources.

<p>The US IMPACT Food Policy Model data sources.</p

QALYs gained and costs per 100,000 person-years.

<p>QALYs gained and costs per 100,000 person-years.</p

Estimated probability of cost-effective and cost-saving policy over the 20-year simulated period.

<p>Cost-effectiveness at the willingness to pay value of $100,000 per quality-adjusted life year.</p

Health-related model estimates over the 20-year simulation period from 2017 to 2036, for US adults aged 30 to 84 years.

<p>Health-related model estimates over the 20-year simulation period from 2017 to 2036, for US adults aged 30 to 84 years.</p

Cost-effectiveness plane by the end of simulation (year 2036).

<p>Each colored dot is the result of a stochastic Monte Carlo iteration. The black dots are the median combinations of cumulative discounted net costs (2017 US dollars) and discounted net QALYs for each simulated scenario, and the ellipses depict the 95% uncertainty interval. Negative costs represent savings. QALY, quality-adjusted life year; USD, US dollars.</p

Simplified model structure.

<p>CHD, coronary heart disease; NHANES, National Health and Nutrition Examination Survey; QALY, quality-adjusted life year.</p

Median US sodium consumption among adults aged 30–84 years under the baseline projection and 3 modeled scenarios.

<p>The dashed horizontal line depicts the 2015–2020 Dietary Guidelines for Americans recommended upper bound of 2,300 mg/day [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1002551#pmed.1002551.ref005" target="_blank">5</a>].</p

Estimated disaggregated discounted cumulative costs for the simulated period 2017 to 2036.

<p>Negative costs represent savings. The shaded areas depict 95% uncertainty intervals. USD, US dollars.</p