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Hao S, Quinn AW, Iasiello JA, Lea CS, Popowicz P, Fu Y, Irish W, Parikh AA, Snyder RA. Correlation of Patient-Reported Social Determinants of Health With Census Tract Measures of Socioeconomic Disadvantage in Patients With GI Cancers in Eastern North Carolina. JCO Oncol Pract 2024; 20:1280-1288. [PMID: 38759124 DOI: 10.1200/op.23.00703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/13/2024] [Accepted: 04/08/2024] [Indexed: 05/19/2024] Open
Abstract
PURPOSE Investigating the impact of social determinants of health (SDOHs) on cancer care in large populations relies on census estimates. Routine clinic SDOH screening provides timely patient-level information which could inform best practices. This study evaluated the correlation between patient-reported SDOH needs and population-level census tract measures. METHODS This was a retrospective cross-sectional study of a cohort of adult patients with GI malignancy screened for SDOHs such as financial insecurity, transportation, and food insecurity during initial outpatient evaluation at East Carolina University (formerly Vidant) Health Medical Center in Greenville, NC (November 2020-July 2021). Primary outcomes included number and severity of identified SDOH needs and area deprivation index (ADI) and census tract measures for each patient. Spearman rank correlations were calculated among patient-level needs and between patient-level needs and similar census tract measures. RESULTS Of 112 patients screened, 58.9% self-identified as White (n = 66) and 41.1% as Black (n = 46). A total of 50.5% (n = 54) resided in a rural county. The collective median state ADI rank was 7 (IQR, 5-9). The median household income was $38,125 in US dollars (USD) (IQR, $31,436-$48,934 [USD]). Only 12.5% (n = 14) reported a moderate or severe financial need. Among reported needs, financial need moderately correlated with food insecurity (coefficient, 0.46; P < .001) and transportation (coefficient, 0.45; P < .001). Overall, census tract measures and reported needs poorly correlated. Lack of transportation correlated with percentage of households without a vehicle (coefficient, 0.18; P = .03) and limited access to healthy foods (coefficient, 0.18; P = .04). CONCLUSION Given the poor correlation between reported and census needs, population-level measures may not accurately predict patient-reported needs. These findings highlight the importance of SDOH screening in the clinical setting to reduce health disparities and identify opportunities to improve care delivery.
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Affiliation(s)
- Scarlett Hao
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Ashley W Quinn
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
| | - John A Iasiello
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
| | - C Suzanne Lea
- Department of Public Health, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Patrycja Popowicz
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Yuanyuan Fu
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
| | - William Irish
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
- Department of Public Health, Brody School of Medicine at East Carolina University, Greenville, NC
| | - Alexander A Parikh
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
- Division of Surgical Oncology, University of Texas Health San Antonio, San Antonio, TX
| | - Rebecca A Snyder
- Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC
- Division of Surgery, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
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Williams A, Newman SD. The effect of proximity to grocery stores and the pandemic on parents' and youths' perceptions of eating habits in predominately African American rural communities. Front Nutr 2024; 11:1413208. [PMID: 39155931 PMCID: PMC11329938 DOI: 10.3389/fnut.2024.1413208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
Background Rural communities have a disproportionately high level of childhood obesity along with high rates of food insecurity. Objectives To assess the eating habits of youth in predominantly African American rural communities and assess the association between proximity to a grocery store and eating habits as well as how the COVID-19 pandemic may have impacted eating habits. Methods 203 youth and parents completed a 16-item survey. Analyses were performed to assess the effect of having a neighborhood grocery store as well as to compare responses between youth and parents. Results Having a neighborhood grocery store was associated with increased consumption of vegetables (F(1,122) = 41.56) and fruits (F(1,121) = 65.05), decreased consumption of chips (F(1,125) = 79.51) and a smaller percentage of overweight youth (χ2(1,125) = 5.03). Parents underestimated the effect of the COVID-19 pandemic on youth eating habits (χ2 (1,198) = 17.88). Conclusion Proximity to a grocery store significantly associated with eating habits and weight in the rural communities examined. Given the steady decrease in the number rural grocery stores over the past decade it is important to consider how to improve access to healthy foods in these communities.
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Affiliation(s)
| | - Sharlene D. Newman
- Alabama Life Research Institute, The University of Alabama, Tuscaloosa, AL, United States
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3
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Busse KR, Poppe KI, Wu Q, Jilcott Pitts SB, Haynes-Maslow L, Ammerman AS, Krzyzanowski Guerra K, Plakias Z, Hanks AS, Garrity K, Gillespie R, Houghtaling B, Seguin-Fowler RA, Garner JA. Household Food Sourcing Patterns and Their Associations With Food Insecurity in Appalachian Ohio. J Acad Nutr Diet 2024:S2212-2672(24)00722-6. [PMID: 39053635 DOI: 10.1016/j.jand.2024.07.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Households experiencing food insecurity may use dynamic strategies to meet food needs. Yet, the relationship between household food sourcing behaviors and food security, particularly in rural settings, is understudied. OBJECTIVE To identify food sourcing patterns and their associations with food insecurity among households in rural Appalachian Ohio during the COVID-19 pandemic. DESIGN Survey data were collected from a cohort of households in Athens County, OH, in July 2020, October 2020, January 2021, and April 2021. PARTICIPANTS/SETTING The sample included 663 households with household food sourcing and food security information for ≥1 survey wave. MAIN OUTCOME MEASURES Household food sourcing patterns. Households reported the frequency with which they obtained food from various retailers and charitable sources, classified as supercenters, supermarkets, convenience stores, farmers markets, or charitable sources. STATISTICAL ANALYSES Principal component analysis was used to identify food sourcing patterns. Linear mixed models were used to assess changes in food sourcing behaviors over the study period and to determine whether food sourcing behaviors differed according to food security status. RESULTS Two patterns were identified: Convenience Stores and Charitable Food and Supermarkets and Farmers Markets, not Supercenters. Relative to July 2020, alignment of households' food sourcing behaviors with the Supermarkets and Farmers Markets, not Supercenters pattern was higher in October 2020 (β .07, 95% CI .02 to .12) and alignment with the Convenience Stores and Charitable Food pattern was lower in April 2021 (β -.06, 95% CI -.11 to -.02). Compared with food-secure households, food sourcing behaviors of food-insecure households were more closely aligned with the Convenience Stores and Charitable Food pattern (β .07, 95% CI .00 to .13); no statistically significant difference in scores was observed for the Supermarkets and Farmers Markets, not Supercenters pattern (β -.07, 95% CI -.15 to .02). CONCLUSIONS These findings support efforts to increase access to healthy, affordable options at venues where food-insecure households may be likely to obtain food, such as convenience stores and charitable sources.
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Affiliation(s)
- Kyle R Busse
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn I Poppe
- Department of Population and Quantitative Health Sciences, Mary Ann Swetland Center for Environmental Health, School of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Qiang Wu
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Stephanie B Jilcott Pitts
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Lindsey Haynes-Maslow
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina; Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | | | - Zoë Plakias
- Department of Economics, College of Business and Economics, Western Washington University, Bellingham, Washington
| | - Andrew S Hanks
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio
| | - Katharine Garrity
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Rachel Gillespie
- Family and Consumer Sciences Extension, College of Agriculture, Food, and Environment, University of Kentucky, 239 Scovell Hall, Lexington, Kentucky
| | - Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska; Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, Virginia
| | - Rebecca A Seguin-Fowler
- Institute for Advancing Health through Agriculture, Texas A&M University System, College Station, Texas
| | - Jennifer A Garner
- Department of Nutritional Sciences, College of Public Health, University of Michigan, Ann Arbor, Michigan.
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Nguyen J, Kurz Goodwin C, Elie-York S, Brown BC, Sambandham A, Umble K, Ammerman AS. An Exploratory Study of the Perceived Need for and Acceptability of a Healthy Frozen Meal Product Among Rural Corner Store Customers in North Carolina. Ecol Food Nutr 2024; 63:98-111. [PMID: 38318712 DOI: 10.1080/03670244.2024.2308668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This pilot study assesses barriers to obtaining healthy affordable food and the early-stage acceptability of a novel subsidized healthy frozen meal product designed to address food insecurity and nutritional status among corner store customers in rural North Carolina. A convenience sample of 50 customers were surveyed to examine the perceived availability of healthy food options, barriers to maintaining healthy diets, food shopping and consumption habits, and reception of the product. Findings confirmed barriers to obtaining healthy foods that the product seeks to address, the validity of corner stores as the intervention site, and approval of the product's taste and concept.
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Affiliation(s)
- Julie Nguyen
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Celeste Kurz Goodwin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sebastian Elie-York
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Blanche Covington Brown
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Akshay Sambandham
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Karl Umble
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Carr JK, Fontanella SA, Kaiser ML. Uncertainty in Thrifty Food Plan Cost Estimates for Community Food Security Assessments. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2023. [DOI: 10.1080/19320248.2023.2179447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Jake K. Carr
- Commercial Real Estate Analytics, Moody’s Analytics, San Francisco, CA, USA
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DeWitt E, Gillespie R, Norman-Burgdolf H, Slone S, Cardarelli KM, Gustafson A. Exploring the Relationship Between SNAP Enrollment and Food Insecurity in Rural Appalachia. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2157231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Emily DeWitt
- Family and Consumer Sciences Extension, College of Agriculture, Food and Environment, University of Kentucky, Lexington, Kentucky, USA
| | - Rachel Gillespie
- Family and Consumer Sciences Extension, College of Agriculture, Food and Environment, University of Kentucky, Lexington, Kentucky, USA
| | - Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, Kentucky, USA
| | - Stacey Slone
- Dr. Bing Zhang Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Kathryn M. Cardarelli
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, Kentucky, USA
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Saint Onge JM, Fagan M, Befort CA. The association between the obesogenic environment and 6-month and 24-month weight change in a rural weight loss intervention trial in the United States. Prev Med 2022; 158:107040. [PMID: 35398370 DOI: 10.1016/j.ypmed.2022.107040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/05/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
The unique obesogenic environment may influence the ability to effectively maintain weight loss in rural areas. The aim of this study was to examine the contextual relationship of neighborhood disadvantage, distance to supermarkets and supercenters, and fast food, dollar store, and exercise facility environments on weight loss following a weight-loss intervention in the United States. This analysis (n = 1177) linked weight loss outcomes from a rural, primary care-based randomized controlled trial to contextual data collected from residential addresses. Outcomes include 6-month and 24-month percent weight loss. These outcomes were compared across contextual variables, including tract level disadvantage, food accessibility, and food/exercise availability. Covariates were included in ordinary least squares (OLS) multivariable regression models for 6-month and 24-month weight loss measures, across three weight loss interventions. Contextual variables were not significantly related to percent weight loss overall across treatment arms. Participants living in a 5-mile buffer to dollar stores experienced approximately a 2% (p < 0.05) lower weight loss, but only in the least effective counseling arm (individual clinic visits), while controlling for both individual and contextual factors. Our results suggest that specific contextual variables in rural populations may play an important role in moderating weight loss outcomes especially under the conditions of less effective interventions.
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Affiliation(s)
- Jarron M Saint Onge
- Department of Sociology, University of Kansas, USA; Department of Population Health, University of Kansas Medical Center, USA.
| | | | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, USA
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8
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Misyak SA, Parker MK, Ledlie Johnson M, Hedges S, Borst E, McNamara Best M, Hedrick VE. A Preliminary Evaluation of Virginia Fresh Match: Impacts and Demographic Considerations for Future Fruit and Vegetable Incentive Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4367. [PMID: 35410044 PMCID: PMC8998410 DOI: 10.3390/ijerph19074367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this communication is to describe the preliminary evaluation of the Virginia Fresh Match (VFM) financial incentive program for fresh fruits and vegetables for Virginia Supplemental Nutrition Assistance Program shoppers and to determine if there were differences in incentive outcomes by race. In this cross-sectional study, a questionnaire was administered to shoppers using Virginia Fresh Match incentives at participating farmers markets and community-based food retail outlets. Repeated measures ANOVAs were used to detect differences in fruit and vegetable consumption between demographic groups over time. Chi-square tests were used to determine if there were associations between race and perceived impact of VFM incentives on making food last and the attribution of VFM incentives to changes in fruit and vegetable consumption frequency. Frequency of fruit and vegetable intake was significantly higher during VFM incentive use, with a difference of 1.17 ± 0.07 and 1.07 ± 0.07 on a Likert scale measure, respectively (p ≤ 0.001). There were racial differences in assertions that VFM incentives helped food to last. VFM incentives were effective at increasing fruit and vegetable consumption, but racial differences should be considered in the administration of VFM to avoid reinforcing systems or approaches that may contribute to disparities in food access and food security.
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Affiliation(s)
- Sarah A. Misyak
- Virginia Cooperative Extension, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Molly K. Parker
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (V.E.H.)
| | - Meredith Ledlie Johnson
- Virginia Cooperative Extension, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
| | - Sam Hedges
- Local Environmental Agriculture Project, Roanoke, VA 24015, USA; (S.H.); (M.M.B.)
| | - Elizabeth Borst
- Virginia Community Food Connections, Fredericksburg, VA 22404, USA;
| | | | - Valisa E. Hedrick
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, USA; (M.K.P.); (V.E.H.)
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Chang R, Javed Z, Taha M, Yahya T, Valero-Elizondo J, Brandt EJ, Cainzos-Achirica M, Mahajan S, Ali HJ, Nasir K. Food insecurity and cardiovascular disease: Current trends and future directions. Am J Prev Cardiol 2022; 9:100303. [PMID: 34988538 PMCID: PMC8702994 DOI: 10.1016/j.ajpc.2021.100303] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/20/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
Food insecurity (FI) - a state of limited access to nutritionally adequate food - is notably more prominent among patients with cardiovascular disease (CVD) than the general population. Current research suggests that FI increases the risk of cardiovascular morbidity and mortality through various behavioral and biological pathways. Importantly, FI is more prevalent among low-income households and disproportionately affects households with children, particularly those led by single mothers. These disparities necessitate solutions specifically geared towards helping these high-risk subgroups, who also experience increased risk of CVD associated with FI. Further, individuals with CVD may experience increased risk of FI due to the financial burden imposed by CVD care. While participation in federal aid programs like the Supplemental Nutrition Assistance Program and the Special Supplemental Nutrition Program for Women, Infants, and Children has been associated with cardiovascular health benefits, residual FI and lower dietary quality among many families suggest a need for better outreach and expanded public assistance programs. Healthcare systems and community organizations can play a vital role in screening individuals for FI and connecting them with food and educational resources. While further research is needed to evaluate sociodemographic differences in the FI-CVD relationship, interventions at the policy, health system, and community levels can help address both the burden of FI and its impacts on cardiovascular health.
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Affiliation(s)
- Ryan Chang
- Washington University in St. Louis, St. Louis, MO, USA
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
| | - Zulqarnain Javed
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
| | - Mohamad Taha
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Tamer Yahya
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Javier Valero-Elizondo
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), USA
| | - Eric J. Brandt
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Miguel Cainzos-Achirica
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Shiwani Mahajan
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Hyeon-Ju Ali
- Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Khurram Nasir
- Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins Medicine, Baltimore, MD, USA
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Cardarelli KM, DeWitt E, Gillespie R, Graham RH, Norman-Burgdolf H, Mullins JT. Policy Implications of the COVID-19 Pandemic on Food Insecurity in Rural America: Evidence from Appalachia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312792. [PMID: 34886518 PMCID: PMC8657698 DOI: 10.3390/ijerph182312792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/25/2021] [Accepted: 12/02/2021] [Indexed: 01/04/2023]
Abstract
Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; expanded federal food assistance; expanded community food resources; and expanded home gardening. Participants provided details regarding the way increased federal assistance, especially expanded benefits within the Supplemental Nutrition Assistance Program, allowed them to purchase greater quantities of nutritious food. This study unveils the specific impacts of the COVID-19 pandemic on one rural population, including the influence of some social determinants of health on food insecurity. Policymakers and stakeholders should recognize the layered protection of multiple federal emergency assistance programs against food insecurity and the potential for long-term population health promotion in rural areas.
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Affiliation(s)
- Kathryn M. Cardarelli
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY 40506, USA
- Correspondence: ; Tel.: +1-859-323-5357
| | - Emily DeWitt
- Department of Family and Consumer Sciences Extension, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (E.D.); (R.G.)
| | - Rachel Gillespie
- Department of Family and Consumer Sciences Extension, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (E.D.); (R.G.)
| | - Rachel H. Graham
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY 40506, USA;
| | - Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (J.T.M.)
| | - Janet T. Mullins
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, KY 40506, USA; (H.N.-B.); (J.T.M.)
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Perceptions of the Food Environment and Access among Predominantly Black Low-Income Residents of Rural Louisiana Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155340. [PMID: 32722214 PMCID: PMC7432768 DOI: 10.3390/ijerph17155340] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022]
Abstract
Food insecurity in rural settings is complex and not fully understood, especially from the perspective of low-income and Black residents. The goal of this study was to use qualitative methods to better understand experiences with food access and perceptions of the food environment among low-income, predominately Black rural Louisiana residents in the United States. Data were collected from focus group discussions (FGD) and focus group intake forms. Study participants were all rural residents eligible to receive at least one nutrition assistance program. FGD questions focused on perceptions of the food environment, with an emphasis on food access. Participants (n = 44) were predominately Black and female. Over half (n = 25) reported running out of food before the end of the month. Major themes included: store choice, outshopping, methods of acquiring foods other than the grocery store, and food insecurity. Concerns around price, quality, and transportation emerged as factors negatively impacting food security. Understanding residents’ perceptions and experiences is necessary to inform contextually appropriate and feasible policy and practice interventions that address the physical environment and social conditions that shape the broader physical food environment in order to achieve equitable food access and food security.
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