1
|
Coleman-Jensen A, Gregory CA, Rabbitt MP. Investing in Research on Food Security Data Quality. J Acad Nutr Diet 2023; 123:S20-S24. [PMID: 37730304 DOI: 10.1016/j.jand.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/08/2023] [Accepted: 03/22/2023] [Indexed: 09/22/2023]
Affiliation(s)
| | - Christian A Gregory
- Economic Research Service, US Department of Agriculture, Kansas City, Missouri
| | - Matthew P Rabbitt
- Economic Research Service, US Department of Agriculture, Kansas City, Missouri
| |
Collapse
|
2
|
Giombi KC, Rabbitt MP, Karns S. Military Eligibility for the Supplemental Nutrition Assistance Program: Simulating the Exemption of the Basic Allowance for Housing from Gross Income. J Nutr 2023; 153:2726-2735. [PMID: 37394118 DOI: 10.1016/j.tjnut.2023.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Twenty-four percent of active-duty service member households experienced food insecurity in 2020; however, limited data have suggested that few participate in the Supplemental Nutrition Assistance Program (SNAP). A potential reason for low SNAP participation among active-duty military households is that the basic allowance for housing (BAH) is considered countable income for SNAP eligibility determination. OBJECTIVES This study explores how many more service members' households, referred to as "SNAP units" (that is, a group of individuals who live together and regularly buy food and prepare meals together), would become eligible for SNAP benefits if the BAH is excluded from countable income in deciding eligibility. METHODS This study used 2016-2020 American Community Survey 5-y estimates to construct a sample of active-duty military households combined with data on military pay and allowances to simulate changes to SNAP eligibility and poverty status with a BAH exemption as well as impacts on federal spending on SNAP. RESULTS Eligibility for SNAP among military SNAP units increases from 0.4% to 1.5% (263% increase) if a service member's BAH was exempted from their gross income. The increase was driven by SNAP units whose highest-ranking service member was from the noncommissioned officer ranks without dependents. As more military SNAP units became eligible and chose to participate, annual SNAP disbursements (that is, amount of funds spent on SNAP) for the whole program increased by up to 1.3%, compared with FY16-20 SNAP disbursements. With an increase in SNAP participation, the poverty rate among military SNAP units decreases from 8.7% to 1.4% (83.9% decrease). CONCLUSIONS Exempting service members' BAH from their gross income would likely increase SNAP eligibility and participation among military households and, in turn, reduce poverty.
Collapse
Affiliation(s)
| | - Matthew P Rabbitt
- United States Department of Agriculture, Economic Research Service, Kansas City, MO, United States
| | - Shawn Karns
- RTI International, Research Triangle Park, NC, United States
| |
Collapse
|
3
|
Sassine AJ, Rabbitt MP, Coleman-Jensen A, Moshfegh AJ, Sahyoun NR. Development and Validation of a Physical Food Security Tool for Older Adults. J Nutr 2023; 153:1273-1282. [PMID: 36868513 DOI: 10.1016/j.tjnut.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Current measures of food insecurity focus on economic access to food, but not on the physical aspect of food insecurity that captures the inability to access food or prepare meals. This is particularly relevant among the older adult population who are at a high risk of functional impairments. OBJECTIVES To develop a short-form physical food security (PFS) tool among older adults using statistical methods based on the Item Response Theory (Rasch) model. METHODS Pooled data from adults aged ≥60 y of the NHANES (2013-2018) (n = 5892) were used. The PFS tool was derived from the physical limitation questions included in the physical functioning questionnaire of NHANES. Item severity parameters, fit and reliability statistics, and residual correlation between items were estimated using the Rasch model. The construct validity of the tool was assessed by examining associations with the Healthy Eating Index (HEI)-2015 scores, self-reported health, self-reported diet quality, and economic food insecurity, using weighted multivariable linear regression analysis, controlling for potential confounders. RESULTS A 6-item scale was developed, which had adequate fit statistics and high reliability (0.62). It was categorized based on raw score severity into high, marginal, low, and very low PFS. Very low PFS was associated with respondent's self-reported poor health (OR = 23.8; 95% CI: 15.3, 36.9; P < 0.0001), self-reported poor diet (OR = 3.9; 95% CI: 2.8, 5.5; P < 0.0001), low and very low economic food security (OR = 6.08; 95% CI: 4.23, 8.76; P < 0.0001), and with lower mean HEI-2015 index score, in comparison to older adults with high PFS (54.5 compared with 57.5, P = 0.022). CONCLUSIONS The proposed 6-item PFS scale captures a new dimension of food insecurity that can inform on how older adults experience food insecurity. The tool will require further testing and evaluation in larger and different contexts to demonstrate its external validity.
Collapse
Affiliation(s)
- AnnieBelle J Sassine
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States
| | | | | | - Alanna J Moshfegh
- Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States.
| |
Collapse
|
4
|
Rabbitt MP, Beymer MR, Reagan JJ, Jarvis BP, Watkins EY. Food insecurity among active duty soldiers and their families during the coronavirus disease 2019 pandemic. Public Health Nutr 2022; 25:1-8. [PMID: 35067266 PMCID: PMC8861550 DOI: 10.1017/s1368980022000192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/04/2021] [Accepted: 01/05/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We examined the determinants of food insecurity among active duty Army households that transitioned into food insecurity during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN We compared Army households that recently transitioned into marginal food insecurity with those households that remained highly food secure (n 2832) to better understand how these households differ in their resilience to food insecurity during economic downturns using data from a military installation in the USA in 2020. SETTING A US military installation in the USA. PARTICIPANTS Active duty US Army soldiers. RESULTS Prior to the pandemic, the prevalence of marginal food insecurity among Army households was similar to that reported for households in the general population. Marginal food insecurity among Army households increased over 1·5-fold - from 19 % to 33 % - with the onset of the pandemic. Relative to Army households with consistently high food security, the Army households that transitioned into marginal food insecurity after the onset of the pandemic were more likely to report concerns about financial insecurity and the job security of their family members. CONCLUSIONS Army households, like their civilian counterparts, are vulnerable to food insecurity because of instability in their income during periods of economic uncertainty. Periods of economic uncertainty are more common for Army households because of the frequent relocations associated with military service which could lead to predictable periodic spikes in their food insecurity.
Collapse
Affiliation(s)
- Matthew P Rabbitt
- U.S. Department of Agriculture, Economic Research Service, PO Box 419205, MS 9999, Kansas City, MO64141-6205, USA
| | - Matthew R Beymer
- U.S. Army Public Health Center, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, MD, USA
| | - Joanna J Reagan
- U.S. Army Public Health Center, Health Promotion and Wellness Directorate, Aberdeen Proving Ground, MD, USA
| | - Brantley P Jarvis
- U.S. Army Public Health Center, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, MD, USA
| | - Eren Y Watkins
- U.S. Army Public Health Center, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, MD, USA
| |
Collapse
|
5
|
Beymer MR, Reagan JJ, Rabbitt MP, Webster AE, Watkins EY. Association between Food Insecurity, Mental Health, and Intentions to Leave the US Army in a Cross-Sectional Sample of US Soldiers. J Nutr 2021; 151:2051-2058. [PMID: 33982122 DOI: 10.1093/jn/nxab089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/16/2021] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous research has demonstrated that certain groups in the United States are at a greater risk for food insecurity. However, food insecurity has not been sufficiently characterized in active duty military populations. OBJECTIVES The primary objective of this study was to determine the prevalence of marginal food insecurity at a large US Army installation. The secondary objective was to determine how marginal food insecurity may be associated with intentions to leave the US Army after the current service period ("intentions to leave"). METHODS A cross-sectional, online survey was administered by the US Army Public Health Center at an Army installation in 2019 (n = 5677). The main predictor was the 2-item food insecurity screener (Hunger Vital Signs), and the main outcome was a 5-point Likert question, "How likely are you to leave the army after your current enlistment/service period?" that was dichotomized for this analysis. Multiple logistic regression was used to assess the association between marginal food insecurity and intentions to leave. Mental health covariates were analyzed as a potential mediator. RESULTS The sample was primarily male (83%), age <25 y (49%), and White (56%). One-third of respondents were classified as marginally food insecure using the Hunger Vital Signs, and 52% had intentions to leave. There was no significant association between marginal food insecurity and intentions to leave in the composite multivariable model, but mediation analyses revealed that food insecurity was significantly and independently associated with anxiety, depression, and suicidal ideation, which was in turn associated with intentions to leave. CONCLUSIONS The association between marginal food insecurity and mental health showed that addressing food insecurity could improve mental health and subsequently reduce intentions to leave. Solutions to reduce military food hardship include expanding Supplemental Nutrition Assistance Program eligibility requirements, improving food resources communication, and expanding healthy food choices on-post.
Collapse
Affiliation(s)
- Matthew R Beymer
- US Army Public Health Center, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, Aberdeen, MD, USA
| | - Joanna J Reagan
- US Army Public Health Center, Health Promotion and Wellness Directorate, Aberdeen Proving Ground, Aberdeen, MD, USA
| | - Matthew P Rabbitt
- US Department of Agriculture, Economic Research Service, Kansas City, MO, USA
| | - Abby E Webster
- US Army Public Health Center, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, Aberdeen, MD, USA
| | - Eren Y Watkins
- US Army Public Health Center, Behavioral and Social Health Outcomes Program, Aberdeen Proving Ground, Aberdeen, MD, USA
| |
Collapse
|
6
|
Heflin CM, Arteaga I, Ndashimye JF, Rabbitt MP. Childhood injuries and food stamp benefits: an examination of administrative data in one US state. BMC Pediatr 2020; 20:297. [PMID: 32552770 PMCID: PMC7298802 DOI: 10.1186/s12887-020-02084-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 04/15/2020] [Indexed: 11/10/2022] Open
Abstract
Background Currently in the United States, childhood injuries are the leading cause of mortality and morbidity, resulting in an estimated 9.2 million emergency department visits and $17 billion annually in medical costs. For preschoolers, it is also the leading cause of disability. Methods We use linked administrative data for SNAP and Medicaid in Missouri from January 2010 to December 2013 to explore monthly patterns in the association between SNAP receipt and ER claims due to childhood injury for children age 0–5 and to examine if these patterns are sensitive to the timing of SNAP benefits. We chose the state of Missouri because unlike most states that disburse SNAP benefits within the first 10 days of the calendar month, Missouri pays SNAP benefits between the first twenty-two days of the month, based on the recipient’s birthdate and last name. Results SNAP benefits received later in the calendar month are associated with reductions in ER claims for childhood injuries. Furthermore, the final week in the SNAP benefit month is associated with an increase in ER claims for childhood injuries. Conclusion In terms of public policy, our results suggest that having SNAP disbursement later in the month may have benefits for households.
Collapse
Affiliation(s)
- Colleen M Heflin
- Public Administration and International Affairs, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244-1020, USA.
| | | | | | | |
Collapse
|
7
|
Tanaka VT, Engelhard G, Rabbitt MP. Examining Differential Item Functioning in the Household Food Insecurity Scale: Does Participation in SNAP Affect Measurement Invariance? J Appl Meas 2019; 20:100-111. [PMID: 30789835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Household Food Security Survey Module (HFSSM) is a scale used by the U.S. Department of Agriculture to measure the severity of food insecurity experienced by U.S. households. In this study, measurement invariance of the HFSSM is examined across households based on participation in the Supplemental Nutrition Assistance Program (SNAP). Households with children who responded to the HFSSM in 2015 and 2016 (N = 3,931) are examined. The Rasch model is used to analyze differential item functioning (DIF) related to SNAP participation. Analyses suggest a small difference in reported food insecurity between SNAP and non-SNAP participants (27% versus 23% respectively). However, the size and direction of the DIF mitigates the impact on overall estimates of household food insecurity. Person-fit indices suggest that the household aberrant response rate is 6.6% and the number of misfitting households is comparable for SNAP (6.80%) and non-SNAP participants (6.30%). Implications for research and policy related to food insecurity are discussed.
Collapse
|
8
|
Engelhard G, Rabbitt MP, Engelhard EM. Using Household Fit Indices to Examine the Psychometric Quality of Food Insecurity Measures. Educ Psychol Meas 2018; 78:1089-1107. [PMID: 30559515 PMCID: PMC6293410 DOI: 10.1177/0013164417728317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study focuses on model-data fit with a particular emphasis on household-level fit within the context of measuring household food insecurity. Household fit indices are used to examine the psychometric quality of household-level measures of food insecurity. In the United States, measures of food insecurity are commonly obtained from the U.S. Household Food Security Survey Module (HFSSM, 18 items) of the Current Population Survey Food Security Supplement (CPS-FSS). These measures, in various forms, are used to inform national programs and policies related to food insecurity. Data for low-income households with children from recent administrations of the HFSSM (2012-2014) are used in this study (N = 7,324). The results suggest that there are detectable levels of misfit with Infit mean square error (MSE) statistics ranging from 6.73 % to 21.33% and Outfit MSE statistics ranging from 5.31% to 9.68%. The data suggest for Outfit MSE statistics that (a) male respondents, (b) respondents with lower levels of education, and (c) respondents who did not report participating in SNAP (Supplemental Nutrition Assistance Program, formerly the Food Stamp Program) tend to have more misfit. For Infit MSE statistics, lack of homeownership appears to be a predictor of misfit. The implications of this research for future research, theory, and policy related to the measurement of household food insecurity are discussed.
Collapse
Affiliation(s)
| | - Matthew P. Rabbitt
- Economic Research Service, U.S.
Department of Agriculture, Washington, DC, USA
| | | |
Collapse
|
9
|
Heflin C, Arteaga I, Hodges L, Ndashiyme JF, Rabbitt MP. SNAP benefits and childhood asthma. Soc Sci Med 2018; 220:203-211. [PMID: 30453112 DOI: 10.1016/j.socscimed.2018.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 12/30/2022]
Abstract
Anecdotal and descriptive evidence has led to the claim that some low-income households may face a "eat or breathe" tradeoff, but quantitative evidence is scarce. We link Medicaid claims data to monthly Supplemental Nutritional Assistance Program (SNAP) participation data from the state of Missouri from 2010 to 2013 to explore monthly patterns in children's emergency room (ER) claims for asthma and to examine whether these patterns are sensitive to the timing and amount of SNAP benefits. This allows us to empirically test whether SNAP households with Medicaid insurance face trade-offs between food and medicine that increases the likelihood that a child in a SNAP and Medicaid household will go to the ER for asthma at the end of the month. While we do not find overwhelming evidence that the timing of SNAP benefits receipt are associated with the timing of asthma-related ER visits, we do find clear evidence that increased SNAP benefits are associated with a reduction in the overall probability of an asthma-related ER visit.
Collapse
|
10
|
Rabbitt MP, Coleman-Jensen A. Rasch analyses of the standardized Spanish translation of the U.S. household food security survey module. ACTA ACUST UNITED AC 2017. [DOI: 10.3233/jem-170443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|