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Article ; Online: Food Insecurity in the COVID-19 Era: A National Wake-up Call to Strengthen SNAP Policy.

Wolfson, Julia A / Leung, Cindy W

2024 Volume 177, Issue 2, Page(s) 255–256

MeSH term(s)	Humans ; COVID-19 ; Food Insecurity ; Food Supply ; Policy
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/M23-3363
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Article ; Online: The impact of the 2021 Thrifty Food Plan benefit re-evaluation on SNAP participants' short-term food security and health outcomes.

Leung, Cindy W / Wolfson, Julia A

Frontiers in public health

2023 Volume 11, Page(s) 1142577

Abstract: Introduction: The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program in the United States, and played a critical role in mitigating food insecurity during the COVID-19 pandemic. In 2021, the updated ... ...

Abstract	Introduction: The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program in the United States, and played a critical role in mitigating food insecurity during the COVID-19 pandemic. In 2021, the updated Thrifty Food Plan (TFP), which provides the basis of SNAP benefit allotments, led to a 21% monthly benefit increase for SNAP participants. The objective of this study was to examine the effects of the TFP re-evaluation on food insecurity, diet quality, and mental health using a natural experiment design. Methods: A longitudinal, web-based study was conducted among 1,004 United States adults with incomes at or below $65,000 in September 2021 (prior to the policy change) and February 2022 (after the policy change). Outcomes of interest included household food security, diet quality, perceived stress, and anxiety/depression, assessed using validated instruments. We used difference-in-differences regression modeling to assess the effects of the policy change on participants' outcomes, adjusting for sociodemographic covariates. Qualitative responses to open-ended questions about the policy change were analyzed using thematic analysis. Results: Prior to the policy change, SNAP participants had significantly worse food insecurity, lower diet quality scores, and higher perceived stress and anxiety/depression when compared to non-participants (all Discussion: The TFP benefit increase may have helped to prevent inflation-related disparities in food insecurity and health outcomes from widening among SNAP participants and non-participants. Further research is needed to determine the long-term impacts of this policy change.
MeSH term(s)	Adult ; Humans ; United States ; Food Assistance ; Pandemics ; Poverty ; COVID-19/epidemiology ; Food Security ; Outcome Assessment, Health Care
Language	English
Publishing date	2023-06-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1142577
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Article ; Online: Trends in Recurring and Chronic Food Insecurity Among US Families With Older Adults.

Leung, Cindy W / Insolera, Noura E / Wolfson, Julia A

JAMA health forum

2024 Volume 5, Issue 3, Page(s) e235463

Abstract: Importance: Food insecurity is a critical social determinant of health for older adults. Understanding national food insecurity trends among families with older adults has important policy implications.: Objective: To compare food insecurity trends ... ...

Abstract	Importance: Food insecurity is a critical social determinant of health for older adults. Understanding national food insecurity trends among families with older adults has important policy implications. Objective: To compare food insecurity trends among US families with an older adult from 1999 to 2003 and 2015 to 2019 and further stratify the analysis by race and ethnicity, socioeconomic status markers, and enrollment in the federal Supplemental Nutrition Assistance Program (SNAP). Design, setting, and participants: In this cohort study using biennial data from the nationally representative Panel Study of Income Dynamics, balanced panels of families with at least 1 older adult (≥60 years) who participated from 1999 to 2003 (n = 1311) and 2015 to 2019 (n = 2268) were created. Analysis was completed in 2023. Main outcome: Food insecurity was assessed using the US Household Food Security Survey Module. Within each 5-year period, we defined recurring food insecurity as 2 or more episodes of food insecurity and chronic food insecurity as 3 episodes of food insecurity. Results: Overall, food insecurity among US families with older adults increased from 12.5% in 1999 to 2003 to 23.1% in 2015 to 2019. Rates of recurring food insecurity more than doubled (5.6% to 12.6%), whereas rates of chronic food insecurity more than tripled (2.0% to 6.3%). Across both time periods, higher rates of food insecurity persisted among Black and Hispanic families, with lower socioeconomic status, and participating in SNAP. Conclusions and relevance: These results highlight how rates of recurring and chronic food insecurity among families with older adults rose substantially over the past 20 years. Monitoring national trends in food insecurity among older adults has direct programmatic and policy implications.
MeSH term(s)	Humans ; Aged ; Cohort Studies ; Poverty ; Food Supply ; Income ; Food Insecurity
Language	English
Publishing date	2024-03-01
Publishing country	United States
Document type	Journal Article
ISSN	2689-0186
ISSN (online)	2689-0186
DOI	10.1001/jamahealthforum.2023.5463
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Article ; Online: Tap water perceptions and water filter use vary with socio-demographic characteristics and are associated with water and sugar-sweetened beverage consumption in university students.

Slotnick, Melissa J / Wolfson, Julia A / Leung, Cindy W

Public health nutrition

2023 Volume 26, Issue 11, Page(s) 2288–2293

Abstract: Objective: The goal of this study is to evaluate university students' perceptions of tap water safety and water filter use and determine how these perceptions and behaviours affect water and sugar-sweetened beverage intake.: Design: Cross-sectional; ... ...

Abstract	Objective: The goal of this study is to evaluate university students' perceptions of tap water safety and water filter use and determine how these perceptions and behaviours affect water and sugar-sweetened beverage intake. Design: Cross-sectional; online survey conducted in Fall 2021. Setting: A large, public Midwestern university in the USA. Participants: Seven-hundred ninety-three university students. Results: Students who experienced food insecurity, were on a Pell grant, were first-generation college students or were racial/ethnic minorities were less likely to trust tap water safety. Tap water filtration behaviour also varied by age and race/ethnicity. Students who did not agree with the statement 'my local tap water is safe to drink' had lower odds of consuming ≥ 3 cups of total water per day (OR = 0·45, 95 % CI: 0·32, 0·62), lower odds of consuming tap water ≥ 3 times/d (OR = 0·46, 95 % CI: 0·34, 0·64), higher odds of drinking bottled water ≥ 1 time per day (OR = 1·80, 95 % CI: 1·22, 2·66) and higher odds of drinking SSB ≥ 1 time per day (OR = 1·47, 95 % CI: 1·01, 2·14) than those who agreed. Students who always or sometimes filtered their tap water had lower odds of consuming ≥ 3 cups of total water per day (OR = 0·59, 95 % CI: 0·39, 0·90) than students who never filtered their tap water. Conclusions: Tap water perceptions and behaviours affect tap and bottled water and SSB intake among university students. Tap water perceptions and behaviours in this demographic provide important context for university programming promoting healthy beverage initiatives.
MeSH term(s)	Humans ; Drinking Water ; Sugar-Sweetened Beverages ; Universities ; Cross-Sectional Studies ; Beverages ; Students ; Demography
Chemical Substances	Drinking Water
Language	English
Publishing date	2023-08-15
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1436024-x
ISSN	1475-2727 ; 1368-9800
ISSN (online)	1475-2727
ISSN	1368-9800
DOI	10.1017/S1368980023001659
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Article ; Online: Characterizing Food Policy Councils' Network Partnerships and COVID-19 Responses.

Mui, Yeeli / Adam, Atif / Santo, Raychel / Bassarab, Karen / Wolfson, Julia A / Palmer, Anne

Nutrients

2024 Volume 16, Issue 7

Abstract: The COVID-19 pandemic pushed millions of Americans into food insecurity. Food policy councils (FPCs) across the country played a vital role in organizing coordinated food responses across multiple sectors. We used a social network analysis (SNA) approach ...

Abstract	The COVID-19 pandemic pushed millions of Americans into food insecurity. Food policy councils (FPCs) across the country played a vital role in organizing coordinated food responses across multiple sectors. We used a social network analysis (SNA) approach to investigate: (1) the network of partnering organizations and agencies within FPCs; (2) how the characteristics of FPCs' network partnerships (i.e., degree, coreness, and density) related to programmatic, policy, and advocacy actions in response to the pandemic; and (3) how FPCs' use of a racial or social equity framework shifted their network partnerships and responses. Local government agencies and food supply chain actors were core in FPCs' network partnerships, while public utilities, correctional facilities, social justice groups, and others were non-core partners. Network density was more likely to be associated with any action by FPCs, and it was especially pronounced for advocacy actions taken by FPCs; trends were similar among FPCs that reported using a racial or social equity framework. The findings begin to uncover core actors in FPCs' partnerships and opportunities to establish new partnerships, particularly with social justice groups. The results also suggest that network density (interconnectedness) may be more important than other network characteristics when responding to food-related needs.
MeSH term(s)	Humans ; Pandemics ; COVID-19/epidemiology ; Food ; Government Agencies ; Nutrition Policy
Language	English
Publishing date	2024-03-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu16070915
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Article ; Online: Disparities in Cardiovascular Health by Food Security Status and Supplemental Nutrition Assistance Program Participation Using Life's Essential 8 Metrics.

Leung, Cindy W / Wolfson, Julia A / Brandt, Eric J / Rimm, Eric B

JAMA network open

2023 Volume 6, Issue 6, Page(s) e2321375

MeSH term(s)	Humans ; Benchmarking ; Food Assistance ; Heart ; Cardiovascular System ; Food Security
Language	English
Publishing date	2023-06-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.21375
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Article ; Online: Associations between food insecurity and diabetes risk factors in US adolescents in the National Health and Nutrition Examination Survey (NHANES) 2007-2016.

Fulay, Aarohee P / Lee, Joyce M / Baylin, Ana / Wolfson, Julia A / Leung, Cindy W

Public health nutrition

2024 Volume 27, Issue 1, Page(s) e68

Abstract: Objective: To evaluate the associations between household food insecurity and diabetes risk factors among lower-income US adolescents.: Design: Cross-sectional analysis. Household food security status was measured using the 18-item Food Security ... ...

Abstract	Objective: To evaluate the associations between household food insecurity and diabetes risk factors among lower-income US adolescents. Design: Cross-sectional analysis. Household food security status was measured using the 18-item Food Security Survey Module. Simple and multivariable linear and logistic regressions were used to assess the association between food security status and fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), HbA1C and homoeostatic model assessment - insulin resistance (HOMA-IR). The analyses were adjusted for household and adolescent demographic and health characteristics. Setting: USA. Participants: 3412 US adolescents aged 12-19 years with household incomes ≤300 % of the federal poverty line from the National Health and Nutrition Examination Survey cycles 2007-2016. Results: The weighted prevalence of marginal food security was 15·4 % and of food insecurity was 32·9 %. After multivariate adjustment, adolescents with food insecurity had a 0·04 % higher HbA1C (95 % CI 0·00, 0·09, Conclusions: Food insecurity was associated with slightly higher HbA1c in a 10-year sample of lower-income US adolescents aged 12-19 years; however, other associations with diabetes risk factors were not significant. Overall, this suggests slight evidence for an association between food insecurity and diabetes risk in US adolescents. Further investigation is warranted to examine this association over time.
MeSH term(s)	Humans ; Adolescent ; Nutrition Surveys ; Cross-Sectional Studies ; Glycated Hemoglobin ; Food Supply ; Risk Factors ; Diabetes Mellitus ; Insulin Resistance ; Food Insecurity
Chemical Substances	Glycated Hemoglobin
Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1436024-x
ISSN	1475-2727 ; 1368-9800
ISSN (online)	1475-2727
ISSN	1368-9800
DOI	10.1017/S1368980024000284
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Article ; Online: SNAP and WIC Participation During Childhood and Food Security in Adulthood, 1984-2019.

Insolera, Noura / Cohen, Alicia / Wolfson, Julia A

American journal of public health

2022 Volume 112, Issue 10, Page(s) 1498–1506

Abstract: Objectives. ...

Abstract	Objectives.
MeSH term(s)	Adolescent ; Adult ; Child ; Dietary Supplements ; Female ; Food Assistance ; Food Security ; Food Supply ; Humans ; Infant ; Poverty ; United States ; Young Adult
Language	English
Publishing date	2022-08-18
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	121100-6
ISSN	1541-0048 ; 0090-0036 ; 0002-9572
ISSN (online)	1541-0048
ISSN	0090-0036 ; 0002-9572
DOI	10.2105/AJPH.2022.306967
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Article: Mexican immigrant health advantage in metabolic syndrome? Examining the contributions of demographic, socioeconomic, and health behavior characteristics.

Carabello, Maria / Wolfson, Julia A

SSM - population health

2021 Volume 16, Page(s) 100932

Abstract: Although Mexican immigrants to the United States (US) have historically held health and mortality advantages over US-born groups, evolving population dynamics in Mexico paired with shifts in Mexico-US immigration patterns and policy regimes have raised ... ...

Abstract	Although Mexican immigrants to the United States (US) have historically held health and mortality advantages over US-born groups, evolving population dynamics in Mexico paired with shifts in Mexico-US immigration patterns and policy regimes have raised new concerns about the metabolic health of recent cohorts of Mexican immigrants. Using a nationally representative sample of adults aged 20-years and older (n = 10,833) from the National Health and Nutrition Examination Study (NHANES, 1999-2016), we assess and seek to explain differences in metabolic syndrome (MetS) risk by race-ethnicity, country of origin, and duration of residence in the US and evaluate whether recent Mexican immigrants continue to exhibit a metabolic health advantage. We decompose the difference in MetS prevalence between US-born whites (45.5%) and recent Mexican immigrants (29.5%) to determine how demographic, socioeconomic, and health behavior characteristics contribute to the patterning of metabolic health. Findings reveal that recent Mexican immigrants hold a metabolic health advantage over all groups, which is accounted for by their younger age structure. Yet recent Mexican immigrants would retain a sizable age-adjusted MetS advantage if they were to achieve parity with US-born whites on education, income, and food security. To ensure that newly-arrived Mexican immigrants continue to experience historically favorable health and mortality prospects, modest policy changes could offer health-promoting protections in the form of increased economic and food security, as well as improved educational opportunities for younger immigrants.
Language	English
Publishing date	2021-10-01
Publishing country	England
Document type	Journal Article
ISSN	2352-8273
ISSN	2352-8273
DOI	10.1016/j.ssmph.2021.100932
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Article ; Online: Food Insecurity Among Older Adults: 10-Year National Trends and Associations with Diet Quality.

Leung, Cindy W / Wolfson, Julia A

Journal of the American Geriatrics Society

2021 Volume 69, Issue 4, Page(s) 964–971

Abstract: Background/objectives: Food insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of ... ...

Abstract	Background/objectives: Food insecurity has emerged as a critical health issue for older adults. Food insecurity has been shown to disrupt healthy eating patterns, but these associations have not been widely studied among older adults. The objectives of the present study were to: (1) examine national trends in food insecurity across a 10-year period, and (2) evaluate the associations between food insecurity and multiple diet quality indices in a recent and nationally representative sample of adults aged 60 or older. Design: Cross-sectional analysis of the 2007-2016 National Health and Nutrition Examination Surveys. Setting: Nationally representative sample of the United States. Participants: The analytic sample was comprised of 5,097 adults aged 60 or older, with household incomes at or below 300% of the federal poverty level. Measurements: Household food security was measured using the 18-item US Household Food Security Survey Module. Diet was assessed using two 24-hour dietary recalls. Multivariate linear and logistic regression models examined the associations between household food security and three evidence-based diet quality indices, adjusting for sociodemographic and health characteristics. Results: Across the 10-year period, food insecurity increased significantly from 5.5% to 12.4% among older adults; this increase was more pronounced among lower-income older adults. From the linear regression models, food insecurity was associated with lower scores on the Healthy Eating Index (β = -1.90, 95% confidence interval (CI) = -3.70, -0.09), the Alternate Healthy Eating Index-2010 (β = -1.47, 95% CI = -2.51, -0.44), and the Mediterranean Diet Score (β = -0.54, 95% CI = -1.06, -0.01) after multivariate adjustment. Further adjustment for the presence of chronic medical conditions did not attenuate these results. Conclusion: Food insecurity is associated with lower overall diet quality among older adults, supporting the need for clinical efforts to identify those at risk of food insecurity and public health efforts to alleviate food insecurity and promote healthy eating behaviors among older adults.
MeSH term(s)	Aged ; Diet/statistics & numerical data ; Diet, Healthy/methods ; Diet, Healthy/statistics & numerical data ; Feeding Behavior ; Female ; Food Insecurity ; Food Supply/standards ; Food Supply/statistics & numerical data ; Humans ; Male ; Middle Aged ; Needs Assessment ; Nutrition Surveys ; Poverty/prevention & control ; Poverty/statistics & numerical data ; Risk Assessment ; Socioeconomic Factors ; United States/epidemiology
Language	English
Publishing date	2021-01-05
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.16971
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