This research investigates the perceived benefits and challenges of participating in the Supplemental Nutrition Assistance Program (SNAP) among households with young children across urban and rural Nebraska, aiming to address the limited exploration of disparities in its reach.
Design
Cross-Sectional (SNAP-Ed Needs and Assets Assessment).
Setting
Households across Nebraska.
Participants
Low-income families with at least 1 child aged 6 or younger (n = 1040).
Measures
Perceived benefits and challenges to SNAP participation across urban-rural populations, controlling for race, income, and education.
Analysis
Chi-square tests and logistic regression with Benjamini-Hochberg correction.
Results
Overall, financial need was perceived as the top reported benefit, while time and efforts for recertification were the top challenge. Rural residents perceived financial need (P < 001) and ability to have enough healthy food (P < 05) as major drivers for SNAP enrollment, whereas urban residents perceived previous SNAP-Ed participation (P < 001) and positive peer influence (P < 01) as benefits. Rural respondents perceived greater challenges in SNAP application requiring more time and effort (P < 001), while urban respondents had significantly higher concerns about native language accessibility (P < 001), poor customer service (P < 05), and unwillingness to depend on government agencies (P < 05).
Conclusion
Geographically and culturally tailored SNAP-Ed interventions and streamlined application processes are required to address the urban-rural disparities.
ToossiSJonesJW. The food and nutrition assistance landscape: fiscal year 2022 annual report. Washington: U.S. Department of Agriculture, Economic Research Service, 2023, Report No. EIB-255. doi:10.32747/2023.8054020.ers
CohenAJOatmenKEHeislerM, et al.Facilitators and barriers to supplemental nutrition assistance program incentive use: findings from a clinic intervention for low-income patients. Am J Prev Med. 2019;56(4):571-579. doi:10.1016/j.amepre.2018.11.010
4.
CunnynghamK. Trends in Supplemental Nutrition Assistance Program Participation Rates: Fiscal Year 2010 to Fiscal Year 2016. Washington, DC: US Dept of Agriculture, Food and Nutrition Service, Office of Policy Support; 2018.
5.
Keith-JenningsBLlobreraJDeanS. Links of the supplemental nutrition assistance program with food insecurity, poverty, and health: evidence and potential. Am J Publ Health. 2019;109(12):1636-1640. doi:10.2105/AJPH.2019.305325
Haynes-MaslowLHardison-MoodyAPatton-LopezM, et al.Examining rural food-insecure families’ perceptions of the supplemental nutrition assistance program: a qualitative study. Int J Environ Res Publ Health. 2020;17(17):6390. doi:10.3390/ijerph17176390
10.
McCarthyHNChoEJacksonJKSauzaCMartinezLECalderonLL. Barriers to utilization of the supplemental nutrition assistance program (CalFresh) in Los Angeles county. J Acad Nutr Diet. 2012;112(9):A91. doi:10.1016/j.jand.2012.06.331
11.
Gaines-TurnerTSimmonsJCChiltonM. Recommendations from SNAP participants to improve wages and end stigma. Am J Publ Health. 2019;109(12):1664-1667. doi:10.2105/ajph.2019.305362
12.
ChengTCTangN. SNAP out of it: a study of low-income families’ underutilization of food stamps. J Poverty. 2016;20(2):152-167. doi:10.1080/10875549.2015.1094765
13.
PurtellKMGershoffETAberJL. Low income families’ utilization of the federal “safety net”: individual and state-level predictors of TANF and food stamp receipt. Child Youth Serv Rev. 2012;34(4):713-724. doi:10.1016/j.childyouth.2011.12.016
14.
PinardCABertmannFMWBykerSC, et al.What factors influence SNAP participation? Literature reflecting enrollment in food assistance programs from a social and behavioral science perspective. J Hunger Environ Nutr. 2017;12(2):151-168. doi:10.1080/19320248.2016.1146194
15.
MartinezSMSinghSEsarykERitchieL. SNAP student rules are not so snappy: lessons learned from a qualitative study of California county agency workers. J Nutr Educ Behav. 2024;56(3):133-144. doi:10.1016/j.jneb.2023.12.004
16.
MezaATesterJMYenIHLaraiaBAWolfsonJALeungCW. Perceptions of SNAP and stocking standards: a qualitative study of California small food store owners and managers. Nutrients. 2021;13(3):752. doi:10.3390/nu13030752
LouieNTKimLPChanSE. Perceptions and barriers to SNAP utilization among asian and pacific islanders in greater los angeles. Am J Health Promot. 2020;34(7):779-790. doi:10.1177/0890117120925746
PurkaitTDevDFischerJABehrendsDSehiNFranzen-CastleL. Perceived benefits and challenges of SNAP participation across urban and rural population. J Nutr Educ Behav. 2024;56(8):S31-S32. doi:10.1016/j.jneb.2024.05.077
LeungCWWolfsonJA. Perspectives from supplemental nutrition assistance program participants on improving SNAP policy. Health Equity. 2019;3(1):81-85. doi:10.1089/heq.2018.0094
23.
LeungCWBlumenthalSJHoffnagleEE, et al.Associations of food stamp participation with dietary quality and obesity in children. Pediatrics. 2013;131(3):463-472. doi:10.1542/peds.2012-0889
24.
InsoleraNCohenAWolfsonJA. SNAP and WIC participation during childhood and food security in adulthood, 1984-2019. Am J Publ Health. 2022;112(10):1498-1506. doi:10.2105/ajph.2022.306967
25.
FriedmanH. Simplified determinations of statistical power, magnitude of effect and research sample sizes. Educ Psychol Meas. 1982;42(2):521-526.
26.
CohenJ. Statistical Power Analysis for the Behavioral Sciences. 2nd ed.New Jersey: Lawrence Erlbaum Associates; 1988.
KaiserL. Why do low-income women not use food stamps? Findings from the California Women’s Health Survey. Public Health Nutr. 2008;11(12):1288-1295. doi:10.1017/s1368980008002528
31.
AlgertSJReibelMRenvallMJ. Barriers to participation in the food stamp program among food pantry clients in los angeles. Am J Publ Health. 2006;96(5):807-809. doi:10.2105/ajph.2005.066977
32.
GriegerLDDanzigerSH. Who receives food stamps during adulthood? Analyzing repeatable events with incomplete event histories. Demography. 2011;48(4):1601-1614. doi:10.1007/s13524-011-0056-x
33.
MabliJ. SNAP participation and urban and rural food security. Alexandria: Mathematica Policy Research for the U.S. Department of Agriculture, Food and Nutrition Service. 2014. https://www.fns.usda.gov/sites/default/files/SNAPFS_UrbanRural.pdf. Accessed June 27, 2024.
VogtR. Financial impacts of the pandemic in rural Nebraska. In: CAP Series 21-1004. Lincoln: Center for Agricultural Profitability, University of Nebraska-Lincoln.
36.
Byker ShanksCAndressLHardison-MoodyA, et al.Food insecurity in the rural United States: an examination of struggles and coping mechanisms to feed a family among households with a low-income. Nutrients. 2022;14(24):5250. doi:10.3390/nu14245250
37.
WendeMEMeyerMRUAbildsoCGDavisKKaczynskiAT. Urban‐rural disparities in childhood obesogenic environments in the United States: application of differing rural definitions. J Rural Health. 2023;39(1):121-135. doi:10.1111/jrh.12677
38.
WenMFanJXKowaleski-JonesLWanN. Rural–urban disparities in obesity prevalence among working age adults in the United States: exploring the mechanisms. Am J Health Promot. 2018;32(2):400-408. doi:10.1177/0890117116689488
39.
WalkerREKeaneCRBurkeJG. Disparities and access to healthy food in the United States: a review of food deserts literature. Health Place. 2010;16(5):876-884. doi:10.1016/j.healthplace.2010.04.013
40.
LarsonNIStoryMTNelsonMC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009;36:74-81.e10. doi:10.1016/j.amepre.2008.09.025
41.
CrouchEAbshireDAWirthMDHungPBenavidezGA. Rural-urban differences in overweight and obesity, physical activity, and food security among children and adolescents. Prev Chronic Dis. 2023;20:E92. doi:10.5888/pcd20.230136
42.
ContrerasDAMartoccioTLBrophy-HerbHE, et al.Rural–urban differences in body mass index and obesity-related behaviors among low-income preschoolers. J Public Health. 2021;43(4):e637-e644. doi:10.1093/pubmed/fdaa162
43.
JohnsonJAJohnsonAM. Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis. Child Obes. 2015;11(3):233-241. doi:10.1089/chi.2014.0085
44.
United States Department of Agriculture - Food and Nutrition Service. What Can SNAP Buy?USDA-FNS. Published April 14, 2021. https://www.fns.usda.gov/snap/eligible-food-items. Accessed August 14, 2024.
45.
ParksCAHanPFrickeHEParkerHAHestermanOBYarochAL. Reducing food insecurity and improving fruit and vegetable intake through a nutrition incentive program in Michigan, USA. SSM Popul Health. 2021;15:100898. doi:10.1016/j.ssmph.2021.100898
46.
WielengaVFranzen-CastleLToneyADingmanH. Nebraska Double up food Bucks increases purchases of fresh fruits and vegetables among SNAP users. Curr Dev Nutr. 2020;4(Supplement_2):731. doi:10.1093/cdn/nzaa051_028
47.
LyerlyRRummoPAminS, et al.Effectiveness of mobile produce markets in increasing access and affordability of fruits and vegetables among low-income seniors. Public Health Nutr. 2020;23(17):1-10. doi:10.1017/s1368980020002931
48.
AndrewsMSmallwoodD. What’s behind the rise in SNAP participation?Amber Waves. 2012;10(1):1-6.
Henning-SmithCMoscoviceIKozhimannilK. Differences in social isolation and its relationship to health by rurality. J Rural Health. 2019;35(4):540-549. doi:10.1111/jrh.12344
United States Department of Agriculture- Food and Nutrition Service. Ensuring Language access for limited English proficient (LEP) individuals and effective communication for individuals with disabilities in consideration of the recent unwinding of the supplemental nutrition assistance program (SNAP) emergency allotments (EA) and upcoming unwinding of COVID-19- program flexibilities, 2023. Published. https://www.fns.usda.gov/cr/unwinding-snap-ea. Accessed June 27, 2024.
