Project:
A Comparison of Demographic Variables, Food/Nutrient Intakes, Level of Food Sufficiency, and Food/Nutrient Changes with Intervention Among Food Stamp Recipients and Nonrecipients in South Carolina, Tennessee, and Virginia

Year: 2000

Investigator: Cason, Katherine L., Janie Burney, Wayne Moore, Richard Poling, Sandra Shivers, Ruby Cox, Kathleen Poole, and Judy Midkiff

Institution: Pennsylvania State University Department of Food Science

Project Contact:
Katherine L. Cason
Pennsylvania State University
Department of Food Science
203B Borland Laboratory
University Park, PA 16801
klc13@psu.edu

The nutritional status and food sufficiency of low-income individuals and their relationship to individual, dietary, and environmental factors are not well understood, but they are basic to improving the health and well-being of low-income individuals and families. In this study, Cason et al. examined the effects of food assistance receipt, nutrition education, and mother’s workforce participation on the dietary patterns of rural households in South Carolina, Tennessee, and Virginia. They used food and nutrient intake data collected from 6,969 participants in the Expanded Food and Nutrition Education Program (EFNEP) and 3,552 Food Stamp Nutrition Education Program (FSNEP) participants in the three States during 1999/2000. They compared food stamp recipients with nonrecipients on relative dietary adequacy, recommended food-related behaviors, and other factors.

EFNEP and FSNEP are nutrition education programs targeted to low-income families and youth that teach how to make healthy food choices, prepare food safely, and manage resources to reduce food insecurity. EFNEP focuses on nutrition education for families with children; FSNEP focuses on education for families eligible for food stamps and serves food stamp recipients and nonrecipients. The Extension Service administers EFNEP and FSNEP programs at each university. Subjects in this study were participants in EFNEP or FSNEP at Clemson University in South Carolina, The University of Tennessee, and Virginia Tech. To be included in the study, participants must have received education targeted to adult learners.

Demographic Comparisons

• The EFNEP group was 57 percent White, 40 percent African-American, and 3 percent Hispanic. Most (78 percent) were 19-50 years of age; another 18 percent were 18 years old or younger. The mean monthly income (not including the value of food stamps) was $378, with 65-year-olds reporting the highest monthly incomes ($437) and those 18 and under reporting the lowest ($126). Food stamp recipients reported lower monthly incomes ($349) than nonrecipients ($649). Participation in the Food Stamp Program varied by age group. It was highest among 19-50 year olds (57 percent) and lowest among those 18 and under (22 percent).
• The racial and ethnic composition of the FSNEP group was similar to the EFNEP group, with a slightly larger percentage being African-American and a smaller percentage White. Most were either 65 years old or older (48 percent) or between 19 and 50 years old (34 percent). Monthly incomes were similar as well, except that those 18 and under had a higher average monthly income than the youngest EFNEP group ($293). Food stamp participation rates were the same as for the EFNEP group among 19 to 50 year olds (56 percent), but higher than for the EFNEP group among those 18 and under (35 percent).

• South Carolina—Twenty-nine percent of all South Carolina EFNEP and FSNEP households were food insecure during the 12 months ending in August 2000. Nearly 12 percent had one or more household members who were hungry due to inadequate resources for food at some time during the year.
• Tennessee—The authors found significant, but weak, associations between receiving food stamps and cutting the size of children’s meals or adults cutting or skipping meals because there was not enough money to buy food. They also found that families on food stamps, particularly those living in farm and rural areas and in central cities, were more likely than nonrecipients to report running out of food before the end of the month with no money to buy more and being unable to afford balanced meals.

• EFNEP Participants—A comparison of the food and nutrient intakes of food stamp recipient and nonrecipient households revealed that food stamp recipients consumed more meat (2.3 versus 2.0 servings), less milk (1.2 versus 1.4 servings), and more fat (71.7 versus 67.9 grams) than nonrecipients. A comparison of responses to a 10-question food behavior checklist revealed significant differences for 4 of the 10 behaviors. Food stamp recipients more often reported planning meals ahead of time (20.3 percent versus 18.7 percent) and running out of food before the end of the month (10.3 percent versus 8.2 percent). Food stamp recipients were less likely than nonrecipients to report refrigerating meat and dairy foods within 2 hours of serving (45.7 versus 47.9 percent) and thawing frozen food correctly (34.0 versus 37.5 percent).
• FSNEP Participants—In this group, food stamp recipients consumed more fat (62.4 versus 56.3 grams) and had higher energy intakes (1,565.7 versus 1,490 calories) than nonrecipients. Food stamp recipients were less likely to report practicing food safety behavior by properly thawing frozen food than nonrecipients (33.7 versus 44.8 percent). Also, a lower percentage of food stamp recipients reported using the “nutrition facts” on food labels to make food choices (9.9 versus 14.9 percent).

• EFNEP Participants—The authors found significant increases among food stamp recipients and nonrecipients for all food and nutrient intakes measured at the completion of nutrition education. However, they note that significant increases in servings of fats/sweets and in the total amount of fat may represent undesirable changes. Following nutrition intervention, recipients increased their intake of fruit and vitamin C significantly above that of nonrecipients. In South Carolina and Virginia, all EFNEP graduates made improvements in several food and nutrition-related behaviors following intervention. A greater percentage planned meals ahead of time, compared prices when buying food, reported running out of food before the end of the month less often, shopped with a grocery list, refrigerated meat and dairy foods within 2 hours of serving, thawed frozen food correctly, thought of healthy food choices when deciding what to feed their families, prepared foods without adding salt, and ate something in the morning within 2 hours of waking. Graduates who received food stamps were more likely to thaw frozen food correctly than nonrecipients were.
• FSNEP Participants—Unlike the EFNEP participants, following intervention, FSNEP clients did not appear to make the undesirable increases in fats and sweets while they increased other dietary components. Food stamp recipients significantly increased their intakes of vitamins A and B6 compared with nonrecipients. FSNEP graduates also made improvements in food and nutrition-related practices. A greater percentage of all FSNEP participants planned meals ahead of time, compared prices when buying food, reported running out of food before the end of the month less often, shopped with a grocery list, refrigerated meat and dairy foods within 2 hours of serving, thawed foods correctly, thought of healthy food choices when deciding what to feed their families, prepared foods without adding salt, used “nutrition facts” on food labels to make food choices, and ate something in the morning within 2 hours of waking. Food stamp recipients differed from nonrecipients after intervention only in that they were less likely to eat something in the morning within 2 hours of waking.

Cason et al. note that although food stamps increase food purchasing power, they do not appear to ensure consumption of nutritionally adequate diets. They did not find substantial differences in the diets of food stamp recipients and nonrecipients at the time they enroll in EFNEP and FSNEP. They found food insecurity and hunger among both groups, and they found few differences between the groups after nutrition education. However, both groups consumed more nutritious diets and improved their food-related behaviors when they received nutrition education.

One goal of the Food and Nutrition Service is to help food stamp recipients bring their food choices and food preparation practices more in line with broadly accepted recommendations for healthful eating. Butler and Raymond (1996) indicated that adequate income was no guarantee of adequate nutrition, and reported that “even rudimentary knowledge of nutrition can increase nutrient intake considerably.” The results of this study suggest that low-income individuals do benefit from the nutrition education provided through EFNEP and FSNEP.

Cason et al. conclude that all food stamp recipients would benefit from a long-term, sustained nutrition education program, which would complement the income subsidy provided by food stamps. Without such a program, they argue, access to supplemental food through food stamps may not promote healthier diets or reduce disease risks. They recommend that food stamp recipients be enabled to make healthy food choices by increasing their nutrition knowledge and their awareness of increased health risk from inadequate or excessive food intakes.