The Effect of Acculturation, Social Integration, and the Food Stamp Program on Diet, Nutritional Status, and Food Insufficiency in the Adult U.S. Hispanic Population

Year: 2000

Research Center: Department of Nutrition at the University of California, Davis

Investigator: Marquis, Grace S., Helen H. Jensen, Robert E. Mazur, and Yi-kyoung Lee

Institution: Departments of Food Science and Human Nutrition, Economics, and Sociology at Iowa State University

Project Contact:
Grace S. Marquis, Ph.D.
1127 Human Nutritional Sciences Bldg.
Dept. of Food Science and Human Nutrition
Iowa State University
Ames, Iowa 50011


This study examined the determinants of dietary adequacy, nutritional status, and food insufficiency among Hispanic Americans residing in the United States between 1988 and 1994. The authors focused on how acculturation, social integration, and Food Stamp Program participation influenced these nutritional outcomes. The results provide a foundation for future research on health, dietary behaviors, and food insecurity of U.S. Hispanics. In addition, these results can assist public and private food assistance and social service programs in providing services to improve the health, nutritional status, and food security of low-income, marginalized populations.

A primary goal of Healthy People 2010 is to decrease the health disparities that exist between population groups in the United States. Hispanic Americans have higher rates of overweight and obesity than non- Hispanic Whites, reaching 42 percent among adult Hispanic women. Rates of some nutrition-related chronic diseases, such as diabetes, are several times higher among Hispanics than the general adult population. The determinants of dietary patterns and disease outcomes are complex. Cultural norms often support a healthy diet. However, low income, poor education and language skills, and a lack of social support, among other factors, may undermine traditional dietary patterns. In addition, lack of nutrition and health services may place this population at increased risk of poor nutritional status, disease and disease-related complications, and mortality.

The authors use the NHANES III sample for their analysis, including data on a total of 5,787 Hispanic individuals. The outcome variables of interest include dietary intake, food insufficiency, and body mass index. Explanatory variables for these outcomes included acculturation (language used at home, birthplace, and age at arrival in the United States), social integration (communication with social partners and participation in church or club), food stamp receipt, and individual and household characteristics.

Most sample individuals were married and lived in metropolitan areas. One-fifth of sample households were female-headed. Almost half of the sampled adults completed high school, but 15 percent had no formal education past fifth grade. The distribution of income was nearly bi-modal, with most adults living in households with incomes of less than 130 percent (43 percent of adults) or more than 185 percent of poverty (42 percent of adults). Almost one-fifth of households received food stamps at the time of the interview.

Nine percent of adults stated that they sometimes or often did not have enough to eat. Fourteen percent had cut the size of an adult’s meal and 8 percent a child’s meal because of a lack of money to buy food. Households receiving food stamps were more likely to report not having enough food and cutting the size of adults’ and children’s meals than nonrecipient households, even when controlling for income.

Among individuals with incomes of less than 185 percent of poverty, less acculturation (i.e., a later age at arrival in the United States) was associated with a better diet. For individuals arriving as adults, both the percent of energy as fat and saturated fat met Dietary Guidelines recommendations. These percentages increased, however, as time in the United States increased. Among those with incomes greater than 185 percent of poverty, Spanish-speaking individuals who came to the United States as children had the poorest quality diets (highest intakes of energy, protein, cholesterol, sodium, and percent of energy as saturated fat). A later age at arrival was associated with a decreased intake of grains but increased intake of fruits and lower percentage of energy intake as fat and saturated fat.

In regression models, the acculturation variables often acted independently. Spanish language was associated with lower intakes of energy, vitamin A, percent energy as fat, and an improved diet. Arrival in the United States as an adult was negatively related to percent of energy as fat and saturated fat and to body mass index. Spanish-speaking individuals who came to the United States as adults had higher intakes of folate and vitamin A. These results again show less acculturation was associated with a better diet. Socioeconomic status showed little association with dietary outcomes, suggesting that economic effects may be captured by other factors.

Social integration and use of food stamps also influenced some nutrition outcomes. Church attendance was associated with increased cholesterol and percent energy as fat, and a poorer quality diet. However, no-involvement in either church or clubs was associated with lower intakes of energy calcium, folate, and vitamin A. Living in a household that received food stamps was associated with a small increase in intakes of energy, protein, sodium, and zinc. However, BMI was also higher for individuals in food stamp households.

Finally, the authors found increased risk of food insufficiency among those with less than a high school education, less social integration, low incomes, and food stamps receipt. Risk factors for adult meal size reduction included low education, low income, and employment in agriculture. Cutting the size of a child’s meal was related to low income, early age at arrival in the United States, and weak-to-low social integration. These results demonstrate the importance of education and income and the probable role of social networks in combating hunger and food insecurity.

This study demonstrates that within the Hispanic population, acculturation, social integration, and Food Stamp Program participation affect diet, nutritional status, and food insufficiency. Other factors were also important. Intakes of calcium and folate were generally very low, demonstrating widespread deficiencies of these nutrients in the Hispanic population at the time of the study. Less acculturation was associated with lower fat intakes, which is important in the fight against obesity and chronic diseases. Low income was a strong predictor of food insufficiency; being foreign-born also increased the risk of child hunger. Although the effects of socialization were less strong, they suggest that being integrated into the community is associated with better dietary outcomes. Food stamp receipt was associated with food insufficiency; however, further research would be necessary to determine causality. The authors conclude that food and nutrition assistance outreach should encourage individuals and their social networks to maintain traditional dietary patterns, as these were generally healthier.