To Feed and Nourish: A Quantitative Study Examining the Relationship Between Food Insecurity and Perceptions of Well-Being Among SNAP-Enrolled Recipients Living in Rural Georgia Communities Open Access

Leung, Emily (Spring 2022)

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Introduction: Food insecurity, recognized as an important social determinant of health, is linked to challenges such as accessibility and social acceptability. Existing literature highlights the association between food insecurity and physical and emotional well-being. Multi-level theoretical frameworks offer insights into the multitude of socio-demographic factors related to food security status. Food insecurity challenges among rural communities characterize the widening gap of health disparities and inequities that set rural areas further behind their urban counterpart. The Emory Prevention Research Center is conducting an evaluation of The Two Georgias Initiative to understand the process of 11 community health coalitions in rural Georgia addressing health inequities, like food insecurity, through the initiative. 

Objective/Aim: This study examines the relationship between food insecurity and perceptions of well-being among SNAP-enrolled recipients living in rural Georgia communities, as well as whether racial and gender membership moderate this relationship. 

Methods: Secondary data analysis was conducted from a 2019 cross-sectional, baseline population-based mail survey from The Two Georgias Initiative. Restriction to SNAP participants and inclusion of eight of the 11 counties that completed food survey modules resulted in an analytic sample of N=286. Descriptive statistics were gathered for the overall sample, as well as for racial, gender, and intersectional subgroups. Bivariate, multivariable, and moderation analyses were also conducted to address the study aims. 

Results: Most SNAP-enrolled individuals (87.4%) reported experiencing food insecurity in the past 12 months and respondents were on average more than somewhat satisfied when reporting well-being measures. Compared to food secure individuals (FS), those reporting food insecurity (FI) scored on average 1.89 and 1.63 points lower on general well-being and the eight-item composite scales, respectively (FI vs. FS general/single-item: 95% CI: (-2.87, -0.90), p= .0002; 8-item composite: 95% CI: (-2.44, -0.83), p< .0001). For every one unit increase in general well-being, the odds of food insecurity are 27.0% lower (95% CI: (0.61, 0.87); p= .0006); similarly, the odds of food insecurity are 35.7% lower (95% CI: (0.51, 0.81); p= .0003) for every one unit increase in the eight-item well-being composite score. A significant interaction was found between race and food insecurity in the model with the eight-item composite as the well-being outcome. Only associations among white respondents were statistically significant; food insecure white respondents reported lower well-being compared to their food secure counterpart. 

Conclusion: A positive relationship, varying among racial groups, was demonstrated between food insecurity and lower well-being. Subgroups assessed in the study differentially experienced evidence-based protective and risk factors of food insecurity and well-being. Future research of stress and coping mechanisms, as well as intersectionality studies, is recommended.

Table of Contents


Introduction and Rationale 1

Problem Statement 3

Theoretical Frameworks 4

Purpose Statement 6

Research Question 6

Significance Statement 6

Definition of Terms 7


Overview of Food Insecurity 8

Food Insecurity and Guiding Theoretical Frameworks 8

Relationship Between Food Insecurity Status and Well-Being 13

Food Insecurity and the “Food Apartheid” 14

Food Insecurity Prevalence in Rural Communities 16

Benefits of the Supplemental Nutrition Assistance Program (SNAP) 19

Challenges of SNAP 22

SNAP Participation in Rural Communities 25

Current Problem/Study Relevance 27


Introduction 29

Background of The Two Georgias Initiative 29

Data Collection Procedures: Study Design, Participants, and Recruitment 30

Measures 33

Focal Variables 33

Potential Moderators 34

Demographic Covariates 35

Food Environment Covariates 36

Data Analysis Methodology 37


Descriptive Statistics 40

Focal Variables 40

Demographic Covariates 41

Food Environment Covariates 44

Associations Between Well-Being and Variables of Interest 49

Associations Between Food Insecurity and Variables of Interest 53

Assessment of Interaction 55

Final Model 55


Comparison of Study Findings to the Literature 59

Relevance of study’s descriptive characteristics 59

Supported bivariate associations 62

Contributions to food insecurity dialogue with the final model 63

Significance of Study Findings to the Literature 64

Societal Significance 65

Strengths 66

Limitations 67

Future Directions 68

Conclusion 68

References 70

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