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)
Abstract
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 1
Introduction and Rationale 1
Problem Statement 3
Theoretical Frameworks 4
Purpose Statement 6
Research Question 6
Significance Statement 6
Definition of Terms 7
LITERATURE REVIEW 8
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
METHODOLOGY 29
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
RESULTS 40
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
DISCUSSION 59
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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