2014 Recipients
RIDGE COMPETITIVE GRANTS PROGRAM

The RIDGE Center for Targeted Studies is pleased to announce that the following four grant proposals were selected by the RIDGE National Research Advisory Committee for funding as part of the Center’s 2014 competitive grants program.

1. The Longitudinal Impact of SNAP Enrollment and Spending on Community Health and Well-being in Rural and Urban Georgia During the Great Recession

Principal Investigator(s): Sarah Shannon, University of Georgia

Collaborator(s): Jerry Shannon, University of Georgia; Jung Sun Lee, University of Georgia; and Grace Bagwell Adams, University of Georgia

Project Summary: Our proposed research project will examine the spatial and social distribution of SNAP during and after the Great Recession and the impacts of SNAP expansion on community health and well-being in Georgia counties and zip codes from 2008 to 2013 using a unique data set of Supplemental Nutrition and Assistance Program (SNAP) enrollments (stratified by demographic groups) and benefit dollars. Georgia provides an ideal case study for investigating differences in SNAP participation and impacts by urban and rural locations due to the presence of a large urban center (Atlanta) and a sizeable rural population. Capitalizing on sophisticated spatial and statistical methods, our research will identify spatial clustering in SNAP distribution at the local level across urban and rural areas, examine how the built environment impacted SNAP enrollment during the economic downturn, and investigate the longitudinal impact of SNAP expansion on indicators of health and well-being, including food security, obesity, low birth weight, and crime. Results of the research will fill important gaps in knowledge about the factors shaping SNAP access at the local level, particularly among different populations by race and rural/urban location. Policy implications include assessing the effectiveness of SNAP program enrollment efforts during a major economic crisis and suggest changes to make future efforts more successful.

2. Student Participation in the USDA School Meals Program in California: Examination of Rural versus Urban Disparities in Changes over Time

Principal Investigator: Lindsey Turner, Boise State University

Collaborator(s): Lisa Powell, University of Illinois at Chicago; and Gregory Hancock, University of Maryland

Project Summary: In 2012, the United States Department of Agriculture issued new standards for meals served through the School Breakfast Program (SBP) and the National School Lunch Program (NSLP).Cost concerns due to implementation of the new standards have been higher among school food authorities in rural versus urban areas. Student complaints about the new NSLP meals in 2012-13 were also higher at rural versus urban/suburban schools. Nationally, student participation in the NSLP dipped by 3.7% from 2010-11 to 2012-13, primarily among full-price paying students, but it is unclear how—or whether—this is associated with changes in meal prices and whether it varies by school locale. Additional work is needed to understand possible rural disparities in meal participation, while controlling for meal price. With >1,000 school districts in the state of California (37% rural, 20% urban), and organized, available administrative claims data on meal participation, these state data are a rich source of information.

The proposed study will alsogather retrospective SBP and NSLP meal price data from California school districts (online and by telephone request) for SY 2010-11 to 2014-15 to develop a comprehensive meal price dataset. Price data will be merged with participation data, plus district demographic and finance characteristics from the public-use Common Core of Data. Mixed effects regression models will be used to examine: 1) district-level changes in SBP and NSLP participation over time; 2) rural versus urban disparities; 3) associations between meal price and participation rates; and 4) differential time trends by locale and other covariates.

3. Unpacking “Rurality”: Evaluating the impact of rural community characteristics and the built environment on SNAP participation

Principal Investigator: Michele Walsh, University of Arizona

Collaborator(s): John Daws, University of Arizona; and Kara Haberstock Tanoue, University of Arizona

Project Summary: Much of the current study of the challenges in health, nutrition, and food security faced by rural populations addresses rurality as a monolithic identifier, failing to consider the significant differences in needs and barriers between rural communities. This project aims to explore intra-rural variation in participation in the Supplemental Nutrition Assistance Program (SNAP) and nutrition and health outcomes through the use of dasymetric mapping and rural typologies developed through multivariate statistical analysis. Through the analysis of community sociodemographic factors and patterns of SNAP participation, paired with the physical aspects of the built environment, this study will identify community-level correlates of SNAP participation and associated health and nutrition outcomes in rural regions.

Dasymetric mapping will be used to generate micro-level data surfaces for SNAP retailer access, SNAP participation, community characteristics captured by the American Community Survey, and health andnutrition outcome indicators drawn from the Behavioral Risk Factor Surveillance System (BRFSS). Analysis of these data surfaces will examine the impact of community-level socio-demographic characteristics and the built environment, namely physical access, on SNAP participation, and how these factors, when combined with SNAP participation, mediate health outcomes. The results of this study will help identify types of rural communities that under-utilize SNAP and will help policy-makers better target outreach programs to ensure that benefits reach those rural communities with the greatest need.

4. Altered daily activities and shame resulting from children experiencing food insecurity in rural South Carolina and Oregon

Principal Investigator: Edward Frongillo, Jr., University of South Carolina

Collaborator(s): Jennifer Bernal, University of South Carolina; and Elizabeth Adams, Child Development and Rehabilitation Center Public Health and Preventive Medicine Oregon Health & Science University

Project Summary: Despite large expenditures in the U.S. to provide food assistance, many children experience food insecurity. Food insecurity has substantial detrimental effects on children, including behavior problems, disrupted social interactions, compromised school performance, poor dietary intake, and poor health. Although several mechanisms have been postulated to explain why food insecurity is detrimental for children, there are almost no empirical data regarding which mechanisms are important. Research in the U.S., Venezuela, and Lebanon has demonstrated that talking with children directly is essential to understanding child experiences of food insecurity. In Venezuela, child experiences of food insecurity were significantly associated with experiencing shame and alterations in child daily activities, including increased child work activities, increased watching television, more frequent taking of naps, and higher absenteeism from school. This proposed study will investigate in the rural U.S. links between child experiences of food insecurity, children’s consequent involvement in activities that could compromise healthy daily activities, shame, and impacts on children (i.e., behaviors, social interaction, and school performance). We propose a qualitative study using in-depth interviews of 40 rural children, aged 9 to 15 years old, in South Carolina and Oregon. The semi-structured interviews will be recorded, transcribed, coded, and analyzed by trained personal. This study will advance understanding of what children do and experience when faced with food insecurity, what the consequences are, why and how these consequences occur, and how to possibly prevent them. The results will help policy makers, practitioners, and scientists design and adapt policies and programs to better protect children.

DOCTORAL DISSERTATION RESEARCH GRANT PROGRAM

Two proposals submitted as part of the RIDGE Center for Targeted Studies’ doctoral dissertation research program were recently selected for funding as part of the 2014 competitive grants program:

1. The Effect of SNAP on Children’s Health: Evidence from Immigrants’ Changing Eligibility

Doctoral Student: Chloe N. East, University of California at Davis

Supervising Professor: Ann Stevens, University of California at Davis

Project Summary: My dissertation research examines the e ect of the Supplemental Nutrition Assistance Program (SNAP) on immigrant children's health outcomes. To identify this effect I use policy variation in SNAP eligibility rules in the wake of welfare reform. My research ts into four RIDGE Research Areas. First, it fits into Research Area 3 by examining the effect of participation in SNAP on children's short and long run physical and mental health, including ADHD status, developmental delays, behavioral and emotional problems, birth weight, obesity, anemia, diabetes, and number of school days missed due to illness. There is very little evidence about the e ects of SNAP on children's health, especially on long run children's health, and this evidence is mixed in its conclusions: some nd negative effects (Gibson, 2003), some positive effects (Almond et al., 2011; Jones et al., 2003) and some no e ects (Currie and Cole, 1991). One possible explanation for these mixed results is that much of the existing literature has relied on comparing the health of participants to non-participants, which may be inaccurate due to the fact that circumstances determining the family's decision to participate in SNAP may also be related to children's health, as discussed in Kreider et al. (2012). My research methodology uses a different form of identi cation by taking advantage of variation in program eligibility rules across states and over time which will allow me to provide more accurate estimates of the program's e ects on children's short and long run health. With this methodology I will compare the health of children in families who are eligible for SNAP in some states and years to, otherwise similar, children in ineligible families in other states and years.1 I will also be able to examine how restricting eligibility for SNAP affects many outcomes that have not been the focus of the existing literature, including health care utilization and long run children's health. If SNAP increases family resources and therefore increases consumption of health care services, then restricting eligibility for SNAP may reduce health care utilization. On the other hand if SNAP improves children's health, then restricting eligibility would lead to worse health and possibly more utilization, and I will be able to identify which of these two effects is occurring in my research.
My research design will allow me to more accurately estimate the effect of SNAP on food security (Research Area 2.) By looking at food security, in addition to food consumption measured in dollars, I will be able to better understand the e ect of SNAP on family food consumption and nutrition, which may help explain the short and long run effects on health I observe. My research also falls under the broad Research Area 7 by examining the effects of SNAP on short and long run child health and health care utilization using policy variation rather than participant comparisons. SNAP is currently the largest federal nutrition program in terms of both total spending and number of participants so the program's costs and benefits are crucial to quantify, especially as they are currently being debated by politicians. Finally, the focus of my research is the health of children of immigrants, who are one of the

2. The Food Environment and Health: The Role Fast Food Restaurants Play on Dietary Patterns and a Call for an Improved Food Desert Measure

Doctoral Student: Ann Marie Roubal, University of Wisconsin

Supervising Professor: Ana Martinez-Donate, Institute for Policy Research, Northwestern University

Project Summary: This research will fill some of the important literature gaps for both fast food restaurants on dietary consumption and farmers markets to improve access to healthy food. Aims 1 fill important gaps in the food environment research by including a representative statewide sample (rather than being limited to a specific sub-group or city) and linking individual dietary consumption measures to ground-truthed assessments of the food environment, reducing and effectively eliminating many of the ecological biases that have plagued this research in the past. Aim 3 will fill important gaps in food desert research by creating a systematic way to count farmers markets and include them in food desert estimates. Farmers markets highlight an important informal mechanism for food acquisition and this research highlights the importance of farmers markets. Additionally, it will be the first research to assess the accuracy of the USDA National Farmers Market Directory by comparing the data to validated estimates from Wisconsin sources. Finally, Aim 3 will uncover characteristics about market locations and electronic benefit transfer. Characteristics of census tracts with and without farmers markets will be compared to identify if markets are being placed in high need areas, such as food deserts. Further, characteristics of market census tracts with and without EBT will be compared to understand whether SNAP funds are able to be redeemed in areas where they are needed. These studies fill a void in farmers market and fooddesert literature which has been unable to successfully count and describe characteristics of farmers markets.