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  • Effects of Food Assistance and Nutrition Programs on Nutrition and Health: Volume 4, Executive Summary of the Literature Review

    FANRR-19-4, December 07, 2004

    This report provides a summary of a comprehensive review and synthesis of published research on the impact of USDA's domestic food and nutrition assistance programs on participants' nutrition and health outcomes. The outcome measures reviewed include food expenditures, household nutrient availability, dietary intake, other measures of nutrition status, food security, birth outcomes, breastfeeding behaviors, immunization rates, use and cost of health care services, and selected nonhealth outcomes, such as academic achievement and school performance (children) and social isolation (elderly). The report is one of four volumes produced by a larger study that includes Volume 1, Research Design; Volume 2, Data Sources; Volume 3, Literature Review; and Volume 4, Executive Summary of the Literature Review. The review examines the research on 15 USDA food assistance and nutrition programs but tends to focus on the largest ones for which more research is available: food stamps, school feeding programs, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Over half of USDA's budget-$41.6 billion in fiscal year 2003-was devoted to food assistance and nutrition programs that provide low-income families and children with access to a healthy diet.

  • Estimating Longrun Food Stamp Program Caseloads

    EFAN-04013, December 03, 2004

    This study analyzes the relationship between Food Stamp Program (FSP) caseloads and the macroeconomy using annual State-level panel data for 1980-99. It is the first study to link the time-series properties of the data to an interpretation of public assistance program policy. A longrun relationship involving FSP caseload equation and the macroeconomy is estimated but requires that Aid to Families with Dependent Children/Temporary Assistance for Needy Families (AFDC/TANF) caseloads be included as an explanatory variable. The resulting equation that connects trends in the economy with the trend in FSP caseloads indicates that the economic expansion in the 1990s permanently lowered future FSP caseloads below what they would be otherwise. The potential for the economy to change the trend in FSP caseloads is in contrast to its role presented in previous studies in which the economic expansion of the 1990s is seen as causing only a temporary decrease in FSP caseloads that dies out over time. Tests of the estimated equation also indicate that the common practice of including year effects (annual dummy variables) or State-specific time trend in the FSP caseload equation may overcontrol for omitted variables. Instead, trends in the regressors should be allowed to explain the trend in FSP caseloads.

  • Nutrition and Health Characteristics of Low-Income Populations: Volume III, School-Age Children

    EFAN-04014-3, December 01, 2004

    Data from the Third National Health and Nutrition Examination Survey (NHANES-III), conducted in 1988-94, were used to compare the nutrition and health characteristics of the Nation's school-age children-boys and girls ages 5-18. Three groups of children were compared based on household income: income at or below 130 percent of poverty (lowest income), income between 131 and 185 percent of poverty (low income), and income above 185 percent of poverty (higher income). This research was designed to establish a baseline from which to monitor the nutrition and health characteristics of school-age children over time, particularly those in low-and lowest income groups.

  • Nutrition and Health Characteristics of Low-Income Populations: Volume IV, Older Adults

    EFAN-04014-4, December 01, 2004

    Data from the Third National Health and Nutrition Examination Survey (NHANES-III), conducted in 1988-94, were used to compare the nutrition and health characteristics of the Nation's older adults-men and women ages 60 years and older. Three groups of older adults were compared based on household income: income at or below 130 percent of poverty (lowest income), income between 131 and 185 percent of poverty (low income), and income above 185 percent of poverty (higher income). This research was designed to establish a baseline from which to monitor the nutrition and health characteristics of older Americans over time, particularly those in low- and lowest income groups.

  • Feasibility and Accuracy of Record Linkage To Estimate Multiple Program Participation: Volume III, Results of Record Linkage

    EFAN-03008-3, November 18, 2004

    This study investigated the feasibility of linking administrative data from multiple USDA food assistance and nutrition programs. This report contains findings from Phase II of the study, which collected and linked 2000-02 administrative data on clients of the Food Stamp Program (FSP) and the Special Supplemental Program for Women, Infants, and Children (WIC) in Florida, Iowa, and Kentucky. The report finds that the percentage of FSP infants (children) with contemporaneous participation in WIC ranged from 84 to 94 percent (50 to 57 percent). Meanwhile, the percentage of WIC infants (children) with contemporaneous participation in FSP ranged from 22 to 38 percent (29 to 50 percent). Most FSP women who gave birth during the 3-year period participated in WIC for some period (83 percent in Florida and 91 percent in Iowa). Phase II also examined the relative timing of participation across programs and the individual and household characteristics associated with multiple program participation.

  • Food Stamp Program Access Study: Final Report

    EFAN-03013-3, November 17, 2004

    The Food Stamp Program Access Study was motivated by a desire to learn whether and how the administrative policies and practices of local food stamp offices influence the chances of eligible households participating in the program. This report examines the participation decisions of potentially eligible households, together with the local office policies and practices that may enhance or inhibit program access. The findings indicate that many households with no recent contact with the FSP would apply for benefits if they believed themselves to be eligible. In addition, outreach activities are effective in communicating eligibility to nonparticipating households. The processes of application and recertification-and to a lesser extent, complying with ongoing program requirements-are hurdles that a sizable number of apparently eligible households fail to surmount. When surveyed, applicants and program dropouts cited various procedural obstacles as factors in their decision not to participate. The econometric analysis also identifies a number of office practices that vary across offices and appear to be significant in participation decisions.

  • Food Stamp Certification Periods and Payment Accuracy: State Experience During 1997-2001

    EFAN-04012, November 12, 2004

    Quality control (QC) reviews of Food Stamp Program (FSP) cases show that error rates across States range from less than 5 percent to more than 25 percent when both overpayment and underpayment error are combined. This study uses QC data for 1997-2001 and a Markov probability framework to characterize year-to-year national and State error rates into variations due to errors occurring with first-month cases (those approved at initial certification); ongoing cases (those subject to the interim action process); and expiring cases (those subject to the recertification process). This information can be used in planning corrective actions by focusing attention on phases of the administrative process that are more responsible for errors. This study also explores the effect on payment accuracy and FSP participation of more frequent recertification of food stamp cases. A motivating concern is that the use of short certification periods (3 months or less) as a strategy to reduce case error may unintentionally reduce program participation.

  • The Role of Economics in Eating Choices and Weight Outcomes

    AIB-791, October 28, 2004

    This report uses data from the USDA's 1994-96 Continuing Survey of Food Intakes by Individuals and the 1994-96 Diet and Health Knowledge Survey to ascertain whether economic factors help explain weight differences among adults. Weight differs among demographic subgroups, and differences in specific behaviors, health awareness, and eating patterns can be linked to weight outcomes. An economic framework helps explain how socioeconomic factors affect an individual's ability to achieve good health. Our results suggest that income, household composition, and formal education help explain variation in behaviors and attitudes that are significantly associated with weight outcomes.

  • Household Food Security in the United States, 2003

    FANRR-42, October 26, 2004

    Eighty-nine percent of American households were food secure throughout the entire year in 2003, meaning that they had access, at all times, to enough food for an active, healthy life for all household members. The remaining households were food insecure at least some time during that year. The prevalence of food insecurity, 11.2 percent of households, was not statistically different from the 11.1 percent observed in 2002. The prevalence of food insecurity with hunger was unchanged at 3.5 percent. This report, based on data from the December 2003 food security survey, provides the most recent statistics on the food security of U.S. households, as well as on how much they spent for food and the extent to which food-insecure households participated in Federal and community food assistance programs.

  • Food Assistance Landscape, September 2004

    FANRR-28-5, October 19, 2004

    Expenditures for USDA's 15 food assistance programs totaled $23.3 billion during the first half of fiscal 2004 (October 1, 2003, to March 31, 2004), an 11-percent increase over the first half of fiscal 2003. If this trend continues during the second half of fiscal 2004, expenditures for the entire fiscal year will surpass the record $41.8 billion spent on food assistance in fiscal 2003 (prior to fiscal 2003, the previous historical record was $38.1 billion set in fiscal 1996). Five programs-the Food Stamp Program, the National School Lunch Program, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the School Breakfast Program, and the Child and Adult Care Food Program-accounted for almost 95 percent of USDA's total expenditures for food assistance. While each of these major programs expanded during the first half of fiscal 2004, most of the increase in total food assistance expenditures was due to the expansion of the Food Stamp Program.

  • Understanding the Food Stamp Program Participation Decisions of TANF Leavers

    EFAN-04011, September 15, 2004

    This paper evaluates factors affecting the decision by families that leave the Temporary Assistance for Needy Families (TANF) program to participate in the Food Stamp Program (FSP). Linked Illinois State-level administrative data are combined with Census data and data from the Illinois Families Study survey to evaluate the FSP take-up decision of TANF leavers 3 years after leaving the welfare rolls. Results indicate that in Chicago, neighborhood characteristics and knowledge of FSP eligibility at the district office level are important factors in understanding the FSP participation decision of TANF leavers even after individual or family-level demographic characteristics are taken into account. This evidence suggests that the density of social networks among the food-stamp-eligible population in the district office areas may mediate the effects of office outreach and communication strategies.

  • Prototype Notebook: Short Questions on Dietary Intake, Knowledge, Attitudes, and Behaviors

    EFAN-04010, September 10, 2004

    This report provides a compendium of 128 survey questions used in previous research to assess dietary knowledge, attitudes, and behaviors for low-income populations over the age of 18. The short questions or sets of questions on nine topics, including fruits and vegetables; grains, legumes, and fiber; variety; fat; calcium food sources; nonalcoholic beverages; knowledge, attitudes; and behaviors, are drawn from an extensive inventory and evaluation of available questions reported in the research literature. Each question is presented using a common template including the citations, data sources, and characteristics such as question reliability, validity, sensitivity to change, availability in other languages, mode of administration, use in populations with low-income and/or low-education levels, relation to nutrition and health outcomes, and availability of comparative data. This report is part of a larger ERS research effort to develop a common core set of questions to assess the dietary behavior impact of Food Stamp Nutrition Education (FSNE) on Food Stamp Program participants.

  • How Much Do Americans Pay for Fruits and Vegetables?

    AIB-790, July 20, 2004

    This analysis uses ACNielsen Homescan data on 1999 household food purchases from all types of retail outlets to estimate an annual retail price per pound and per serving for 69 forms of fruits and 85 forms of vegetables. Among the forms we priced, more than half were estimated to cost 25 cents or less per serving. Consumers can meet the recommendation of three servings of fruits and four servings of vegetables daily for 64 cents.

  • Evaluating the Impact of School Nutrition Programs: Final Report

    EFAN-04008, July 13, 2004

    This study develops estimates of the efficacy of school nutrition programs in improving a broad range of dietary outcomes by comparing the nutritional status of students and their families during the school year with the status when school is out. The study finds evidence that children who have a School Breakfast Program (SBP) available consume a better overall diet, consume a lower percentage of calories from fat, are less likely to have a low intake of magnesium, and are less likely to have low serum levels of vitamin C and folate. For every outcome examined, SBP availability either promotes better outcomes or at the least does not promote worse outcomes. The results of this study suggest that the availability of an SBP has beneficial effects for children. This report describes the study's broad evaluation of the SBP and the National School Lunch Program (NSLP). The study used the National Health and Nutritional Examination Survey III (NHANES III)-a nationally representative data set that contains detailed information on food consumption, a complete clinical exam, and a laboratory report for respondents.

  • Food Stamp Program-Elderly Nutrition Demonstrations: Interim Report on Elderly Participation Patterns

    EFAN-04009, June 28, 2004

    To raise participation in the Food Stamp Program (FSP) by low-income, elderly individuals, USDA implemented the Elderly Nutrition Demonstration in six States (Arizona, Connecticut, Florida, Maine, Michigan, and North Carolina) in 2002. Each of the demonstrations is organized around one of three strategies to increase participation: simplifying the eligibility requirements for elderly individuals that apply for food stamps, directly assisting them with completing the application process, or offering them the option of receiving packages of commodities each month instead of getting benefits through an electronic benefits transfer card. Preliminary analysis indicates that FSP participation by the elderly rose substantially after the demonstrations started. In Arizona, Florida, Maine, and North Carolina, participation grew significantly more in demonstration counties than in nondemonstration counties. In Connecticut and Michigan, the more modest growth rates in the demonstration counties were similar to the rates in the rest of the State. The analysis also provides some evidence that the demonstrations attract elderly individuals eligible for relatively low FSP benefits, particularly in Maine and North Carolina, where a large number of individuals eligible for a $10 benefit are applying.

  • Innovative WIC Practices: Profiles of 20 Programs

    EFAN-04007, June 11, 2004

    WIC provides supplemental food, nutrition education, and social service referrals to low-income pregnant, breastfeeding, and postpartum women, infants, and children younger than age 5. WIC has come under increased scrutiny as it has expanded rapidly, and some have suggested new directions for the program. This study examines a range of innovative practices at 20 State or local WIC agencies. The study focuses on practices in three main areas: breastfeeding promotion and support (including peer counseling and programs for high-risk groups), nutrition and health education (including obesity prevention, preventive health care, and staff training), and service delivery (such as home and workplace visits). For each innovative program, the report provides background information and discusses the source of the innovation, key challenges, implementation lessons learned, evidence of its success, and the feasibility of replicating the practice.

  • Maternal Employment and Children's Nutrition: Volume I, Diet Quality and the Role of the CACFP

    EFAN-04006-1, June 08, 2004

    Compared with children of nonworking mothers, children of full-time working mothers have lower overall HEI (Healthy Eating Index) scores, lower intake of iron and fiber, and higher intake of soda and fried potatoes, even after taking into account differences in maternal and other family characteristics. Nutritional differences between children of part-time working mothers and children of nonworking mothers were more sensitive to maternal and family characteristics, with no clear pattern of nutritional differences emerging. This study analyzed differences in nutrition outcomes among children whose mothers work full time, part time, and not at all, and the role USDA's Child and Adult Care Food Program (CACFP) plays in meeting the nutrition needs of participating children, especially those whose mothers work.

  • Maternal Employment and Children's Nutrition: Volume II, Other Nutrition-Related Outcomes

    EFAN-04006-2, June 08, 2004

    The higher income of households with working mothers is related to lower participation in USDA's Special Supplemental Nutrition Program for Women,Infants,and Children (WIC) and School Breakfast and Food Stamp Programs. In contrast,children of working mothers are more likely to participate in the National School Lunch Program. This study analyzed differences in nutrition and nutrition-related outcomes among children whose mothers work full time, part time, and not at all (homemakers). This report focuses on indirect nutrition-related outcomes, including food program participation, children's eating patterns,household food acquisition and sufficiency, and children's physical activity and risk of overweight. Study results indicate that households with working mothers spend more on food and have higher levels of food sufficiency than households without working mothers. Working mothers,however, participate less in meal planning, shopping,and food preparation. The children of working mothers are more likely to skip morning meals,rely more on away-from-home food sources, spend more time watching TV and videos,and face significantly greater risk of overweight.

  • Linking WIC Program Data to Medicaid and Vital Records Data: Phase II Report, Data Development Initiatives for Research on Food Assistance and Nutrition Programs-Final Report

    EFAN-04005-2, June 02, 2004

    This report is a followup to a proposal to create a national database that links State data from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with Medicaid and vital records data. The linked information would create new opportunities for Federal and State program administrators, as well as independent researchers, to examine a number of factors related to program participation and dynamics. The report provides an implementation plan for creating a national database, including potential costs, benefits, and alternatives. The initiative is one of three that have the potential to improve the usefulness and cost-effectiveness of research on Federal food assistance and nutrition programs. The other initiatives are addressed in the reports, Linking the Current Population Survey and State Food Stamp Program Administrative Data (E-FAN-04-005-1) and Establishing a Web-Based Data Collection System for National School Lunch and National School Breakfast Program Data (E-FAN-04-005-3).

  • Emergency Providers Help Poor Households Put Food on the Table

    Amber Waves, June 01, 2004

    In 2003, USDA spent $41.7 billion on 15 food assistance programs aimed at improving the nutrition and well-being of needy Americans. The Food Stamp Program, the largest of the programs, served over 21 million people, and 16.4 million school children received free or reduced-price lunches from the National School Lunch Program. Yet, 4.3 million American households visited a food pantry, and 1.1 million people ate a meal at an emergency kitchen in a typical month in 2001.