Date of Conferral

2020

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Mary Lou Gutierrez

Abstract

Obesity remains a public health issue in the United States because it contributes to chronic diseases. The Supplemental Nutrition Assistance Program (SNAP) was designed to increase food security, alleviate hunger, and increase access to a healthful diet; however, it may have the opposite effect and contribute to obesity. The purpose of this study was to examine to what extent participation in SNAP impacts food insecurity, diet quality, and obesity in U.S. adults. The social-ecological model guided the study which was conducted using a quantitative a cross-sectional research design and secondary analyses of the 2013-2014 National Health and Nutrition Examination Survey (NHANES). The sample consisted of all adults 25 years and older included in the NHANES. Logistic regression analysis results indicated marginal food security was associated with obesity among SNAP (OR = 1.28) and NON-SNAP (OR = 1.54). Full food security was associated with obesity (OR = 1.65) only among NON-SNAP. Among both groups, the greater the diet quality reported the greater the odds of obesity. Poverty mediated the association between marginal food security and obesity only among NON-SNAP participants. Adjusting for socio-economic factors SNAP modified the effect between food security and obesity (OR = 1.30) and diet quality was associated with obesity (OR = 1.72). The results of this study may be uses as support for policies and programs to improve the nutritional impact of SNAP and targeted interventions to address food security in low-income adults.

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