Food Affordability, Preference, and Insecurity among Socially Disadvantaged Populations

Abstract

The phrase “social determinants of health” refers to individuals’ socioeconomic and environmental situations that are shaped by societal distribution of wealth, power, and resources. Food access, which includes both having the options to choose healthy foods and having sufficient food so as to alleviate hunger, is a social determinant of health that disproportionally affects vulnerable populations facing health disparity. This dissertation closely follows the food-related themes of social determinants of health by grounding its general overarching topic in healthy food options and hunger. First, this dissertation assesses the effect of financial incentives and nutrition education on low-income individuals’ purchase of fruits and vegetables in a field setting. This portion of the dissertation uses information collected from participants’ scanned discount card and grocery receipts to examine whether healthy eating education (a grocery store tour and/or a cooking class) affects low-income individuals’ weekly purchase of fresh produce, given a level of a weekly voucher usable on fresh fruits and vegetables only. Second, this dissertation examines the effect of a hypothetical incentive for fruits and vegetables and personally salient nutrition education on low-education individuals’ attitudinal and intention measures to purchase fruits and vegetables. This objective uses an internet experiment to investigate lower-education individuals’ intention to purchase fresh fruits and vegetables given a message containing the following elements: a weekly voucher to purchase fruits and vegetables, a short description about MyPlate dietary guideline developed by the United States Department of Agriculture (USDA), a short description that compares individuals’ self-reported fruits and vegetables consumption to MyPlate dietary recommendations. Third, this dissertation explores the relationships among physical limitations, chronic illness, and food insecurity among the elderly to better inform health policies that aim to reduce health care cost and utilization among seniors.