Statistics for Spatial Data.

Context: Research consistently shows that the majority of American children do not consume diets that meet the recommendations of the Dietary Guidelines for Americans, nor do they achieve adequate levels of daily physical activity. As a result, more children are overweight today than at any other time in U.S. history. Schools offer many opportunities to develop strategies to prevent obesity by creating environments in which children eat healthfully and engage regularly in physical activity.

Methods: This article discusses the role of schools in obesity prevention efforts. Current issues in schools' food and physical activity environments are examined, as well as federal, state, and local policies related to food and physical activity standards in schools. The article is organized around four key areas: (1) school food environments and policies, (2) school physical activity environments and policies, (3) school body mass index measurements, and (4) school wellness policies. Recommendations for accelerating change also are addressed.

Findings: The article found that (1) competitive foods (foods sold outside of federally reimbursed school meals) are widely available in schools, especially secondary schools. Studies have related the availability of snacks and drinks sold in schools to students' high intake of total calories, soft drinks, total fat and saturated fat, and lower intake of fruits and vegetables; (2) physical activity can be added to the school curriculum without academic consequences and also can offer physical, emotional, and social benefits. Policy leadership has come predominantly from the districts, then the states, and, to a much lesser extent, the federal government; (3) few studies have examined the effectiveness or impact of school-based BMI measurement programs; and (4) early comparative analyses of local school wellness policies suggest that the strongest policies are found in larger school districts and districts with a greater number of students eligible for a free or reduced-price lunch.

Conclusions: Studies show that schools have been making some progress in improving the school food and physical activity environments but that much more work is needed. Stronger policies are needed to provide healthier meals to students at schools; limit their access to low-nutrient, energy-dense foods during the school day; and increase the frequency, intensity, and duration of physical activity at school.

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Schools and Obesity Prevention: Creating School Environments and Policies to Promote Healthy Eating and Physical Activity

The purposes of this study were to estimate the prevalence of household food insufficiency in Canada, to identify sociodemographic characteristics of households most likely to report food insufficiency and to examine the relationship between food insufficiency and physical, mental and social health. These objectives were achieved through an analysis of data from the 1996/1997 National Population Health Survey. An estimated 4% of Canadians, 1.1 million people, were found to be living in food-insufficient households. Single-parent families, households reporting their major source of income as welfare, unemployment insurance or workers' compensation, those who did not own their own homes and households in Western Canada were more likely to report food insufficiency. The likelihood of reporting food insufficiency increased dramatically as income adequacy deteriorated. Individuals from food-insufficient households had significantly higher odds of reporting poor/fair health, of having poor functional health, restricted activity and multiple chronic conditions, of suffering from major depression and distress, and of having poor social support. Individuals in food-insufficient households were also more likely to report heart disease, diabetes, high blood pressure and food allergies. Men in food-insufficient households were less likely to be overweight; after adjusting for potentially confounding variables, no other associations were found between food insufficiency and body mass index. These findings suggest that food insufficiency is one dimension of a more pervasive vulnerability to a range of physical, mental and social health problems among households struggling with economic constraints.

/pdf/household-food-insufficiency-is-associated-with-poorer-10d86f3y5z.pdf

Household Food Insufficiency Is Associated with Poorer Health

During the past decade, rates of food insecurity and obesity have risen, and an association has been made between these two seemingly paradoxical states Although this relationship has not been repeatedly seen in men, research suggests a correlation in women Studies have not been able to consistently show a relationship in children, because findings differ based on age, race/ethnicity, household income, and sex Several proposed hypotheses explain why a correlation between food insecurity and obesity exists in adults—especially women—but not in children This review proposes a conceptual framework linking the Food Stamp Program and other coping strategies to the food insecurity–obesity relationship This link has implications for Food Stamp Program policy changes, welfare reform, and poverty prevention

The Food Insecurity–Obesity Paradox: A Review of the Literature and the Role Food Stamps May Play

This chapter discusses both food security and food assistance programs The latter are a response to threats to the former, so the topics are best treated jointly First I review the concept of food security, then presents a basic analytical model of food security, approached as a subtopic of the economics of health The discussion then turns to the multiple threats to food security, available empirical indicators of food security, and various mechanisms for reducing vulnerability Food security is linked to the consumption, production, and marketing of food, the functioning of factor markets?especially for labor?social safety nets, governmental and nongovernmental assistance agencies, initial asset and income distributions, and myriad other subjects across several disciplines The aim of this chapter is therefore not to plumb each subtopic in depth so much as to identify the key issues and the relevant literatures to which readers interested in greater detail should turn After tackling food security, the review turns to the related literature on government food assistance programs, the suite of distributive and regulatory interventions through which states try to ensure citizens' food security A range of domestic food assistance programs are considered first, emphasizing in particular the United States' relatively well-studied programs Then attention turns to international assistance programs, especially food aid The next and largest subsection considers issues common to both domestic and international food assistance programs: additionality, targeting, intertemporal variability, direct and indirect costs, and incentives

Food Security and Food Assistance Programs

Food stamp participants have higher food insufficiency rates than eligible nonparticipants, even after controlling for other factors. Given the Food Stamp Program's prominent role in the alleviation of hunger, this is a counterintuitive result. We conjecture that these higher rates are due to adverse selection insofar as households more likely to be food insufficient are also more likely to receive food stamps. We establish a theoretical framework to address this adverse selection. Using a simultaneous equation model with two probits, we show that once one controls for this adverse selection, food stamp recipients have the same probability of food insufficiency as nonrecipients. Copyright 2001, Oxford University Press.

The Food Stamp Program and Food Insufficiency

The mission of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is to safeguard the health of low-income women, infants, and children up to age 5 who are at nutritional risk. WIC provides nutritious foods to supplement diets, nutrition education, and referrals to health care and other social services. Administered by USDA's Food and Nutrition Service (FNS), the program has grown rapidly since its establishment in 1972, and is now one of the central components of the Nation's food and nutrition assistance system. Almost half of all infants and about one-quarter of all children 1-4 years of age in the United States now participate in the program. Federal program costs were almost $4 billion in fiscal 2000, making WIC the country's third-largest food assistance program in terms of total expenditures. WIC accounts for almost 12 percent of total Federal expenditures for food and nutrition assistance. This report presents comprehensive background information on the WIC program-how it works, its history, program trends, and the characteristics of the population it serves. It also examines issues related to program outcomes and administration. How the WIC community responds to these issues may have a large impact on future program operations.

https://www.michigan.gov/documents/fanrr27_49263_7.pdf

The wic program: background, trends, and issues

Expenditures for USDA's 15 food assistance programs totaled $46 billion in fiscal 2004 (October 1, 2003, to September 30, 2004), marking the second consecutive year in which spending exceeded the previous record high. The fiscal 2004 spending level represented a 10-percent increase from the previous fiscal year, the fourth consecutive year in which total food assistance expenditures increased. 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 94 percent of USDA's total expenditures for food assistance. While each of these major programs expanded during fiscal 2004, most of the increase in total food assistance expenditures between fiscal 2003 and fiscal 2004 was due to the increase in Food Stamp Program expenditures.

https://papers.ssrn.com/sol3/Delivery.cfm/SSRN_ID754764_code331453.pdf?abstractid=754764&mirid=4

The Food Assistance Landscape

After controlling for self-selection bias, participation in the WIC program (Special Supplemental Nutrition Program for Women, Infants, and Children) has a significant positive effect on children's intakes of iron, folate, and vitamin B-6. Iron is one of the five nutrients targeted by the program, the others being protein, calcium, vitamin A, and vitamin C. Folate and vitamin B-6, along with zinc, were recommended by a 1991 USDA study as nutrients that the program should also target. The data set used, the 1994-96 Continuing Survey of Food Intake by Individuals, reflects the dramatic increase during the 1990's in the number of children in the program.

Wic and the nutrient intake of children

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides participating infants with free infant formula. This study estimated that between 57 and 68 percent of all infant formula sold in the United States was purchased through WIC, based on 2004-06 data, and that formula costs to the WIC program have increased. Typically, WIC State agencies receive substantial rebates from manufacturers for each can of formula provided through the program. Each WIC State agency, or group of agencies, awards a contract to the manufacturer offering the lowest net wholesale price, defined as the difference between the manufacturer’s wholesale price and the State agency’s rebate. After adjusting for inflation, net wholesale prices increased by an average 73 percent for 26 fluid ounces of reconstituted formula between States’ contracts in effect in December 2008 and the States’ previous contracts. Most (72 percent) of the increase in real net wholesale prices was due to higher wholesale prices, the rest (28 percent) was due to lower rebates. As a result of the increase in real net wholesale prices, WIC paid about $127 million more for infant formula over the course of a year.

/pdf/rising-infant-formula-costs-to-the-wic-program-recent-trends-dtoxik5h7u.pdf

Victor Oliveira

Papers

The Food Stamp Program and Food Insufficiency

The wic program: background, trends, and issues

The Food Assistance Landscape

Wic and the nutrient intake of children

Rising Infant Formula Costs to the WIC Program: Recent Trends in Rebates and Wholesale Prices