Purpose: In the United States (U.S.), states can set different minimum wages than the federal government. We investigated the association between state-level minimum wage policies and racial/ethnic inequities in household food insecurity in the U.S. between 2015-2019. We hypothesized that the association between state-level minimum wage and food insecurity would be stronger for non-Non-Hispanic (NH) White households.

Methods: Household-level food insecurity and sociodemographic data were obtained from the U.S. nationally representative Current Population Survey 2015-2019 (n=189,665 households) and merged by state and year with state minimum wage and state cost of living data for 2015-2019 from governmental sources. We fitted state-clustered modified Poisson regression models with robust standard errors with household food insecurity as outcome and minimum wage (US$) as predictor, adjusting for cost of living and household sociodemographic covariates. We tested for interactions between minimum wage and householder race/ethnicity on food insecurity and fitted race/ethnicity-stratified models. Further, with Map the Meal Gap 2019 data, we mapped the proportion of weekly wages needed to achieve food security in each state based on state-level minimum wages and food costs.

Results: State hourly minimum wages ranged between US$7.25-10.50 in 2015 and between US$7.25-14.00 in 2019. In fully adjusted models, state minimum wage had a small but significant impact on household food insecurity: a US$1 increase in hourly minimum wage was associated with a 1% lower probability of food insecurity prevalence (PR=0.99, 95%CI=0.98-0.99). The interaction p-value for race/ethnicity and minimum wage was p=0.06. When stratified by race/ethnicity, results were only statistically significant for NH White households (PR=0.98, 95%CI=0.96-0.99). For NH Black (PR=0.99, 95%CI=0.96-1.02) and Hispanic (PR=0.98, 95%CI=0.94-1.02) households, the association between minimum wage and food insecurity was also negative but not significant, whereas the association was positive and non-significant for households of other race/ethnicities (PR=1.04, 95%CI=0.99-1.08). In general, states with higher minimum wages had better purchasing power for food even after considering variability in food costs.

Conclusions: Higher wages have better purchasing power for food when considering state-specific food costs. However, state minimum wages were only minimally associated with household food insecurity, with no apparent impact on racial/ethnic inequities in food insecurity.

Purpose:
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a U.S. nutrition assistance program serving pregnant and postpartum women, and children 0-5 years who live in low-income households. WIC provides supplemental foods which can only be purchased in WIC-authorized stores. At least 20% of WIC participants in Washington state are of immigrant background, but information on how many WIC-authorized stores are considered “ethnic stores”, where immigrant households could access culturally preferred foods, is unknown. This study’s purpose is to assess the availability and distribution of WIC-authorized ethnic stores in Washington state in relation to the location of immigrant WIC-eligible populations.

Methods:
Information on WIC-authorized stores in Washington state was obtained from the WIC Shopper cellphone app; stores were categorized as ethnic or non-ethnic based on online store information. Sociodemographic data for Washington state census tracts were obtained from the American Community Survey (ACS) 2017-2021. Using ArcGIS Pro, a map displaying the census tract level percentage of 1) foreign-born individuals and 2) WIC-eligible children as well as 3) the location of WIC-authorized stores (ethnic/non-ethnic) was generated. The distribution of, and distance to, WIC-authorized ethnic/non-ethnic stores based on the distribution of foreign-born individuals and WIC-eligible children were analyzed in R (using chi-square tests) and ArcGIS Pro (using the “Generate Origin-Destination Link” function).

Results:
Twenty nine percent of Washington state census tracts had WIC-authorized stores and only 1.7% had at least one WIC-authorized ethnic store. Census tracts with high proportions of both foreign-born individuals and WIC-eligible children had the highest proportion of WIC-authorized ethnic stores (14.5%) and the shortest distance to the nearest WIC-authorized ethnic store (3.0 km) when compared to census tracts with low proportions of foreign-born individuals and WIC-eligible children (0.5% and 20.3 km, respectively; p<0.001).

Conclusions:
While census tracts with higher proportions of foreign-born and WIC-eligible populations had the greatest accessibility to WIC-authorized ethnic stores, WIC-authorized ethnic stores are rare in Washington state. Washington WIC should consider loosening store authorization criteria to make it easier for ethnic stores to become authorized and, thus, better meet the cultural needs of WIC participants of immigrant backgrounds.

Purpose
Veggie Van (VV) is a multi-level evidence-based mobile produce market intervention which has shown increases in fruit and vegetable consumption in lower-income communities. We conducted a hybrid type 1 effectiveness-implementation study to understand the impact of a VV intervention delivered by community partners on food security and diet-related behaviors.

Methods
In partnership with 9 community organizations, we conducted a cluster-randomized trial in 34 communities in 6 states in the United States. Partners selected community sites (e.g., community centers, churches) that reached lower-income individuals with limited access to healthy food. Between 2020-2022, sites were randomized in pairs to receive the VV intervention or a planning condition (delayed intervention control). Eligible study participants were age 18+, the primary shopper, and lived near/around the community site. Data collection included surveys on food insecurity, nutrition-related behaviors and perceptions, and two 24-hours dietary recalls at baseline and 1-year follow-up. We used SAS PROC GLIMIX to examine the effect of the intervention while adjusting for clustering within sites and baseline values.

Results
Across participants (N=699) in 34 communities, there was a non-significant (p=0.2) 7.5 percentage-point increase in the rate of high food security (from 47.7% to 55.2%) in VV intervention communities compared to a 3.8 percentage-point increase (from 47.0% to 50.8%) in control communities. Within communities that entered the study after the peak of COVID-19 related shutdowns (2021 or later) VV customers had significantly better (p=0.01) average food security scores (n=102, adj. mean=1.4, SE=0.18) after 1 year than non-shoppers (n=201, adj. mean=2.0, SE 0.15) using the USDA screener where lower scores indicate higher food security. While we saw trends of higher fruit and vegetable consumption at VV intervention sites and among customers, there were no statistically significant differences.

Conclusions
COVID-19 negatively impacted data collection, leading to reduced sample size and power, as well as implementation of the VV model. Additionally, highly fluctuating rates of food insecurity, increased access to food benefits, and changing dietary patterns during this period likely affected outcomes. Despite these limitations, VV customers improved their food security. Future research will examine how fidelity to the VV model by partners affects participant outcomes.

Purpose: To describe the evaluation approach and baseline results of the Rhode Island (RI) Retail Supplemental Nutrition Assistance Program (SNAP) Incentive, “Eat Well Be Well.” This is the first statewide nutrition incentive program in the USA to provide a $0.50 credit for every $1.00 spent on fresh F&V at qualified retailers to SNAP customers.

Methods: “Eat Well Be Well” is being evaluated using a pre-post intervention-comparison study design to examine whether the incentive affects F&V intake among SNAP participants, with Connecticut as the comparison state. Baseline data were collected pre-policy implementation between May-September 2023 (follow-up May-Aug 2024). Participants (N= 1,253) completed a 45-minute online survey consisting of socio-demographic and food shopping questions and a food frequency questionnaire hosted by VioScreen. Recruitment included community partner engagement and WIC text-message blasts. Due to the risk of bots and duplicate entries, numerous strategies including the use of Captcha, geolocation, and single-use QR codes were implemented. Data were examined continuously for integrity; those with implausible dietary data were contacted by an RA to readminister the questionnaire via Zoom.

Results: After excluding those that had greater than 95 percentiles for F&V intake, the analytic sample consisted of 621 individuals from RI and 632 from CT. Mean age of participants was 35.2±11.7, 91.6% were female, 20.3% spoke mostly Spanish at home, 22.7% reported having full-time employment and 15.3% reported having a college degree. Participants in RI and CT were largely similar, though there were more Spanish-speaking participants and college graduates in CT vs. RI (22.0 vs. 18.7% and 17.1 vs. 13.5%, respectively). Most reported that a supermarket was their primary outlet for food shopping (71.7%) and that a lack of money was their primary barrier to accessing food (39.7%). The mean intake of total F was 2.4±2.0 and of total V was 2.3±1.5 cup equivalents.

Conclusions: Using a complex online survey enabled rapid recruitment of a large sample and timely policy evaluation, while employing a rigorous study design. This survey methodology can help inform future large online surveys. The results of this evaluation will have important implications for policymakers seeking large-scale implementation of nutrition incentives.