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Reductions in public health obesity prevention interventions due to COVID-19 disproportionately affect neighborhoods with pre-existing health inequities

  • Program: Community Health Planning and Policy Development
  • Objective: This study aimed to characterize changes in Supplemental Nutrition Assistance Program Education (SNAP-Ed) interventions implemented by local public health departments (LHDs) in California during COVID19 and explore the association of neighborhood-level socioeconomic factors with COVID19-related changes in these activities. Design: SNAP-Ed intervention data reported in a national database by California LHDs for federal fiscal years 2019 and 2020 were matched with census tract level data from the American Community Survey and California Healthy Places Index to analyze inequities in COVID19-related changes in SNAP-Ed implementation. Setting: SNAP-Ed interventions implemented by California LHDs in diverse settings Main Outcome Measures: Change in the number of California LHD SNAP-Ed sites and programs, number of people reached, and intervention dose between 2019 and 2020. Analysis: For California LHD SNAP-Ed in 2019 and 2020 the following were measured by census tract: the number of programs and sites, people reached, program sessions and hours, policy systems and environment changes, and intervention dose. Number of sites and programs by setting (schools, early care, and education, after/before school programs, food distribution, healthcare services, and other) were also measured. Models estimated associations between census tract characteristics (urbanicity, percentage by race-ethnicity, at or below 185% of the Federal Poverty Level and under 18 years of age, and quartiles of the California Healthy Places Index) and the measured changes in California LHD SNAP-Ed between 2019 and 2020. Results: Faced with the challenges of working under COVID19 restrictions, in 2020, the mean number of programs and sites, number of people reached, and intervention dose decreased by census tract. Decreases in the number of programs and sites were highest in early care and education, schools, and after-school program settings. There were small increases in the number of food distribution sites that implemented policy, systems, and environmental changes. Greater decreases in SNAP-Ed programming were observed in census tracts with higher prevalence of poverty and the least healthy pre-existing neighborhood conditions, as measured by the Healthy Places Index. Conclusions and Implications: While SNAP-Ed programming by California LHDs declined throughout the state during COVID19, neighborhoods with pre-existing inequities were disproportionately affected by these program reductions. Increases in food distribution sites indicate that LHDs adjusted priorities to address the heightened need in that area. Prioritization of SNAP-Ed in disadvantaged neighborhoods is warranted to address inequities that may have been exacerbated by COVID-19-related reductions in obesity prevention efforts.
Erin E Esaryk
Nutrition Policy Institute
Research Data Analyst
  • Linked Session ID: 947609
  • Authors: Erin E Esaryk, Carolyn D Rider, Gail Woodward-Lopez
    Nutrition Policy Institute
  • Learning Outcome 1: Describe changes due to COVID-19 in SNAP-Ed interventions by local health departments in California
  • Learning Outcome 2: Demonstrate how changes in SNAP-Ed interventions due to COVID-19 disproportionately affected neighborhoods with greater poverty and less healthy conditions.
  • Learning Outcome 3: Identify how SNAP-Ed agencies could ameliorate current, and avoid future, programmatic inequities in the face of public health emergencies.
  • Linked Session Title: CHPPD POSTER SESSION 8