The article “Parent perceptions of changes in eating behavior during COVID-19 of school-aged children from Supplemental Nutritional Assistance Program Education (SNAP-Ed) eligible households in California” was recently published in the journal Preventive Medicine Reports. The study examines the impact of the COVID-19 pandemic on the eating behaviors of school-aged children from households with low income eligible for the Supplemental Assistance Program Education (SNAP-Ed) in California. Researchers assessed parent perceptions of changes in their children's eating habits throughout the pandemic, identifying shifts in dietary patterns that included a decreased use of school meals, and other changes observed by parents such as cooking at home, fast food, and fruits and vegetable consumption. The research underscores the need for tailored strategies in schools and at home to support the nutritional well-being of children during future public health emergency conditions. The study was led by Nutrition Policy Institute researchers Suzanne Rauzon, Sri Hewawitharana, Erin Esaryk, Hannah Thompson, Gail Woodward-Lopez, and California Department of Public Health co-authors Lauren Whetstone and Ingrid Cordon.

A recent study examined changes in Supplemental Nutrition Assistance Program Education programming by California's local health departments during the COVID-19 pandemic. Local health department SNAP-Ed programs comprise California's largest obesity prevention program. In March 2020, when schools and other institutions closed their doors in response to the COVID-19 emergency, the impact on public health programs like SNAP-Ed was immediate and large. As the pandemic continued, California's local health departments reported numerous challenges, including the diversion of staff, funding, and other resources from programs like SNAP-Ed to emergency response. Nutrition Policy Institute researchers measured the changes in local health department SNAP-Ed programming and documented dramatic reductions in reach and dose during the early stages of the pandemic. Reductions disproportionately impacted disadvantaged communities, including those with higher poverty, higher proportions of Black and Latino residents, and less healthy neighborhood conditions. Disproportionately reduced access to important health programs may have worsened health disparities in diet and physical activity-related chronic diseases, as well as increasing susceptibility to COVID-19. This study demonstrates the importance of an equity-centered approach to promoting healthy eating and active living, even—or perhaps especially—during public health emergencies. Study results were published in the journal SSM-Population Health by Gail Woodward-Lopez, Erin Esaryk, Sridharshi Hewawitharana, Janice Kao, Evan Talmage, and Carolyn Rider of NPI with funding from the USDA's Supplemental Nutrition Assistance Program Education.

The American Public Health Association holds an Annual Meeting & Expo for public health professionals to engage, collaborate, and network with the overarching goal of advancing the nation's health. This year's meeting in Boston, November 6-9, 2022 will celebrate 150 Years of Creating the Healthiest Nation: Leading the Path Toward Equity. Nutrition Policy Institute researchers will share findings that bring nutrition equity to the forefront of federal programs, school nutrition, community health, health literacy, and the food retail environment. A list of the poster presentations and live oral presentations is found below. 

Retail food environment: 

• What can we learn from California's investment in the Healthy Stores Refrigeration Grant Program? 
  Authors: Carolyn Chelius, Caroline Long, Taylor Baisey, Wendi Gosliner
  Wednesday, November 9, 8:30 a.m. - 10:00 a.m.; oral presentation

School meals: 

• Providing School Meals to All Students Free of Cost: Challenges and Benefits Reported by School District Foodservice Professionals to Inform California's Policy Implementation
  Authors: Wendi Gosliner, Monica Zuercher, Juliana Cohen, Christina Hecht, Michele Polacsek, Kenneth Hecht, Lindsey Turner, Marlene Schwartz, Anisha Patel, Lorrene Ritchie
  Monday, November 7, 4:30 p.m. - 6:00 p.m.; oral presentation

• Impact of a teacher intervention to encourage students to eat school lunch 
  Authors: Hannah Thompson, Stephanie Machado, Kristine Madsen, Renata Cauchon-Robles, Marisa Neelon, Lorrene Ritchie
  Monday, November 7, 4:30 p.m. - 6:00 p.m.; oral presentation

SNAP-Ed: 

• Evaluation identifies the most promising combinations of school-based Supplemental Nutrition Assistance Program-Education (SNAP-Ed) interventions for improving student fitness
  Authors: Sridharshi Hewawitharana, Gail Woodward-Lopez, Punam Ohri-Vachaspati, Francesco Acciai, Hannah R. Thompson, Wendi Gosliner
  Monday, November 7, 4:30 p.m. - 6:00 p.m.; oral presentation

• Reductions in public health obesity prevention interventions due to COVID-19 disproportionately affect neighborhoods with pre-existing health inequities
  Authors: Erin E Esaryk, Carolyn D Rider, Gail Woodward-Lopez
  Tuesday, November 8, Session 8; 3:00 p.m. - 4:00 p.m.; poster presentation

• A novel approach to measuring potential for health equity impact in community health interventions 
  Authors: Janice Kao, Gail Woodward-Lopez, Christina Becker, Carolyn Rider, Erin Esaryk, Evan Talmage
  Tuesday, November 8, Session 7; 3:00 p.m. - 4:00 p.m.; poster presentation

WIC: 

• Assessing changes associated with expanding the WIC Cash-Value Benefit for the purchase of fruits and vegetables among children age 1 to 5 years: a longitudinal study
  Authors: Marisa Tsai, Christopher Anderson, Catherine Martinez, Martha Meza, Lauren Au, Lorrene Ritchie, Shannon Whaley
  Tuesday, November 8, 2:30 p.m. - 4:00 p.m.; oral presentation

Other: 

• Impact of an arts-based public health literacy program delivered online to high school students during the COVID-19 pandemic
  Authors: Hannah Thompson, Jackie Mendelson, Maya Zamek, Gabriel Cortez, Dean Schillinger
  Wednesday, November 9, 12:30 p.m. - 2:00 p.m.; oral presentation

Food insecurity, which affects college students at roughly four times the rate of the general population, is a detriment to their health and academic pursuits. Photo by Antor Paul on Unsplash

Nutrition Policy Institute researchers contribute to studies that inform policy changes

Marcela Gonzalez, who had wanted to be a physical therapist since she was a teenager, was in the final stage of realizing her dream.

But when she started in the PT program at the University of California San Francisco in 2021, a vexing struggle of her undergraduate years came back. Academic pressures and stomach troubles, compounded by financial worries, drained her of any energy and capacity to feed herself.

“I didn't eat; I lost a lot of weight because I just couldn't eat,” Gonzalez recalled. “I was too stressed out all the time; I was a mess.”

During her first year at UCSF, Gonzalez, for whom food has “always just been hard,” discovered that she qualified for CalFresh (California's version of the Supplemental Nutrition Assistance Program, formerly known as “food stamps”). Her participation in the program – as well as the presence of a campus food pantry – helped lift a heavy mental burden and allowed her to refocus on school.

By enrolling in CalFresh, UCSF student Marcela Gonzalez was able to refocus on school and continue on her path to become a physical therapist.

To understand the mechanisms that connect eligible students with CalFresh benefits, which could greatly improve their lives and education, University of California researchers interviewed UC campus staff responsible for guiding undergraduate and graduate students through the application process. Their recently published study, which involved researchers at UC Agriculture and Natural Resources' Nutrition Policy Institute, illuminated several major facilitators and barriers to CalFresh enrollment.

Campus-county coordination, boosting staffing key factors

Ensuring that college students have access to CalFresh is especially crucial, given that food insecurity affects that segment of the population roughly four times the rate of the general population, according to the study's principal investigator and co-author Suzanna Martinez, an associate professor in the department of epidemiology and biostatistics at UCSF.

It's estimated that more than 40% of college students face uncertain access to healthy food – and inflation, the rising cost of attending college and increasingly unaffordable housing are likely to swell those numbers.

That's why researchers say it's critical for campus staff who work on CalFresh outreach to collaborate with the financial aid office and the county office that administers the CalFresh program locally. Through close coordination, staff members can determine if students meet the necessary exemptions and help them with the paperwork.

“When that happens, it's much easier than when a student applies without their campus Basic Needs coordinator, or when they just go to the county and apply on their own,” Martinez explained. “Maybe they don't know all of the verification documents that have to be included, or they might not know their financial aid status.”

Erin Esaryk, NPI research data analyst and first author of the study published in the Journal of Nutrition Education and Behavior, also highlighted the need for increased campus staffing to help with CalFresh enrollment, as well as more outreach by campus and county staff to student populations about the benefits.

“When there's a lot of outreach, that helps alleviate some of the stigma, to normalize the receiving of CalFresh,” Esaryk said.

Helping others worry less about food

Gonzalez, for whom food has “always just been hard,” works to educate her classmates about CalFresh eligibility and the enrollment process.

Given her own history of travails, Gonzalez, the physical therapy student, wanted to help others at UCSF “de-stress” about food. In summer and fall 2021, she served as a “CalFresh ambassador” for her cohort of new PT students, developing presentations and guides that break down how to apply for or renew CalFresh benefits.

She became the go-to person for her classmates' questions on the logistics and details of applying for the program, and also encouraged fellow health-professional students who, like herself, did not think they would qualify.

“To take out less loans, or to not worry about food a little bit every week, is a great thing,” said Gonzalez, pointing out that subtracting food costs allows students to shave down their loans.

After helping introduce her classmates to CalFresh, she transitioned to working at the food pantry at the Parnassus campus. In addition to setting up and distributing the items, Gonzalez also posts on Instagram and TikTok (@ucsf_basicneeds) to promote the “food market,” which attracts about 100 students and campus community members every Thursday afternoon.

“You never know what you're going to get, but there's so much really good, fresh produce,” she said.

Campus food pantries deliver health benefits

Researchers are also studying how campus food pantries affect students' overall health, including easing the challenges of anxiety, depression and sleep deprivation. Another recent study published in the Journal of Nutrition Education and Behavior analyzed health-survey responses of 1,855 undergraduate and graduate students at all 10 UC campuses – before and after access to a campus food pantry.

“What we found was that students reported improvements in their perceived health and sufficient sleep,” said UCSF's Martinez, the lead author. “We also found that they reported fewer depressive symptoms, compared to before having access to the food pantry.”

By 2019, all UC campuses had established food pantries, although nationwide only about 25% of four-year colleges have one. The significant health benefits reported by UC students in this study give researchers hope that campus food pantries will see additional governmental support, in California and beyond.

In a recent study, students reported that college food pantries were a boon to their overall health. Photo by Aaron Doucett on Unsplash

“It was important to evaluate whether the food pantries were actually making a difference…if you don't have numbers or evidence, then you're not going to get funded to support future programming,” Martinez said.

Research guides state policy changes

Studies of food insecurity in the college setting have already informed policymaking aimed at smoothing the application process for CalFresh – benefits regarded by Martinez as a better long-term solution than food pantries, which constitute an emergency “short-term response” to the problem.

One example of the research's impact is a law passed last year in California that requires community colleges and California State University campuses to designate a campus-county liaison who would help students procure social services, including CalFresh. A separate law expanded the list of training programs within which students would potentially qualify for CalFresh, and another bill currently under consideration by the state Legislature would make the processing of students' CalFresh applications more consistent from county to county, through more standardized training of staff.

Meanwhile, on the research front, Esaryk, Martinez and their colleagues are completing a follow-up study on students and CalFresh enrollment, this time looking at the perspectives of county staff. And while their broader goal remains clarifying and streamlining student eligibility rules and processes at all levels, they remain focused on students and meeting their needs.

“Right now, our main mission is just to try to increase awareness of CalFresh for students and to let them know they may be eligible,” Martinez said, “and then assist them through that application process so they can actually get the benefits.”

In addition to Esaryk and Martinez, NPI director Lorrene Ritchie and Laurel Moffat of Washington State University are also authors of the CalFresh/SNAP benefits study, while co-authors of the college food pantry study are Ritchie, Gwen Chodur of UC Davis, Sevan Kaladijian of UC Irvine and Michael Grandner of the University of Arizona.