Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: A mixed methods study in Vermont

Abstract

Background Federal nutrition assistance programs serve as safety nets for many American households, and participation has been linked to increased food security and, in some instances, improved diet quality and mental health outcomes. The COVID-19 pandemic brought new and increased economic, social, and psychological challenges, necessitating inquiry into how nutrition assistance programs are functioning and associated public health outcomes. Methods Using data from a representative statewide survey administered in Vermont (n = 600) during the early months of the COVID-19 pandemic, we examine participant experiences with the 3 major federal nutrition assistance programs: the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and school meal programs. We explore quantitative and qualitative responses regarding perceptions of program utility, and use nearest neighbors matching analyses in combination with bivariate statistical tests to assess associations between program participation and food insecurity, perceived stress, and fruit and vegetable intake as indicators of dietary quality. Results One in four respondents (27.3%) used at least one federal nutrition assistance program. As compared to non-participants, we find higher rates of food insecurity among program participants (57.5% vs. 18.1%; p < .001), an association that persists even when we compare similar households using matching techniques (p ≤ .001). From matched analyses, we find that, compared to low-income non-participants, low-income program participants are less likely to meet fruit intake recommendations (p = 0.048) and that low-income SNAP and WIC participants are less likely to meet vegetable intake recommendations (p = 0.035). We also find lower rates of perceived stress among low-income school meal participant households compared to low-income nonparticipants (p = 0.039). Despite these mixed outcomes, participants broadly valued federal nutrition assistance programs, characterizing them as helpful or easy to use. Conclusions We find that federal nutrition assistance programs as a group were not sufficient to address food insecurity and stress or increase fruit and vegetable intake in the state of Vermont during the early months of the COVID-19 pandemic. Nonetheless, participants perceived benefits from participation in these programs. Optimizing the utility of nutrition assistance programs depends on critical examination of their functioning under conditions of great stress.