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This dissertation contains three essays that look at the impact of food assistance programs on individuals behavior. The United States government offers a variety of welfare programs meant to provide assistance to families and individuals. This dissertation focuses on two specific food assistance programs: the Supplemental Nutrition Assistance Program (SNAP) and National School Lunch Program (NSLP). While the NSLP is not traditionally thought of as a welfare program, it provides subsidized meals for all school children, regardless of income, and further subsidizes meals for children from low-income households. The first essay uses primary data to determine if pre-ordering and nudging affect childrens selection behavior in the lunchroom. Research on food assistance programs and nutrition is particularly important given recent legislation changes and increases in adolescent obesity. The second essay analyzes the impact of students a la carte choices in the lunchroom on their selection of fruit, vegetables, and low fat dairy. The third essay studies the impact that state policies have on an individuals decision to migrate to another state.
In recent years the `farm to table' trend, the idea of understanding linkages between agricultural supply, food systems, and the food that is consumed, has been growing in popularity. This dissertation takes this idea a step further and examines topics on the progression from `farm to health outcomes.' It is important to recognize not only that food systems impact the way consumers eat, but that those food choices impact health outcomes and the way that medical care is consumed. The three essays of this dissertation examine three separate points along this continuum to improve the understanding of how food systems, food choice, health outcomes, and healthcare consumption interact. The first essay evaluates factors associated with school districts' decisions to participate in farm to school (FTS) programs. I leverage the USDA's Farm to School Census to analyze factors associated with FTS participation, the types of FTS activities implemented, and the challenges faced by participating school districts. I use spatially articulate data to estimate the spatial spillover effects of FTS participation. The results demonstrate that both school characteristics and local farm production factors are associated with FTS participation. The estimated spatial spillover effect is positive, suggesting that areas with a high penetration of FTS activities have lower barriers associated with implementing FTS programs. In my second essay, I shift to evaluating how parent-child pairs make the daily school lunch decision. Meals served in the National School Lunch Program (NSLP) are on average more healthful than alternatives, implying that increasing participation in the NSLP can improve nutrition for a large number of children. However, there is little understanding of the household decision process that determines participation in the NSLP. This study uses a parent-child choice experiment to assess the impact of both parent and child on NSLP participation. The results show that both have a significant impact on the chosen meal, where parents are concerned with meal palatability and nutrition, while the child only cares about palatability. The decision is also influenced by the household structure and demographics, and the inclusion of local foods in the school lunch option. My final essay evaluates how access to medical care can impact lifestyle choices. I evaluate if there is an ex ante moral hazard effect in health insurance markets. Ex ante moral hazard occurs when an individual takes on more risk knowing they will not bear the full cost of the consequences. In the case of health insurance, this could mean taking on unhealthful eating habits knowing that if these habits lead to illness the cost of care will be covered by insurance. Using panel data from the National Longitudinal Youth Survey 1997, I find evidence of an ex ante moral hazard effect in BMI, binge drinking, and smoking, suggesting that people take on less healthful behaviors, holding all else constant, when they have health insurance. The existence of ex ante moral hazard suggests that insurance companies can seek efficiency gains by finding ways to structure policies that diminish this moral hazard effect.
This dissertation's three essays explore the determinants of food insecurity for rural farm households, the influence of rainfall variability and long-run changes in rainfall levels on the migration decisions of working-age household heads, and the distributional impacts in core and periphery regions of food assistance to households in the hinterland. The first essay examines how socio-economic characteristics of households, local conditions, and public programs are associated with the probability that a farm household in rural Malawi is food insecure. The statistical analysis uses nationally representative data for 7,965 randomly-selected households interviewed during 2004/05 for the second Malawi Integrated Household Survey (IHS-2). Regressions are estimated separately for households in the north, center, and south of Malawi to account for spatial heterogeneity. Results of a Probit regression model reveal that households are less likely to be food insecure if they have more cultivated land per capita, receive agricultural field assistance, reside in a community with an irrigation scheme, and are headed by an individual with a high school degree. Factors that positively correlate with a household's food insecurity are number of household members and distance to markets. The second essay uses nationally representative data from Malawi's 2004/05 Integrated Household Survey (IHS-2) to examine whether rainfall conditions influence a rural worker's decision to make a long-term move to an urban or another rural area. Results of a Full Information Maximum Likelihood regression model reveal that (1) rainfall shocks constrain migration, most likely by making it difficult for prospective migrants to cover costs of migration, (2) migrants choose to move to communities where rainfall variability is lower, and (3) rainfall shocks have larger negative effects on the earnings of recent migrants than on long-time residents' earnings. The third essay examines how benefits from food assistance programs to needy households spillover between areas and among household income groups in the United States. We study the effect of the Supplemental Nutrition Assistance Program (SNAP) in the Portland Oregon metro Core and its Periphery trade area, using a Multiregional Input- Output (MRIO) model based on a Social Accounting Matrix (SAM). The analysis captures direct, indirect and induced effects of SNAP on each region and spillover effects on the other region. SNAP benefits to the lower income household classes in each region are traced to their effects on the local economy in each region, and to the effects on household income by income class. The analysis finds that (1) the economic impact on the Portland Core from a given level of SNAP benefits to households in the Periphery is greater than the economic impact in the Periphery from the same level of SNAP benefits to households in the Core; (2) high-income households benefit more than low-income households from the indirect and induced economic impact of SNAP.
As the world becomes more diverse and more integrated, examining how racial, political, and food diversity influences individuals' consumption, behaviors, and health becomes more paramount than ever before. The United States grows more racially diverse with large racial and ethnic shifts on the horizon regarding the proportion of the population. With the U.S. population expected to become more diverse, individuals' political affiliation becoming more prevalent to personal identity, and food security becoming more problematic; we examine how racial, political, and food diversity influences individuals' consumption and preferences with the intent to understand what changes in health and preferences may occur. These essays contribute to the literature in a novel way by understanding how the local racial, political, and food environments impact individual consumption and behavior choices. Additionally, these papers novel approaches yield strong evidence that these different measures of diversity play an important and larger role in individuals' daily lives then realized. We utilize a cutting edge propensity score matching technique to understand the impact of the food access program WIC (Women, Infants, and Children Supplemental Health Program) in "WIC Participation and Relative Quality of Household Food Purchases: Evidence from FoodAPS" essay. In this essay, we show the health benefits participants in WIC receive when participating in the p rogram. Second, we leverage a special type of survey called a List Experiment to understand respondents' social desirability bias given their political environment in the essay titled "Social Desirability Bias and Polling Errors in the 2016 Presidential Election." In this essay, we show that people respond differently to the question of whether they support a particular presidential candidate when they are given the opportunity to directly or indirectly express this support. Lastly, we explore how local racial diversity directly impacts an individual's healthy food consumption in the essay titled "Diversity and Health: Exploring Local Racial Diversity's Impact on Health Through Food Consumption". This final essay attempts to ascertain the associative effects of racial diversity on an individual's healthy food consumption. This result shows the dramatic impact racial diversity has on healthy food consumption by improving individuals' food intake, but concentrated on certain races. Overall, this dissertation shows the dramatic influence social and environmental context has on individual outcomes via health and preferences.
For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families. In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
"Empirical work shows that health insurance coverage improves children's health and that healthier children have better educational and labor market outcomes. This suggests that the benefits of higher insurance rates among children go beyond improvements in health. However, there are no investigations in the United States that track the long-term socioeconomic benefits of health insurance coverage during childhood. Using data from the Children of the National Longitudinal Survey of Youth to estimate family fixed effects models, I find evidence that health insurance coverage at ages 0-4 has a positive effect on test scores in mathematics, reading recognition, reading comprehension, and vocabulary at ages 5-14. The second essay in this dissertation, co-authored with Charles Courtemanche, investigates the effect of the Massachusetts health care reform on self-reported health. The main objective of this reform was to achieve universal health insurance coverage through a combination of insurance market reforms, mandates, and subsidies. This reform was later used as a model for the Patient Protection and Affordable Care Act (ACA). Using individual-level data from the Behavioral Risk Factor Surveillance System and a difference in differences estimation strategy, this essay provides evidence that this reform led to better overall self-assessed health. Several determinants of overall health, including physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity also improved. Public food assistance programs share the fundamental goal of helping needy and vulnerable people in the U.S. obtain access to nutritious foods that they might not otherwise be able to afford. These programs also have other objectives, such as improving recipients' health, furthering children's development and school performance. To investigate these broader impacts, the third chapter of this dissertation, co-authored with David Ribar, examines the relationship between participation in food assistance programs, family routines and time use. Results from fixed effects models estimated using longitudinal data from the Three-City Study indicate that SNAP participation is negatively associated with homework routines. WIC participation on the other hand, is positively associated with family routines in general and with dinner routines, homework routines, and family-time routines in particular."--Abstract from author supplied metadata.
Three essays on food insecurity and child welfare.