Food acquisition methods and correlates of food insecurity in adults on probation in Rhode Island

Abstract

Background: Individuals under community corrections supervision may be at increased risk for food insecurity because they face challenges similar to other marginalized populations, such as people experiencing housing instability or substance users. The prevalence of food insecurity and its correlates have not been studied in the community corrections population.

Methods: We conducted a cross-sectional study in 2016, surveying 304 probationers in Rhode Island to estimate the prevalence of food insecurity, identify food acquisition methods, and determine characteristics of groups most at-risk for food insecurity. We used chi-square and Fisher's exact tests to assess differences in sociodemographics and eating and food acquisition patterns, GIS to examine geospatial differences, and ordinal logistic regression to identify independent correlates across the four levels of food security.

Results: Nearly three-quarters (70.4%) of the participants experienced food insecurity, with almost half (48.0%) having very low food security. This is substantially higher than the general population within the state of Rhode Island, which reported a prevalence of 12.8% food insecurity with 6.1% very low food security in 2016. Participants with very low food security most often acquired lunch foods from convenience stores (and less likely from grocery stores) compared to the other three levels of food security. Participants did not differ significantly with regards to places for food acquisition related to breakfast or dinner meals based upon food security status. In adjusted models, being homeless (AOR 2.34, 95% CI: 1.31, 4.18) and depressed (AOR 3.12, 95% CI: 1.98, 4.91) were independently associated with a greater odds of being in a food insecure group. Compared to having help with meals none of the time, participants who reported having meal help all of the time (AOR 0.28, 95% CI: 0.12, 0.64), most of the time (AOR 0.31, 95% CI: 0.15, 0.61), and some of the time (AOR 0.54, 95% CI: 0.29, 0.98) had a lower odds of being in a food insecure group. Food insecure participants resided in different neighborhoods than food secure participants. The highest density of food insecure participants resided in census tracts with the lowest median incomes for the general population. The areas of highest density for each level of food security for our participants were in the census tracts with the lowest levels of full-time employment for the general population.

Conclusions: The prevalence of food insecurity and very low food security were markedly higher in our probation population compared to the general RI population. These findings suggest that access to food on a regular basis is a challenge for adults on probation. Depression and being homeless were independently associated with a greater odds of being in a food insecure group. In addition to intervening directly on food insecurity, developing interventions and policies that address the contributing factors of food insecurity, such as safe housing and treatment for depression, are critical.

Fig 1. Conceptual framework for the relationships between potential correlates and outcomes of food insecurity.

Many of these relationships can be bidirectional with food insecurity, which adds to the complexity of this framework.

Fig 2. Percentage of adults on probation reporting each indicator of food insecurity in the last 30 days, by food security status (n = 304), Rhode Island, 2016.

For each of the ten indicators for food insecurity, the percentages of each level of food security that reported an affirmative response to each indicator are shown. For the indicators, cut the size of a meal or skipped a meal and did not eat for a whole day, the mean number of days that individuals that provided an affirmative response to these indicators are represented by food security level.

Fig 3. Kernel density estimates of probationers place of residence by food security status, 2016.

(A) Presents where participants with high food security reside. (B) Presents where participants with marginal food security reside. (C) Presents where participants with low food security reside. (D) Presents where participants with very low food security reside. The counts for each ramp represent the number of people per square mile. (E) Presents the median income ($) of the general population by quintiles at the census tract level. (F) Presents the employment rate of adults aged 16–64 years of the general population by quintiles at the census tract level. The blue box provides a study frame to reference the Kernel density estimates. This study frame was selected to include the majority of participants that lived within the catchment area for the specific probation office that was the venue for the study.