Supplemental nutrition assistance program (SNAP) participation and food cost in rural appalachia

Background: Food cost influences the decision and ability to eat a healthy diet, particularly in rural Appalachian food deserts. These regions have high rates of unemployment, food insecurity and a significant number of families dependent on SNAP to meet nutrition needs. Food price indices rose 4.8 and 2.75% in 2011 and 2012, respectively, but the average monthly SNAP benefit in Kentucky has increased by only $.38 since 2010. The purpose of this study was to determine whether food costs were associated with SNAP participation rates, nutritional quality of food and geographical location. Method: The Overall Nutritional Quality Index and cost of 92 foods were assessed seasonally in four Kentucky counties. The counties were purposively chosen to include a rural food desert with a high rate of SNAP participation; a non-food desert, rural area with high SNAP participation; an urban county with low SNAP participation; and an urban area with moderate SNAP participation. Repeated measures ANOVA and post-hoc analysis were used to assess differences in food cost by nutritional quality, geographical area and SNAP participation. Results: Food costs were higher in rural counties with high rates of SNAP participation and cost was highest in the rural food desert. Foods in the highest and lowest quartiles of nutritional quality were the most economical. Conclusion: SNAP participants in the rural counties are at greater risk of food insecurity and poor dietary habits. Cardiovascular disease is disproportionately higher in these counties and the inadequacy of SNAP benefits is most likely contributing to this disparity.