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Farmers’ Market Incentives for Low-Income Families: Who Uses, How Much, and Why

      Introduction

      Focusing on participation and utilization, this research helps to assess the potential impact and contributions of farmers’ market incentive programs, often seen as means for improving nutrition and preventing disease among low-income families.

      Methods

      Evaluating the largest farmers’ market incentive program in the U.S. (California Market Match), this study used (1) 3 administrative databases (n=1,469, 6,799, and 30,506), (2) a participant survey (n=2,723), and (3) longitudinal interviews (n=163) with active and former participants. Quantitative data were analyzed with contingency tables and multiple regression. Qualitative data were coded into analytically significant themes. Data were collected in 2015–2018 and analyzed in 2018–2021.

      Results

      Participation was typically low and varied across localities (3.7%–19.8% of eligible families in a sample of ZIP codes). According to administrative records, market visits by participants in 2 California regions averaged 2.18 and 3.12 per season. However, 77.1% of participants in the shopper survey indicated that they were repeat customers, and 51.0% indicated that they were regular utilizers. Deterrents to utilization included perceptions of inconvenience and high prices but not availability of produce in the community or travel time to markets. Utilization was most frequent among Asian shoppers and residents of Southern California outside Los Angeles County.

      Conclusions

      Farmers’ market incentive programs such as Market Match appear likely to benefit population health through a core of committed shoppers. Improvement in participation and utilization may be attained through a better understanding of the communities that the markets are intended to serve.
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      References

        • Black AP
        • Brimblecombe J
        • Eyles H
        • Morris P
        • Vally H
        • O Dea K.
        Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review.
        BMC Public Health. 2012; 12: 1099https://doi.org/10.1186/1471-2458-12-1099
        • Thomson K
        • Hillier-Brown F
        • Todd A
        • McNamara C
        • Huijts T
        • Bambra C.
        The effects of public health policies on health inequalities in high-income countries: an umbrella review.
        BMC Public Health. 2018; 18: 869https://doi.org/10.1186/s12889-018-5677-1
        • Katikireddi SV
        • Skivington K
        • Leyland AH
        • Hunt K
        • Mercer SW.
        The contribution of risk factors to socioeconomic inequalities in multimorbidity across the lifecourse: a longitudinal analysis of the Twenty-07 cohort.
        BMC Med. 2017; 15: 152https://doi.org/10.1186/s12916-017-0913-6
        • National Center for Chronic Disease Prevention and Health Promotion
        Division of Nutrition, Physical Activity, and Centers for Disease Control and Prevention.
        State indicator report on fruits and vegetables 2013. Centers for Disease Control and Prevention, Atlanta, GA2013 (Accessed December 6, 2021)
        • Usual dietary intakes: food intakes, U.S. population, 2007–10
        Epidemiology and Genomic Research Program.
        National Cancer Institute, 2020 (Updated October 31, 2019. Accessed April 12, 2020)
        • Darmon N
        • Drewnowski A.
        Does social class predict diet quality?.
        Am J Clin Nutr. 2008; 87: 1107-1117https://doi.org/10.1093/ajcn/87.5.1107
        • Wang Y
        • Beydoun MA.
        The obesity epidemic in the United States – gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis.
        Epidemiol Rev. 2007; 29: 6-28https://doi.org/10.1093/epirev/mxm007
        • Braveman PA
        • Cubbin C
        • Egerter S
        • Williams DR
        • Pamuk E.
        Socioeconomic disparities in health in the United States: what the patterns tell us.
        Am J Public Health. 2010; 100: S186-S196https://doi.org/10.2105/AJPH.2009.166082
        • Kumar A
        • Arora A
        • Sharma P
        • et al.
        Is diabetes mellitus associated with mortality and severity of Covid-19? A meta-analysis.
        Diabetes Metab Syndr. 2020; 14: 535-545https://doi.org/10.1016/j.dsx.2020.04.044
        • Poly TN
        • Islam MM
        • Yang HC
        • et al.
        Obesity and mortality among patients diagnosed with COVID-19: a systematic review and meta-analysis.
        Front Med (Lausanne). 2021; 8620044https://doi.org/10.3389/fmed.2021.620044
      1. USDA Economic Research Service. Food Access Research Atlas.https://www.ers.usda.gov/data-products/food-access-research-atlas/about-the-atlas. Accessed February 11, 2022.

        • Chen D
        • Jaenicke EC
        • Volpe RJ.
        Food environments and obesity: household diet expenditure versus food deserts.
        Am J Public Health. 2016; 106: 881-888https://doi.org/10.2105/AJPH.2016.303048
        • Morland KB
        • Evenson KR.
        Obesity prevalence and the local food environment.
        Health Place. 2009; 15: 491-495https://doi.org/10.1016/j.healthplace.2008.09.004
        • Moore LV
        • Diez Roux AV
        • Nettleton JA
        • Jacobs Jr, DR
        Association of the local food environment with diet quality–a comparison of assessments based on surveys and geographic information systems: the multi-ethnic study of atherosclerosis.
        Am J Epidemiol. 2008; 167: 917-924https://doi.org/10.1093/aje/kwm394
        • Alcott H
        • Diamond R
        • Dube JP
        • Handbury J
        • Rahkovsky SM.
        Food deserts and the causes of nutritional inequality.
        Q J Econ. 2019; 134: 1793-1844https://doi.org/10.1093/qje/qjz015
        • Barker L
        • Crespo R
        • Gerzoff RB
        • Denham S
        • Shrewsberry M
        • Cornelius-Averhart D.
        Residence in a distressed county in Appalachia as a risk factor for diabetes, Behavioral Risk Factor Surveillance System, 2006-2007.
        Prev Chronic Dis. 2010; 7 (PMID: 20712931. PMCID: PMC2938398): A104
        • Dean WR
        • Sharkey JR.
        Rural and urban differences in the associations between characteristics of the community food environment and fruit and vegetable intake.
        J Nutr Educ Behav. 2011; 43: 426-433https://doi.org/10.1016/j.jneb.2010.07.001
        • Leggat M
        • Kerker B
        • Nonas C
        • Marcus E.
        Pushing produce: the New York City Green Carts initiative.
        J Urban Health. 2012; 89: 937-938https://doi.org/10.1007/s11524-012-9688-4
        • Wetherill MS
        • Gray KA.
        Farmers’ markets and the local food environment: identifying perceived accessibility barriers for SNAP consumers receiving temporary assistance for needy families (TANF) in an urban Oklahoma community.
        J Nutr Educ Behav. 2015; 47: 127-133.e1https://doi.org/10.1016/j.jneb.2014.12.008
        • Leone LA
        • Haynes-Maslow L
        • Ammerman AS.
        Veggie Van Pilot study: impact of a mobile produce market for underserved communities on fruit and vegetable access and intake.
        J Hunger Environ Nutr. 2017; 12: 89-100https://doi.org/10.1080/19320248.2016.1175399
        • Seguin RA
        • Morgan EH
        • Hanson KL
        • et al.
        Farm Fresh Foods for Healthy Kids (F3HK): an innovative community supported agriculture intervention to prevent childhood obesity in low-income families and strengthen local agricultural economies.
        BMC Public Health. 2017; 17: 306https://doi.org/10.1186/s12889-017-4202-2
        • Moran AJ
        • Gu Y
        • Clynes S
        • Goheer A
        • Roberto CA
        • Palmer A.
        Associations between governmental policies to improve the nutritional quality of supermarket purchases and individual, retailer, and community health outcomes: an integrative review.
        Int J Environ Res Public Health. 2020; 17: 7493https://doi.org/10.3390/ijerph17207493
        • Bowling AB
        • Moretti M
        • Ringelheim K
        • Tran A
        • Davison K.
        Healthy Foods, Healthy Families: combining incentives and exposure interventions at urban farmers’ markets to improve nutrition among recipients of U.S. federal food assistance.
        Health Promot Perspect. 2016; 6: 10-16https://doi.org/10.15171/hpp.2016.02
        • Jilcott Pitts SB
        • Wu Q
        • Demarest CL
        • et al.
        Farmers’ market shopping and dietary behaviours among Supplemental Nutrition Assistance Program participants.
        Public Health Nutr. 2015; 18: 2407-2414https://doi.org/10.1017/S1368980015001111
        • Olsho LE
        • Payne GH
        • Walker DK
        • Baronberg S
        • Jernigan J
        • Abrami A.
        Impacts of a farmers’ market incentive programme on fruit and vegetable access, purchase and consumption.
        Public Health Nutr. 2015; 18: 2712-2721https://doi.org/10.1017/S1368980015001056
        • Savoie-Roskos M
        • Durward C
        • Jeweks M
        • LeBlanc H
        Reducing food insecurity and improving fruit and vegetable intake among farmers’ market incentive program participants.
        J Nutr Educ Behav. 2016; 48: 70-76.e1https://doi.org/10.1016/j.jneb.2015.10.003
        • Freedman DA
        • Flocke S
        • Shon EJ
        • et al.
        Farmers’ market use patterns among Supplemental Nutrition Assistance Program recipients with high access to farmers’ markets.
        J Nutr Educ Behav. 2017; 49: 397-404.e1https://doi.org/10.1016/j.jneb.2017.01.007
        • Pellegrino S
        • Bost A
        • McGonigle M
        • et al.
        Fruit and vegetable intake among participants in a District of Columbia farmers’ market incentive programme.
        Public Health Nutr. 2018; 21: 601-606https://doi.org/10.1017/S1368980017003020
      2. Vericker T, Dixit-Joshi S, Taylor J, et al. The evaluation of food insecurity nutrition incentives (FINI) interim report. Washington, DC: U.S. Department of Agriculture, Food and Nutrition Service. https://www.fns.usda.gov/snap/evaluation-food-insecurity-nutrition-incentives-interim-report. Published May 2019. Accessed July 12, 2021.

        • Cohen AJ
        • Lachance LL
        • Richardson CR
        • et al.
        “Doubling up” on produce at Detroit farmers markets: patterns and correlates of use of a healthy food initiative.
        Am J Prev Med. 2018; 54: 181-189https://doi.org/10.1016/j.amepre.2017.10.005
        • Ratigan AR
        • Lindsay S
        • Lemus H
        • et al.
        Factors associated with continued participation in a matched monetary incentive programme at local farmers’ markets in low-income neighbourhoods in San Diego, California.
        Public Health Nutr. 2017; 20: 2786-2795https://doi.org/10.1017/S1368980017001549
        • Sudman S.
        Improving the quality of shopping center sampling.
        J Mark Res. 1980; 17: 423-431https://doi.org/10.1177/002224378001700402
        • Strauss A
        • Corbin J.
        Basics of qualitative research.
        Sage, Los Angeles, CA1998
        • U.S. Department of Agriculture
        Food and Nutrition Service.
        USDA fiscal year 2019 year end summary. U.S. Department of Agriculture, Food and Nutrition Service, Washington, DC2019 (Accessed May 4, 2020)
        • Dimitri C
        • Oberholtzer L
        • Zive M
        • Sandolo C.
        Enhancing food security of low-income consumers: an investigation of financial incentives for use at farmers markets.
        Food Policy. 2015; 52: 64-70https://doi.org/10.1016/j.foodpol.2014.06.002
        • Lowery B
        • Sloane D
        • Payán D
        • Illum J
        • Lewis L.
        Do farmers’ markets increase access to healthy foods for all communities? Comparing markets in 24 neighborhoods in Los Angeles.
        J Am Plann Assoc. 2016; 82: 252-266https://doi.org/10.1080/01944363.2016.1181000
        • Rummo PE
        • Noriega D
        • Parret A
        • Harding M
        • Hesterman O
        • Elbel BE.
        Evaluating a USDA program that gives SNAP participants financial incentives to buy fresh produce in supermarkets.
        Health Aff (Millwood). 2019; 38: 1816-1823https://doi.org/10.1377/hlthaff.2019.00431
        • Thaler RH
        • Sunstein CR.
        Nudge: Decisions About Health, Wealth, and Happiness.
        Prager, London, United Kingdom2009