Food insecurity and risk of nutrition insecurity among Supplemental Nutrition Assistance Program participants in Rhode Island and Connecticut, USA

Objective: To 1) describe food insecurity and risk of nutrition insecurity (henceforth nutrition insecurity); 2) test the associations between perceived food access and neighborhood environment and food and nutrition insecurity, and differences in these associations; and 3) test the associations between food and nutrition insecurity and diet quality, among a sample of adults with low income. Methods: Between May-September 2023, Supplemental Nutrition Assistance Program (SNAP) participants in Rhode Island and Connecticut, USA (n = 1234) completed a food frequency questionnaire, from which we calculated healthy eating index (HEI)-2015 scores. An online survey included questions on perceived food access barriers and the food environment, and food and nutrition security. We used separate adjusted regression models to estimate correlates associated with food and/or nutrition insecurity and their associations with diet quality. Results: Individuals were 35 years old, on average, 92 % were women, 43 % identified as Hispanic, and 58 % and 30 % were food and nutrition insecure, respectively. The average HEI-2015 score was 64. Lack of money was associated with an 8-fold higher odds of experiencing food insecurity (95 % Confidence Interval [CI] = 5.76, 10.67). The largest magnitude of association with nutrition insecurity was having few or no full-service grocery stores nearby (Odds Ratio[OR] = 2.27; 95 % CI = 1.27, 4.06), followed by lack of money and limited transportation. Associations between food and nutrition insecurity and HEI-2015 were negative but not statistically significant. Conclusions: The prevalence of food insecurity among SNAP participants was higher than Americans, on average. Perceived food access barriers were associated with food and nutrition insecurity.