Results of the FY 2009 Needs Assessment Shelley Kuklish Epidemiologist Arizona Nutrition Network

Results of the FY 2009 Needs Assessment

Shelley Kuklish

Epidemiologist

Arizona Nutrition Network

Outline

• Population Overview

• Poverty

• Demographics of Food Stamp Recipients

• Nutrition Related Behavioral and Lifestyle Characteristics of Food Stamp Eligibles

• Food Purchasing Attitudes and Behaviors

• Partner Satisfaction Survey Results

Population Overview

•¾ of Arizona’s population is in Maricopa and Pima Counties

Source: 2006 Claritas Data

•Population is relatively young

•65% of the population in the state is <44 years of age

•Unemployment rate is similar to the national average (4.7% compared to 5.0%)

Source: Arizona Department of Economic Security

•Per capita income is lower than national average ($31,936 compared to $36,714)

•Navajo County had lowest per capita income ($19,505)

Poverty

PHOENIX

TUCSON

Source: US Census Data, 2000

Population in Poverty by Age Group, Arizona 2000

21%

30%

45%

19%

26%

40%

13%

18%

28%

8%

13%

24%

14%

20%

31%

<100% FPL <130% FPL <185% FPL

Under 5 years: 5-17 years 18-64 years 65+ years ALL AGES

Source: US Census, 2000. Categories are cumulative

2%

8%4%

27%

48%

27%30%

6%

13%

43%

13%

4%

25%22%

26%

0%

10%

20%

30%

40%

50%

60%

<130% 130 to <185% Not in Poverty

Elementary Some High School High School Graduate

Some College College Graduate

Educational Attainment by Poverty Level

Source: Behavior Risk Factor Surveillance System, 2007

Families <130% FPL by Family Type, Arizona 2000

Married couple,

w ith children

36%

Single Father w ith

children9%

Single Mother,

w ith children

33%

Married couple,

no children

15%

Other family

7%

Source: US Census, 2000

Married Couple with Children Under 18 by Poverty Level, Arizona 2000

<130% FPL15%

>185% FPL74%

<185% FPL7%

<150% FPL4%

Single Father with Children Under 18 by Poverty Level, Arizona 2000

<130% FPL27%

>185% FPL56%

<185% FPL10%

<150% FPL7%

Single Mother with Children Under 18 by Poverty Level, Arizona 2000

<130% FPL41%

>185% FPL42%

<185% FPL10%

<150% FPL7%

Source: US Census, 2000

Children in Poverty• Just under half (47%) of children in AZ in 2006 live in low

income families.– 1 in 5:

• live in families considered poor • have no employed parents

– Over half have at least one employed parent– Almost half live in single parent households– % of children living in low income families increases as

educational attainment decreases.– % living in low income families varies by race/ethnicity:

• 72% of American Indian children• 68% of Hispanic children• 25% of White children

Source: National Center for Children in Poverty

•Over half (61.5%) of schools in AZ qualify for FSNE

•Just over half (56%) of eligible schools are currently receiving FSNE through LIA partners

•Average of 604,559 students receive free and reduced cost lunches per day

Source: Arizona Department of Education

Demographics of Food Stamp Recipients

Demographics of Food Stamp Recipients

• Over a half million (618,447) participants in March 2008– Average monthly per person benefit was $101.43– Average monthly household benefit was $251.32– Total issuance for the month totaled over $62 million

• Majority (89%) have incomes lower than the FPL• Over half (61.3%) are preschool age children• 11.3% are elderly• One-third (31.1%) of households are single

parents with children

Source: DES Family Assistance Statistical Bulletin, 2008

USDA Report of Food Stamp Recipients in AZ, 2006

Arizona Food Stamp Recipients by Age and Race/Ethnicity 20070-19 Years of Age

Other1%

White21%

Hispanic57%

Black8%

American Indian13%

20+ Years of Age

White41%

Hispanic34%

Black8%

American Indian15%

Other2%


Arizona Food Stamp Recipients by Age and Gender 2007

0-19 Years of Age

Female50.1%

Male49.9%

20+ Years of Age

Female68%

Male32%


Geographic Location:

• Food Stamp Recipients:– Half reside in Maricopa County– Just under one-fifth (17%) reside in Pima

County

• Food Stamp Program Eligibles:– 36.7% of the population eligible for food

stamps in Yavapai County were receiving food stamps. Pinal, Santa Cruz and Graham counties followed (43%).


Nutrition Related Behavioral and Lifestyle Characteristics of

FSP Eligibles

Leading Cause of Death, Arizona 2006

Other Cause of

Death47%

Stroke5%

Diabetes3%

Heart Disease

23%

Cancer22%

Source: Arizona Health Status and Vital Statistics, 2006

0% 10% 20% 30% 40% 50% 60%

Ate 5 or more servings of fruit andvegetables per day

Met reccomendations for physicalactivity

Overweight

Obese

<130%

<185%

Not in Poverty

Risk Factors by Poverty Level


Fruit and Vegetable Fruit and Vegetable ConsumptionConsumption

Fruit and Vegetable Consumption by Poverty Level for Adults, 2007

70%

67%

70%

28%

20%

27%

29%

28%

2%

9%

4%

3%

70%

71%

3%

Not in Poverty

130- to <185% FPL

<130% FPL

Not reported

Total

<5 servings 5 or more servings Not reported


Fruits and Vegetables:

• Most (82.9%) high school students ate less than 5 servings of fruit and vegetables per day– American Indians more likely to eat 5 or more

servings per day (32% compared to 16% for Whites).

Source: Youth Risk Behavior Survey, 2007

Fruits and Vegetables Formative Research Results on FSP Eligibles• Aware of the importance of eating fruits and

vegetables• Reasons for not eating fruits and vegetables:

– short shelf life– expensive– no time to prepare– don’t like vegetables– not in the habit of eating vegetables.

• Believe that frozen and canned fruits and vegetables are not as nutritious as fresh.

Source: AzNN Social Marketing Formative Research

Overweight and Obesity

Adult Overweight and Obesity

• Over half (58.7%) of adults in AZ are overweight or obese.– More likely to be overweight or obese:

• Hispanics (55.4%) • American Indians (64.2%) • Adults with incomes 130-184% FPL (64.8%).• Santa Cruz County (78.7%)


Adolescent Overweight and Obesity

• One in four (25.9%) high school students were at risk for or were overweight.– More likely to be at risk:

• African Americans (29%) • Hispanics (19%)

– More likely to be overweight:• American Indians (20%) • Hispanics (17%)


Childhood Overweight and Obesity

• Children age 2 and older who were overweight:– Inter Tribal Council of Arizona WIC - 24.1%– Navajo WIC program - 16.3%– Arizona WIC program - 14%

Source: Arizona WIC Program

Physical Activity

Adult Physical Activity

• Over half (51.6%) of Arizona adults did not meet physical activity recommendations.– Less likely to meet recommendations:

• Adults with incomes below 185% FPL• Maricopa County, across all income groups.


Adolescent Physical Activity

• Two-thirds (68%) of high school students did not meet physical activity recommendations for in the past week. – One quarter (28%) reported spending at least

3 hours watching TV per day.– One fifth (21%) reported spending at least 3

hours playing video games per day.


Physical Activity Formative Research Results on FSP Eligibles

• Believe that getting regular exercise is key to a healthy lifestyle.

• Reasons for not being physically active: – laziness– too tired– not enough will power– too busy

• Common physical activities participated in:– Walking– Bicycling– Cleaning– Going to the park with the kids– Walking with kids to and from school– Yard work


Physical Activity Formative Research Results on FSP Eligibles• Common physical activities for kids:

– Soccer– Walking to the park– Running– Swimming– Basketball– Kick ball– Tennis


Food Purchasing Attitudes and Behaviors

Shopping Behaviors/Food Resource Management:

• Food accounted for 13.4% of total household expenditures in the Phoenix Area. – Families and single consumers spent almost

half (46.8% ) of their food budgets on food prepared away from home

– Just 9.4% of the food budget was spent on fruits and vegetables

Source: Consumer Expenditure Survey, 2005-2006

Shopping Behaviors/Food Resource Management:

• AzNN Evaluations from 2006 and 2007 indicated that of the 339 people surveyed:– Just under half (42%) planned meals ahead of

time– Over half (58%) compare prices before buying

food– Over half (62%) look for specials when

grocery shopping– Almost all (97%) shop for fruits and

vegetables in supermarkets

Food Resource Management Formative Research on FSP Eligibles

• Purchases influenced by preferences of children and husband

• Number of healthy foods purchased limited by financial constraints

• Use coupons, sales and inexpensive food items• Limit purchase of new and unfamiliar foods• Purchase dairy at practically every grocery trip• Agree that if they like a recipe from a food demo and

know how to prepare the recipe, they will prepare it for their families

• Want food demos in familiar locations such as WIC and food banks by WIC counselors or promoters


Where and how FSP Eligibles Eat

• 71% of FSP eligibles reported eating meals as a family at least 5 days per week.

• Eating behaviors of high school students in the past week:– 10% consumed 3 or more servings of milk– 17% ate 5 or more servings of fruits and

vegetables

Source: Social Marketing Demographic Surveys

Youth Risk Behavior Survey, 2007

Where and how FSP Eligibles Eat

• School environment (middle and high schools):– Two-thirds (69%) of schools had snacks or beverages

available for purchase on school grounds.• 39% had low fat or fat free milk available for purchase• 37% had fruits or vegetables available for purchase• 66% had 100% fruit and vegetable juice available for

purchase

• Three quarters (73%) of schools had a required physical activity class.

Source: Arizona Department of Education,

School Health Profiles

Food Stamp Redemption

• A national analysis of food stamp redemption patterns conducted by the USDA found : – used the EBT system frequently– left very little unspent at the end of the month– Households had an average of 8 transactions per

month• ~$25 per transaction

• Over the past 5 years, food stamp EBT transactions at Arizona farmers’ markets have increased from less than $500 in 2003 to over $4,000 for the first half of 2006 (based on a convenience sample of 6 markets).

Source: USDA/AZFMNP

Summary

• Population Overview– ¾ of population in Maricopa and Pima Counties– Relatively young– Unemployment rate comparable with national average

• Some counties have higher unemployment rates

• Poverty– High percentage of the state population at or below

185% FPL– Children and elderly are more likely to be in poverty– Single parent households more likely to be in poverty– Poverty increases as education level decreases

Summary

• Demographics of Food Stamp Recipients– Over a half million participants in March 2008– Total issuance for March = $62 million – Over half are preschool age children– 11.3% are elderly– One-third of households are single parents with children

• Nutrition Related Behavioral and Lifestyle Characteristics of Food Stamp Eligibles– Adults with incomes <185% FPL

• Less likely to meet recommendations for physical activity and fruit and vegetable consumption

• More likely to be overweight or obese

Summary

• Food Purchasing Attitudes and Behaviors– 2/3 of FS eligibles surveyed reported eating meals as

a family at least 5 days per week– Phoenix consumers spent:

• Almost ½ of their food budgets on food prepared away from home

• Just under 10% of the food budget was spent on fruits and vegetables

– National food stamp redemption patterns: • Left very little unspent at the end of the month• Avg. of 8 transactions per month at $25 per transaction

Partner Satisfaction

Survey Results, FY 2008

Network Strengths

• Diversity of network members.

• Design of the Fun Food News, posters and recipe cards.

• Television ads for social marketing campaigns.

• The www.eatwellbewell.org website.

http://www.eatwellbewell.org/

Areas of Improvement

• The planning process used to prepare the network’s objectives.

• Utilization of partner input.• Opportunities for network members to take

leadership roles.• Communication among members of the

network.• Communication between the network and

the broader community.

Next Steps:

• Network management and staff are committed to addressing the identified concerns and improving program relationships.

• Several changes have already taken place and many more are in the planning stages.

• The LIA partners are the heart of this program and their feedback is critically important.

The Nutrition Network sincerely thanks you for your time and

commitment to this program and to the Food Stamp Population of

Arizona.

Both reports are available at:

http://www.eatwellbewell.org/partners/tools_stats.php




Thank You!

Shelley KuklishEpidemiologist

Arizona Nutrition NetworkArizona Department of Health Services

[email protected]

mailto:[email protected]

Documents

Results of the FY 2009 Needs Assessment Shelley Kuklish Epidemiologist Arizona Nutrition Network