”*4 - dv—‘vwr -q~ ~\ Mmhzmmmm um .i.‘ . . . .. n“, ‘ yu. . H -..y .umu ,,-. . I run.- 1.1:... . . ,f. ’1- . a~ M .,. Will!!![MINI/HITIIHIHIVIIMH’WIIIU1WWW 193 00753 0979 LIERARY Michigan State University This is to certify that the thesis entitled DIFFERENCES BETWEEN FOOD BANK USERS, NON-USERS AND PAST USERS IN A POPULATION OF LON-INCOME SINGLE MOTHERS presented by PATRICIA KAY SMITH has been accepted towards fulfillment of the requirements for nge in“ m <§&,é_é4¥o~SME> Major professor Datelg‘lo’QQ 0-7639 MS U is an Affirmative Action/Equal Opportunity Institution ”first? PLACE IN RETURN BOX to move this checkout from your record. TO AVOID FINES retun on or before due due. DATE DUE ~ DATE DUE DATE DUE . r; _ ' - ‘3..- L3 3129: .L‘. H i JEN l 1 L33 3 I» E": A“ ‘ A.‘ ’ 2,)“; ' We I Wot-1999 ”In J 1"? fi usu Is An Afflrmdlve Mon/Equal Opportunity autumn Wane-9.1 DIFFERENCES BETWEEN FOOD BANK USERS, NON-USERS AND PAST USERS IN A POPULATION OF LOW-INCOME SINGLE MOTHERS By Patricia Kay Smith A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE Department of Food Science and Human Nutrition 1991 ABSTRACT DIFFERENCES BETWEEN FOOD BANK USERS, NON-USERS AND PAST USERS IN A POPULATION OF LOW-INCOME SINGLE MOTHERS by Patricia Kay Smith Seventy-four low-income single mothers with young children, recruited through a door-to-door census in Lansing, MI, participated in a structured, one-hour interview. Thirty-seven subjects were users, 21 were non-users, and 16 were past users of the Ingham County Food Bank Average income for all families was 81% of the 1989 poverty level for a family of three. Results demonstrated that users compared to non—users: (1) had larger households with older children; (2) purchased food more frequently at a convenience store; (3) participated in more assistance programs; (4) were less able to buy enough food with available resources; (5) skipped meals (mothers and children) more often because of no food in the home; and (6) reported fewer family members who would gladly give help or support. Past users were more stigmatized by assistance program participation than users. All three groups would turn to family members first for emergency food assistance. No past users would turn to the food bank first for help. Copyright by PATRICIA KAY SMITH 199 l ACKNOWLEDGEMENTS I would like to acknowledge the unending patience and support from the following people: My husband, Garry Goolsby; My major professor, Dr. Sharon Hoerr; My friend and fellow survivor, Dr. Carol Friesen; My committee members Dr. Judith Anderson, Dr. Harry Perlstadt, Mary Kieselbach-Director of the Ingham County Food Bank, and Dr. Won Song; My intrepid interviewers Victoria Louden, Gail Moore, Gail Haus, Jill Rosekrans, Marci Askegard, and especially Karen Ellerman and Jennifer Baumgartner; The office secretary, Linda Hudson, who always had a warm and welcoming smile; My father and sister, who have always stuck with me through thick and thin; The world's most patient and articulate statistics consultant, Dr. John Gill; and of course All the women who invited us, strangers though we were, into their homes and shared their lives with us. iv TABLE OF CONTENTS LIST OF TABLES ................................................................................ vii LIST OF FIGURES .............................................................................. ix CHAPTER I Introduction ............................................................................... 1 Food Bank Use in Ingham County, Michigan ........................................ 3 Operational Definitions .................................................................. 5 CHAPTER II Review of the Literature At Risk - Single Mothers with Young Children ............................. 7 Domestic Resource Management .............................................. 11 Overall Food Shopping Proficiency .................................. 12 Choice of Store--Location and Type ................................. 13 Size Effect on Food Cost .............................................. 16 Brand Preference ....................................................... 18 Food Shopping Frequency ............................................ 19 Social Welfare Resource Management ........................................ 20 Multiple Assistance Program Participation .......................... 21 Factors Affecting Program Participation ............................. 23 Social Support and Help-Seeking Behavior .................................. 28 Statement of the Problem ................................................................ 33 The Research Hypotheses ............................................................... 33 CHAPTER III Methods Sampling ......................................................................... 35 Interviewing Procedures ........................................................ 37 The Questionnaire ............................................................... 39 Data Analysis .................................................................... 40 Income Calculations .................................................... 41 Index Scores ............................................................ 41 CHAPTERIV Results and Discussion Division of the sample into food bank non—users, users and past users .................................................................... 52 H01: Demographics ........................................................... 53 H02: Domestic Resource Management ..................................... 69 H03: Cash Value Available to Purchase Food ............................. 82 H04: Assistance Program Participation ..................................... 87 H05: Ingham County Food Bank ........................................... 100 H06: Informal Social Support Network .................................... 104 H07: Meal Skipping Due to Lack of Food ................................. 108 CHAPTER V Summary and Recommendations Summary of Results ............................................................ 114 Implications for Policy .......................................................... 118 Strengths and Limitations of the Study ....................................... 119 Suggestions for Future Research .............................................. 121 Strategies for Dissemination of the Findings ................................. 122 Conclusions ...................................................................... 123 LIST OF REFERENCES ........................................................................ 126 APPENDICES A — Hunger and Emergency Food Assistance Bibliography ...................... 132 B - Food Closets Within the City of Lansing ....................................... 142 C - Conceptual Model of the Study Variables ...................................... 144 D — Boundary Maps of Selected School Attendance Areas ........................ 145 E - Pro-Survey Flyer .................................................................. 149 F -- Pre-Screening Questions .......................................................... 150 G — Informed Consent Form .......................................................... 151 H - UCRIHS Letter of Approval ..................................................... 152 I— Questionnaire ....................................................................... 153 J - Where the Subjects Obtained Information About What Was Happening in Lansing ....................................................... 179 K - Sarnple Revised Questionnaire ................................................... 180 vi Table 3.1. Table 3.2. Table 3.3. Table 3.4. Table 4.1. Table 4.2. Table 4.3. Table 4.4. Table 4.5. Table 4.6. Table 4.7. Table 4.8. Table 4.9. Table 4.10. Table 4.11. Table 4.12. Table 4.13. Table 4.14. Table 4.15. LIST OF TABLES Questions considered for inclusion in the domestic resource management index ............................................................... 45 Questions considered for inclusion in the social support network index. ............................................................................. 46 Correlation matrix of domestic resource management variables ........... 48 Correlation matrix of social support network variables ..................... 49 Average composition of respondents' households .......................... 53 Demographics of households and families by food bank use status of the single mother. ............................................................ 54 Sources and average amount of families' incomes in the month before the interview. ............................................................ 55 Age, race, and marital status of low-income single mothers by food bank use status ................................................................... 57 Education status of low-income single mothers by food bank use status ............................................................ 58 1989 Federal poverty income guidelines by family size. ................... 61 Maximum 1989 monthly food stamp coupon allotments. .................. 61 Average frequency of household grocery shepping in the month before the interview. ............................................................ 71 Frequency of household grocery purchases by food bank use status of single mother. ................................................................ 71 The choice of primary grocery store by percentage (number) of neighborhood residents in the sample ......................................... 74 Mean appliance and utility scores by food bank use status of single mother. ........................................................................... 78 Average household expenditures for food in the last month by food bank use status of the single mother. ......................................... 82 Adequacy of the households“ food stamp allotments by food bank use status of the single mother ................................................. 85 Average number of assistance programs (other than food bank) participated in by families, categorized by food bank use status of the single mother. ............................................................... 91 The degree of multiple assistance program participation by families in each food bank use category. ............................................... 91 Table 4.16. Table 4.17. Table 4.18. Table 4.19. Table 4.20. Percentage (number) of respondents who had participated in the food stamp and AFDC programs reporting being bothered or embarrassed by their participation ............................................................ 94 Relationship between stigma associated with FS use and AFDC participation by percentage (number) of respondents participating in both programs ................................................................... 94 Where low-income, single mothers found out about the ICFB ............ 101 Average friend and family frequency of interaction indices of single mothers by the woman's food bank use status .............................. 104 The relationship of mothers' meal skipping to childrens's meal meal skipping in the month before the interview by percentage (number) of the whole sample ................................................. 109 Figure 4.1. Figure 4.2. Figure 4.3. Figure 4.4. Figure 4.5. Figure 4.6. Figure 4.7. Figure 4.8. Figure 4.9. Figure 4.10. Figure 4.11. Figure 4.12 LIST OF FIGURES Employment status of low-income single mothers as a percentage of each food bank use category ................................................... 5 9 The direction of perceived income change over the last twelve months by the proportion of women in each food bank use category ..... 63 Comparison of the racial composition of Lansing, Michigan, and the study sample. .................................................................... 65 Percentage of food bank non-users, users and past users choosing each store as their principal grocery store. ................................... 69 Primary transportation to the grocery store of food bank users, non- users and past users ............................................................. 73 Perceived adequacy of food storage space by food bank use group. ..... 79 Proportion of subjects responding when asked whether or not they were able to purchase enough food for their household with available cash and food stamps. .............................................. 86 Assistance program participation of low-income single mothers and their families by food bank use status ......................................... 88 Percentage (number) of children in each age group by food bank use category ........................................................................... 89 Percentage (number) of respondents in each food bank use category botheredor embarrassed by AFDC and food stamp program participation. ..................................................................... 96 Where low-income, single mothers would turn first for help if they needed food or help buying food by proportion of food bank use categories ......................................................................... 103 Percentage of children and mothers skipping meals due to lack of food in the home by food bank use category ................................. 110 CHAPTERI Introduction Food banks, food closets and food pantries are private, community-based organizations which rely heavily on donations of food, money, and volunteer time to provide a few days supply of groceries to people in need. These facilities are a temporary stop-gap measure for households without food and with no place else to turn for help. Perhaps surprisingly, emergency food assistance requests through food banks have been increasing nationwide despite reports in recent years of an improving economy (eg., Bread for the World, 1985; Contra Costa County Hunger Task Force, 1987; The Maryland Food Committee, 1988; Minnesota Food Education and Resource Center, 1985; Project Bread Hunger Hotline et a1, 1987). In 1989, emergency food requests to the Ingham County Food Bank (ICFB) in Lansing, Michigan, came in from an average of 1,719 households per month, an increase of 17% over the average of 1,465 requests per month in 1988 (M. Kieselbach, personal communication, February 2, 1990). Use of the ICFB reached a previous all-time high of 1,666 households a month in 1983, which was the bottom of the most recent economic recession in the state. A request for emergency food assistance identifies a family in crisis. The crisis, characterized by no food in the home, might be the culmination of one or more chronic problems within the family or household, such as underemployment, low educational attainment, lack of adequate food storage or preparation facilities, or barriers to maximum participation in the social welfare system. Or the crisis might be the outcome of an acute event which drains resources already depleted by err-going problems. A medical emergency not covered by insurance, a high housing or utility bill, or divorce or 1 abandonment are examples of potentially resource-draining events (eg., Contra Costa County Hunger Task Force, 1987; Governor's Task Force on Hunger, 1988; Interim Study Committee on Hunger and Nutrition in South Carolina, 1986; Oregon Food Share, 1986; Project Bread Hunger Hotline, 1986; The Task Force on Hunger, 1985). Whatever the cause, it is unlikely the family's food crisis occurred overnight. No published studies have been located which specifically examine why some low- income families reach a point where they turn to a food bank, while comparable families do not. Several studies in the research literature have examined low-income families in relation to other assistance programs such as the Supplemental Food Program for Women, Infants and Children (W1C), Aid to Families with Dependent Children (AFDC or ADC), or food stamps (e.g., Emmons, 1986; MacDonald, 1985; Rush et al, 1988; Stuart, 1975). Other reports, primarily by community- or govemment-based organizations, provide profiles of hungry people and/or emergency assistance in a specific area of the country (see Appendix A). However, no research has been found regarding the following relevant questions: 1) What, if any, characteristics or behaviors differ between families that do not use the food bank and families that do? 2) What appear to be the most prevalent chronic factors present in a family or household which might lead up to food bank use? 3) Are there families who should be turning to the food bank in times of distress who are not doing so, and if not, why not? This exploratory study was undertaken to look at factors which might differentiate low-income food bank users and non-users, such as issues related to the management of food resources in the household, social welfare system participation, informal social support, demographics, and selected hunger indicators. The results might be used by local social service and assistance agencies to screen for families at risk for a potential food crisis in the home, to improve interventions for at—risk families, and to reach at-risk families not yet in any assistance system. Information obtained on the needs and experiences of both the user and non-user families might also be used by agencies such as the ICFB, the Expanded Food and Nutrition Education Program (EFNEP), and WIC as another weapon in the ongoing battle for limited county, state, and federal dollars. Food Bank Use in Ingham County, Michigan The ICFB is a tax-exempt, non-profit organization made up of a system of 34 "food closets" or distribution centers throughout Ingham County. Twenty-one of the closets are located within the city limits of Lansing, the geographic area of interest within the county (see Appendix B). The food closets are all run by volunteers . The ICFB also has a central office with three full-time paid and several volunteer staff members and a warehouse from which donated and purchased food is distributed to the individual closets. All applicants for assistance are screened through the central office, where a record is kept on a recipient data form of all assistance requests. Eligibility is determined on an individual basis. Names and social security numbers of all the adults in the household must be provided and some form of identification must be shown by the individual picking up the food from the food closet. An individual or household can receive assistance from the ICFB up to five times a year, but no more than once in any thirty day period, except under extenuating circumstances verified by someone such as a Department of Social Services (DSS) caseworker, school counselor, or Public Health nurse. If requests for assistance are received from an individual or household three months in a row, they might be asked to participate in EFNEP, see a budget counselor, or participate in a garden project sponsored by the ICFB. There appears to be a large gap between actual food bank use and potential need in Ingham County. Potential need for the purposes of this study was defined as number of persons living near, at or below the federal poverty threshold. In 1989, the ICFB supplied three to six day emergency food packages to an average of approximately 5,150 individuals per month (M. Kieselbach, personal communication, February 2, 1990). This was at a time when there were over 33,000 persons in Ingham County living below 100% of the federal poverty level and over 44,000 living below 125% of the poverty level (13.2% and 17.4%, respectively, of the county's population) (Bureau of the Census, 1983). Therefore, there were over 38,000 individuals not using the ICFB in any given month who were potential users. Not everyone living below 125 % of poverty is at risk for running out of food, but clearly there are a great number of people in Ingham County "living on the brink" financially. Prior studies conducted in several locations around the United States, including Ingham County, have created profiles of food bank users (Appendix A). Using data from a random selection of ICFB intake sheets from 1985, Dahl (1986) and Wu (1986) determined that 75% of the ICFB users were getting food stamps, 46% received AFDC, and 11% had at least a part-time jobl. Obviously, although use of the ICFB might have been a consequence of poverty, it did not necessarily reflect non-participation in social programs or even unemployment. In Ingham County, the typical food bank user household (S four times per year) was found to be a single-parent family with two children (Dahl, 1986). Almost 90% of the single-parent households with children in the city of Lansing are headed by a woman (U .8. Bureau of the Census, 1983). It was therefore assumed for the purposes of this study that an equally high percentage of the single-parent households using the Ingham County Food Bank (ICFB) are headed by women. Children under 18 years old made up fifty-four percent of the "typical" ICFB users in the Dahl study and 55% of the"frequent" (2 five times a year) ICFB users in the Wu (1986) study. Another study conducted in the same year (Howard, 1986), using a random sample of 179 intake records of ICFB users, found that 64% of the individuals served in those cases were children . 1 Recent figures for 1989 showed that 54% of ICFB users received food stamps, 34% were on AFDC, and 16% were employed at least part-time (M. Kieselbach, personal communication, February 2, 1990). Although not the focus of this study, the fact that low-income women and young children are potentially at risk for the consequences of nutritional deficit cannot be ignored. An acute food crisis in the home necessitating use of the food bank is not necessarily synonymous with nutritional risk. However, poor young children in the United States have been shown in previous studies to exhibit low height-for-age, a sign of possible chronic nutritional deficit (Jones, N esheim & Habicht, 1985; Owen, Kram, Nelson & Montalvo, 1969). Young children are particularly vulnerable to the effects of undemutrition because they are going through a period of rapid growth and development. In women of child-bearing age, the greatest consequence of possible undemutrition due to chronic lack of food is the risk present to any children they may conceive (eg., Als, Tronick, Adamson & Brazelton, 1976; Habicht, Yarbrough, Lechtig & Klein, 1973; Lubin, Bonner & Schrock, 1980). Therefore, families with a female single parent and at least one child age six years or under were selected as the focus of this study because: 1) low-income, single mothers and their children appear to be the predominant users of the ICFB; 2) the need to turn to the food bank might be a sign of a chronically low food supply in the home exacerbated by an acute crisis; and 3) young children and women of child-bearing age are particularly vulnerable to the potential effects of undemutrition. Operational Definitions Domestic resource management — the manner in which the household's food and food purchasing resources are handled; includes factors such as choice of food store, size effect on food cost, brand preference, food shopping proficiency, frequency of shopping and adequacy of food storage, major appliances and utilities. Social welfare resource management — the extent to which a family participates in all social welfare programs for which it might be eligible; affected by barriers to participation such as stigma or lack of knowledge about a particular program. Informal social support - the extent to which a person's material needs (ie., money, food, transportation), informational needs (ie., advice, referrals) and/or socioemotional needs (companionship, security, sense of worth) are met by her network of friends and family. Federal poverty threshold/Poverty level/Poverty line — the level of household income equal to three times the cost of the USDA's Thrifty Food Plan; varies according to number of family members and place of residence. Updated each February to account for changes in the Consumer Price Index. Income - before tax cash receipts from all sources, including money borrowed or used from savings; does not include non-cash benefits, such as food stamps and WIC. Low-income - family or household income at or below 185% of the federal poverty threshold. Some studies reviewed defined low-income as either those in the lowest income quartile of their study or below the poverty threshold and may or may not include government assistance benefits. Poor - having a family or household income, before or after receipt of government benefits, at or below 100% of the federal poverty threshold. Poorest of the poor - having a family or household income, before or after receipt of government benefits, at or below 50% of the federal poverty threshold. Food security - access at all times, through normal food channels, to enough nutritionally adequate food for an active, healthy life. (Select Committee on Hunger, 1989; World Bank, 1986). Family -- all closely related individuals within a household; can include parents, siblings, children, grandchildren, and wards of the Respondent. Does not include relatives such as aunts, uncles, cousins, or grandparents. Household - all persons, related or not, who live in the same house and regularly buy food and share meals together. CHAPTERII Review of the Literature When an attempt is made to uncover why a low-income household must reach out for emergency assistance, it becomes evident that there are many factors at work, each one of which might interact with any of the other factors. This study focused on what conditions might lead to a food crisis in a very specific type of family, what activities are undertaken to avoid running out of food, and what actions the family takes when and if it does run out of food. The first section of this review of the relevant literature examines from a demographic standpoint why single mothers with young children are a group at risk for poverty and therefore possess increased potential for a food crisis in the home. The second, third and fourth sections of the literature review examine the behaviors and characteristics other than demographics which were selected for examination in this stud -- the management of domestic food resources in low-income households, the management of social welfare resources by low-income families, and informal social support networks and help-seeking behavior among single and low-income mothers. EB'l-S' llll .11: CHI Single mothers and their children are at a high risk for poverty, especially if the women are divorced, separated or never married (as opposed to widowed). Aid to Families with Dependent Children (AFDC) is a federal means-tested entitlement program developed to assist financially troubled single parent families. However, in Michigan, if a single mother has to rely solely on AFDC and food stamps to provide for her family and the family qualifies for maximum benefits from both programs, the family's income will still be at only 82% of the poverty threshold (Shapiro & Greenstein, 1988). According to estimates based on a sample survey by the US. Census Bureau (1987), 23% of all families in the United States with children under age 18 at home are headed by a woman: 18% of white families, 54% of African American families, and 29% of Hispanic farrrilies. Twenty-eight percent of families headed by single women include children under the age of six. The number of female headed households with children has increased 136% since 1970. This more than doubling of female-headed families with children in the United States built on a trend that was seen starting in 1960 (Norton and Glick, 1986). Drawing primarily on early to mid-1980's US. census data, Norton and Glick constructed the following "social and economic profile" of single parent families. Eighty-eight percent of these families nationwide are headed by women; 60% of the female-headed single parent families have incomes which place them below the poverty line. This rate of poverty is more than twice that of families headed by a single father. About one-third of all female— headed families with children under 18 years of age in the United States are headed by an African American woman. This is approximately one—half of all African American families with young children. Only 15% of white families with young children are headed by a single woman. Never married women make up 20% of the single mothers, an increase of 500% from 1970, but the number of women who have become single parents through widowhood has mhnw by over 20% during the same time period. According to Norton and Glick's (1986) analysis, twenty-eight percent of female single parents are not likely to have a high school diploma (a decline from 48% in 1970) and 46% are unlikely to have gone on for even one more year of education after high school. Only 8% of female single parents are likely to have at least a four year college degree. Fifty-three percent of lone mothers with any preschoolers and 45% with any children under three years of age are working. Divorced mothers are more likely to be working than never married mothers, white mothers more likely than African American mothers. Data from the 1979 decennial census showed that in Lansing, Michigan, women headed 28% of all families with children under the age of 18 in the home, a somewhat higher percentage than national estimates of 23% (U .S. Bureau of the Census, 1983). Sixty-five percent of these families were headed by white women and 30% by African American women. The mean yearly income of these female-headed families was approximately $10,200.00 (1979 dollars), but forty-three percent of these families had incomes which placed them below the 1979 poverty threshold. Twenty-eight percent of these families had children below the age of six present and incomes below the poverty threshold . In 1986, the median income for female headed families in the United States was estimated to be $14,280. This amount was 54% of the median income for households headed by a single male and 43% of the median income for households headed by a married couple (U .8. Bureau of the Census, 1987). A woman with children can become a single mother for several reasons - divorce, separation, widowhood, or having children out-of-wedlock. In 1986, 52% of the African American single mothers heading families in the United States had never married, 43% were divorced or separated and 5% were widowed. In that same year, 75 % of the white single mothers heading families were separated or divorced, 17% had never married and 7% were widowed (US. Bureau of the Census, 1987). Divorce or separation can have a devastating effect on the income status of the household. Weiss (1984), using data from the University of Michigan's Panel Study of Income Dynamics (PSID), followed for five years the income and consumption patterns of a samme of divorced and separated mothers with children under 18 living in the household. He compared them to a married sample drawn from the P811) data set. Regardless of income status before the dissolution of the marriage, divorce or separation brought about a 10 dramatic drop in income for the woman. In the first year after the break-up, income was reduced by 55% for those women in the upper income levels, by 44% for those at the middle income level, and by 23% for those with the lowest pre-break-up incomes. On the average, once the incomes dropped they did not rise for the duration of the time period studied; however, it must be noted that the incomes also did not tend to drop farther. On the other hand, the incomes of the women who were married for the duration of the study rose steadily over the five years. The husband's income accounted for an average of 80% of the income in these households. The incomes of all the separated or divorced mothers averaged half those of the still married women by the end of the five years. This income decline was especially devastating for the low-income single mothers, who started out the study with incomes at about three-fourths of their manied counterparts. Income has been shown to be the single greatest determinant of food expenditure in the household. Hermann (1964), in developing an economic model to explain the variance in household food expenditures, found that 23% of the variance was explained by household income. Therefore, marital status can jeopardize food availability to the family through its effect on income. Although there appears to be a dearth of literature specific to the economic status of families with children headed by never-married women, the logical assumption can be made that their financial outlook is as bleak as, if not worse than, that of families with a divorced or separated single mother. Some factors figuring into this might be lack of a source of child support, interrupted education, and limited work experience before the birth of the first child, particularly if the woman was a teenage mother (Wilson, 1988). Women who become mothers for the first time while still adolescents are at particular risk for economic problems. A longitudinal study was conducted in Baltimore comparing women who were unwed mothers in their teens with both classmates and same age women from several national surveys (Furstenberg, Brooks-Gunn & Morgan, 1987). In 1984, seventeen years after the beginning of the study, the teenage mothers were still not 11 as likely to have their high school diploma or equivalent as their classmates and they were also less likely to have completed school than women in the national surveys who delayed childbearing until their twenties. At the 1984 follow-up less than one-quarter of the teenage mothers had never been married. However, of those that had ever married, 44% were currently divorced and another 6% had been married more than once. Women from the national studies who had their first child later demonstrated more permanence in their relationships and were more likely to be married and less likely to be divorced. When examining the welfare dependence of the teen mothers, the researchers found that although 29% had received welfare in the year before the 1984 follow-up, only 12% of the entire sample had received public assistance for the entire study period. In this population, the most significant determinants of being on welfare in 1984 at the 17 year follow-up included: a) 9th grade education or less, p = .001; b) being below expected grade level at time of first pregnancy, p = .003; c) having two or more additional children within five years of the first, p = .03; and d) not being married within five years of the first birth, p = .03. Receiving welfare during the five years after the first birth and not being a high school graduate were significant at the p = .12 and p = .15 levels, respectively. W A large part of managing a family's or household's domestic or in-house food resources is the actual process of obtaining the food. Hammett and Van de Mark (1973) pointed out that food buying is a "complex procedure", but concluded that low-income (as well as experience and family stability) is related to frequently making routine purchase choices which bypass some of the more complicated decision-making steps. A large body of research literature exists focusing on the low—income consumer and basic aspects of food shopping decisions-ie.,overall food purchasing proficiency, store choice, package size, brand preference, and frequency of shopping. This will be the focus of this section of the 12 review of the literature. It must be noted that much of the research in this area was conducted ten to twenty-five years ago, when advocacy for the poor was an area of tremendous interest in the United States. This does not, however, denigrate the value of this research in explaining the basic food shopping behaviors of today's low-income consumer. Although preplanning of food purchases using a shopping list or through menu planning are assumed in home economics to be an important part of the food purchasing process, an extensive search of the consumer, home economics, and dietetics literature failed to uncover any studies concerning the efficacy of these activities as related to expenditures of either time or money. These two processes appear not to have been the central focus of any organized research, although they have been peripherally examined in the research literature as a part of the total food purchasing process (eg., Anderson, 1988; Koh, 1978; Suter & Barbour, 1975; Sinkula, 1984; Verma, Montgomery & Cyrus, 1987). [1 ll E l S] . E t] . When it comes to food, low-income, female heads of households are apparently able to make "econorrrical purchases of what they ordinarily buy" (p. 50) according to a study in Riley County, Kansas, by Barney and Morse (1967). This ability was assessed by comparing what the homemakers actually spent on a typical shopping trip, usually shopping at only one store, with what college students who were seniors in home economics determined the same list of items would cost after comparison shopping at two stores. Students could substitute brands, but nothing else. The low-income homemakers spent 7% less than what the students estimated the foods would cost (p S .01, ANOVA), indicating that the women had better "buymanship" skills than the supposedly highly educawd and well-trained students. When a household has limited food buying resources, it is not only important that the homemaker shop economically, but that she also get the maximum nutrient return per 13 dollar spent on food. In examining data from over 14,000 households in the Nationwide Food Consumption Survey 1977-78, Peterkin and Hama (1983) found that the low-income households (0-99% of the poverty threshold) had a higher nutrient return per dollar than households with higher incomes. However, these low-income households were still less likely than those with higher incomes to attain recommended levels of the nutrients studied. Apparently this was because, with smaller weekly food expenditures, they had to purchase less food (Morgan, Peterkin, Johnson & Goungetas, 1985). This had been seen earlier by Barney and Morse (1967), who found that honremakers in their study spent just slightly more than half of what was necessary to purchase the U.S.D.A.'s Low-Cost Food Plan for their families. This finding was taken as an indication that the homemakers had insufficient food monies to purchase an adequate diet for their familiesl. From the above studies, it appears that many low-income homemakers, although not able to provide their families with what might be considered optimal in terms of nutrient intake, are managing the best they can with limited resources. An important question addressed primarily through descriptive studies in the late 1960's and the 1970's was whether the poor, particularly the urban poor, paid more for food than higher income consumers. It was hypothesized that perhaps the large grocery store chains charged more for food in the inner-city than in the suburbs. Another theory was that the poor had less access to large stores due to lack of transportation, which forced them to shop at expensive small neighborhood markets or convenience stores. Under these circumstances the low-income shepper would be affected by what Kunreuther (1973) referred to as the "store effect" in the pricing of any given food item. He defined store effect as the difference in price for the same size item between small and large stores. 1 No comparison appears to have been made, however, between the homemakers food expenditures and the cost for their families of the U.S.D.A.'s Thrifty Food Plan, which is the estimated amount of food necessary for a minimally adequate diet. 14 Karnmcr and Shawhan (1970) compared similar-sized food stores in low- and high- irrcome areas of Cincinnati, but found no significant differences in the prices charged for a market-basket of 57 items. The authors concluded that prices were the same at similar types of stores regardless of location. However, they did find that prices varied between different types of stores, with convenience stores charging the most. In a 1968 study conducted in Philadelphia (Goodman,1968), a sample of residents in an urban redevelopment area were surveyed regarding the food stores in which they shopped. The average cost of a market-basket of food items at these stores was determined. It was found that 92% of the respondents reported doing their principal grocery shopping outside of the area in which they lived. Eighty-one percent shopped at large chain supermarkets as opposed to medium-sized independent stores or small "mom- and-pop" type stores, even though there were no chain supermarkets located within the study area. Almost half (45%) of the study participants drove to the store where they did most of their grocery shopping, while 55% walked or used public transportation. This appeared to demonstrate a willingness to spend time and/or money to travel some distance for an affordable food source. The most frequently stated reasons for shopping at a particular store by the respondents in the survey by Goodman (1968) were price (52%) and quality (42%), followed by location (28%). Fifty-one percent stated they believed the large supermarkets had lower prices relative to the other types of stores in the study. Surprisingly, one of the medium-sized independent stores within the study area had the lowest average prices of the twelve stores examined. Three of the four independent stores regularly patronized had lower average prices than the large chain supermarkets. The small neighborhood markets were 10-15% more expensive than the other stores studied. Only two-fifths of the respondents reported using the small stores (all located within the study area) even as a secondary shopping resource. These shoppers used the small stores three or more times a 15 week, but typically bought less than three types of goods, indicating that use of these types of stores was on an "emergency" or "fill-in" basis. Studies conducted in other cities have supported these findings. Berry and Solomon (1971) studied choice of store in a low-income, primarily Mexican-American area of Denver. Although there were no supermarkets within walking distance of the center of the area studied, 65% of the respondents made the effort to shop regularly at chain supermarkets located on the edge or outside of the study area. Again, the two most important factors mentioned for choosing a particular store were price (55%) and quality (32%), followed by location (29%). Sixty-four percent of the sample used automobile transportation to get to the store, either their own car or riding with someone else. Boone and Bonno (1971) found that the consumers most frequently patronizing the small neighborhood markets in a small southern city were those living in extreme poverty. Convenience, friendship, and availability of credit were named as the primary reasons for patronizing these stores. The shoppers in this group also indicated that they realized that they were paying higher prices than if they shopped somewhere else. Shoppers actually paid 6%-12% more than at the lowest priced chain supermarkets or medium-sized independents in the study. Boone and Bonno concluded that low-income households did indeed pay more if they shopped at the small neighborhood stores, but that in many cases people shopped there by choice and not out of necessity. The higher cost of shopping at convenience stores appears to be supported by Campbell and Desjardins (1987) in their intensive study of the management of food resources by 2010w—income Canadian families. A positive correlation was found between frequency of shopping in convenience stores and weekly per capita food expenditures (r=.421, p=.06), indicating a strong trend toward higher food costs for the family the more often convenience stores were patronized. However, it appears that the poorest of the poor usually choose not to shop at convenience stores, even though they are the group least likely to own an automobile 16 (Alexis, Simon, & Smith, 1969). In a study in Rochester, New York, it was found that although only 22.5% of the respondents in the $O-$3,000 income bracket owned cars, as opposed to 72.5% of those in the $3,001-SS,000 low-income bracket, the choice of store type did not differ significantly between the two groups. Fifty-nine percent of the low- income group as a whole tended to shop at chain stores and 33% did their grocery shopping at independent neighborhood markets. This was significantly different from the middle and high income consumers in the study, where over three-quarters of both these groups did their major food shopping in chain supermarkets (X2 = 23.2, p S .01). From these studies on choice of food store, it can be seen that urban, low-income consumers do pay more for food if they shop at small, neighborhood markets or convenience stores. However, the majority of shoppers make an effort to access less expensive (or perceived less expensive) large stores, even if they have to go outside their immediate neighborhood to do so. Additionally, these consumers have access to some form of transportation, primarily automobiles,,for shopping. If any group uses the expensive, small neighborhood markets as their primary shopping location, it is likely to be the poorest of the poor. They appear to do so not only because of easy access, but because of friendship with the store owner and, in some areas, availability of credit. But even this poorest group will shop at a larger, more economical store if they can. W The particular store a person shops in is not the only reason a consumer might pay more for food items. Pricing also tends to be affected by what Kunreuther (1973) termed the "size effect" or "the differences in price per ounce for various sizes of a particular brand item within any given store" (p. 369). When looking at the size effect on pricing of eight commonly purchased items in 11 large and 11 small stores, he found that with only one exception in the large stores and three exceptions in the small stores, the average price per ounce did indeed decline as the size of the package increased. Savings, if the largest size 17 was purchased rather than the smallest, ranged from 15% to 50%. Frank, Douglas, and Polli (1967) found that household income and education of the household head were negatively correlated with purchasing small sizes of items, as were brand loyalty and total amount of the item purchased over time. Average price paid per unit and the number of adults in the household tended to be positively correlated with purchasing smaller sizes. Kunreuther measured size effect in a survey of middle-income and low-income consumers in New Haven, Connecticut, by using a ratio of actual size purchased1 to the number of sizes thought to be available by the particular shopper. The low-income respondents had the lowest ratio for seven of the eight items studied. This indicated that even though the low-income shoppers were aware that there was a variety of sizes to choose from, they tended to purchase the smaller sizes. Seventy-two percent of the low- incorne homemakers indicated that they knew large size packages usually cost less per ounce. However, low-income consumers, when considering which size of an item to purchase, must make several decisions. They must decide how much of their food budget they can spend for a particular item, how much storage space they have available, household consumption rates, and even if they are able to get larger sizes home if they did not come to the store by car. Over half of the low-income shoppers (59% vs. 13% of the middle-income shoppers) felt they had inadequate storage space, and 42% walked to their principal grocery store. Other interesting findings in this study included that, although the size of the low- income families was an average of 1.2 persons larger than the middle-income families, the low-income households averaged less spent per week on groceries than the middle-income households ($36.60 vs. $39.40). Also, more than 60% of the total low-income population showed at small local grocers. Although the scope of this study was limited, it demonstrated a tendency for low- 1 '1" equaling the smallest size available to m equaling the largest size available 18 income families to purchase small sizes of food items, even though they were aware that this was more expensive than buying the larger sizes when they were available. These consumers, when compared to middle-income consumers, appeared to be influenced by smaller food budgets, less available storage space, and lack of automobile transportation. BtandErcfetence Another factor affecting the actual food purchasing decision is brand preference. N ational brands generally cost more than private store brands or generic items. Coe (1971), using a list of 25 commonly purchased grocery items, studied and compared the brand preferences and loyalties of middle- and low-income consumers. Eighty-nine percent of the low-income group indicated that their regular purchases from this group of foods were of national brand items, as opposed to 58% of the purchases of the middle- income group. There were eight items that, if someone from the low-income group purchased them, they only purchased a national brand. Through anecdotal comments of the respondents it was found that the low-income shoppers were generally aware that the national brands were more expensive. A known brand name and higher price were equated with quality by this group. These consumers felt "protected" by the fact that the national producers were willing to keep their products in the public eye through extensive advertising. The middle-income consumers, on the other hand, felt that the higher prices on the national brands were due to the cost of the advertising and that unknown store brands were not only less expensive, but were just as "safe". This group felt protected by consumer protections laws and regulations. In contrast, Sanjur and colleagues (1979), when studying food expenditures and consumption of 576 urban and rural low-income EFNEP families in New York state, found that the honremakers in the study listed price most frequently (44%) as the factor influencing food purchasing decision, not brand preference (29%). These two reasons were followed by amount of the product needed for the week (19%), food quality (17%), l9 sale items (16%), and amount of spendable money (8%). When the researchers examined in more detail the influence of brand preference on the purchase decision, only when purchasing fish or grain products were the homemakers more likely to purchase national brands than store brands (level of significance not given). W Frequency of shopping has been hypothesized to have an effect on family food expenditures. The twenty families in the Campbell and Desjardins study (1987) shopped for food on an average of six days during the two weeks examined. The researchers found no difference in cost per capita or cost per meal between those families that bought most of their food in one or two large shopping trips and those that made many small trips. It was poinwd out that transporting the groceries home can be a major barrier to engaging in large shopping trips. Only one family in their small sample population had a car. The most prevalent means of getting to the store was walking. Families who shop more often might not be spending any more money than infrequent shoppers because they do not have more money to spend. But are frequent and infrequent shoppers getting the same "value" for their food dollars? Block and Kellerman (1977), after studying the food purchasing and consumption practices of 289 low-income, rural households in Missouri, developed a measure of "food shopping efficiency" (the Daily Recommended Food Servings Efficiency or DRSE), which evaluated "how well the households met their nutritional needs given their limited financial resources" (p. 257). This measure took into account how well the household met the consumption standards of the recommended servings from the basic four food groups (USDA, 1958), as well as the amount of money spent on food. Using multiple regression, with the DRSE as the dependent variable, the researchers found that shopping less than once a week had a significant, positive relationship with greater shopping efficiency (p<.05). They hypothesized that this might have been due to one or more factors, such as more careful 20 planning, less impulse buying, taking advantage of economy-of-size savings by purchasing larger sizes, more home production, or the purchase of fewer perishable items. The research presented above on the management of domestic food resources demonstrates that low-income consumers are able to shop efficiently for what they ordinarily buy and that they make an effort to access low cost food sources. The poorest consumers appear to be those most likely to shop at local markets and convenience stores, but they tend to do so out of choice, not necessity. Low-income consumers as a group, however, are more likely than higher income consumers to purchase smaller size packages and national brands. Both these practices have the effect of increasing food costs. Shopping less than once per week, although it does not affect total amount of food dollars spent for food, appears to be an important factor in the household getting the most nutrition for available food dollars. Wm Participation by a low-income household in one or more government assistance programs for which members of the household are eligible can be viewed as a positive step toward increasing the household's disposable income. This increase in income can be accomplished either through an actual cash transfer to the household, as with Aid to Families with Dependent Children (AFDC or ADC), or by freeing up household monies by providing in-kind benefits which cover some of the basic needs of the household. Food stamps (FS) and the Women, Infants and Children Supplemental Food Program (WIC) are major food-related, in—kind benefit programs. Other programs which directly benefit the children in the household--such as free or reduced price school lunch, Headstart meals, and the summer school feeding program--reduce the direct demand on home food supplies. Another program, the Expanded Food and Nutrition Education Program (EFNEP) is unique in that it does not offer material assistance, but provides low-income homemakers 21 with the knowledge and skills necessary to better use limited food dollars to give their families the most nutritious, low-cost meals possible. “1.1!. E E"' In Michigan, if a family with no other income source received the maximum AFDC and food stamp allotments allowed in 1987, they would still be living at only 82% of the poverty threshold (Shapiro & Greenstein, 1988). If a three person family were living on AFDC alone, their maximum benefit would only have brought them up to 56% of the poverty threshold. Being on AFDC in Michigan does, however, automatically qualify the family for Medicaid benefits. Multiple assistance program participation among the low-income population appears to be the norm rather than the exception, particularly if food stamps are one of the programs being used by the household. Long (1988) in her analysis of April 1984 panel data from the Survey of Income and Program Participation (SIPP) found that 95% of the households which contained at least one person receiving food stamps (FS households) also were participating in at least one other government assistance program. Sixty-six percent of FS households were participating in four or more assistance programs, a proportion twice that of the study's low-income population as a whole. Long calculated that, for the average FS household, 84% of the poverty gap1 was closed by the income from in-kind and cash government benefit programs Long's (1988) results showed that the FS households participating in the largest number of programs had lower incomes before and higher incomes after receiving benefits from the programs than those FS households that used relatively fewer programs. Each additional program a household used increased household income by approximately $132.00 per month. Over 60% of the FS households that participated in a total of six or more assistance programs (including food stamps) had incomes above poverty after the 1 ”The difference between actual pre-transfer cash income and the poverty level." (Weinberg, 1986) 22 income transfers were received, as opposed to only 43% of the FS households participating in one to three programs. It must be noted, however, that it was the households with disabled or elderly members which were most likely to move out of poverty and not households headed by a single mother or even two-parent households. Another study of the April 1984 SIPP data set (Weinberg, 1987) examined government assistance program use by "pre-transfer" poor female-headed single parent households1 in more detail. This researcher found that 86% of these households were receiving at least some government assistance income, 58% of them receiving AFDC. Thirty-one percent were participating in a combination of AFDC, food stamps and Medicaid and another 22% were using these three programs plus at least one other program. Emmons (1986) studied govemment and emergency (private) food program participation of a non-random sample of 76 low-income urban families that were on both food stamps and AFDC and had at least one child under age three. Ninety percent of the families were headed by single women. When examining participation by the families in other food and meal programs over the course of a month, she found that 71% participated in at least one other food or meal program, such as WIC, T'EFAP (federal surplus commodities), Headstart, school lunch or breakfast, or emergency foods. Twenty-one percent of the families, all of whom were supposedly "caught in the safety net" of government benefit programs, had to use emergency food programs at least once during the month. These sixteen families used emergency foods a total of 36 times. Thirty-three of these occurrences were visits to a food closet and three to soup kitchens. Because of the biases inherent in non-random sample selection, it is not known whether these families were representative of the population as a whole or not. 1 Households which had yearly incomes at or below the Federal poverty level before the receipt of government assistance 23 It can be seen from the above studies that multiple program participation is important, especially for those families who rely on govemment benefits as their main source of income. However, even with the use of multiple programs, a single-parent family is not likely to have an income which brings it up to the official poverty threshold and it might still be at risk for a food crisis in the home due to its low income. E E El] . E E . . . An individual might not participate in a particular assistance program for which s/he is eligible if the assistance is not needed or is not perceived as being needed. However, there might also be barriers to participation present. Nine hundred and forty-nine households from the Panel Study of Income Dynamics (PSlD) were found to be eligible for food stamps in 1979 (Coe, 1983). However, 54.6% of these eligible households did not participate in the food stamp program that year. Thirty-eight percent of the eligible, non- participating households thought that they did not meet the eligibility requirements; 13% said they did not need food stamps; 11% had been told they were ineligible; 8% cited stigma as a barrier to participation and another 8% cited administrative hassles. Only 4% of the respondents gave knowing nothing about the eligibility requirements as their reason for non-participation and only 1% felt that the benefits were to low too bother applying for. It was clear from these figures that informational problems, particularly those concerning program eligibility, were a major barrier to program participation. Further analysis using dummy variable regression found that participation in AFDC or general assistance (GA) was positively associated with participation in the food stamp program (p 5 .01), as was the number of children in the household under the age of 18 (p 5 .01). AFDC or GA recipients were 51% more likely to participate in the food stamp program than someone not receiving public assistance income. Thirty-eight percent of the variance was accounted for by the fact that these households were less likely to feel they did not meet some non-financial criteria. Another 13% was accounted for by the fact that 24 AFDC and GA recipients were less likely to feel there was a stigma attached to food stamp use. The number of hours worked in a year by the household head (p 5 .05), the household head's level of education (p 5 .01), and the monthly household income (p 5 .01) all had a significant negafiye impact on food stamp program participation. Those households where the head worked more than 1500 hours a year or where there was other outside income were likely to not participate because they thought the household was ineligible for food stamps. Household heads with the highest levels of education, although possessing more information about program eligibility than their less well-educated counterparts, tended to have negative attitudes toward the program. Wyers (1977) defined stigma as "loss of face, dignity, self-respect, and/or social acceptance which occurs as a result of exposing a personal blemish or handicap" (p. 956). He made the point that it is not the action per se, i.e. receiving assistance, that is the stigma, but "it is the evaluation of others that produces the stigmatizing effect, the 'spoiled identity' " (p. 958). It is generally believed that the stigma attached to receiving public assistance accounts for a large proportion of non-participation in assistance programs. It might therefore be surprising that perceived stigma in the use of food stamps accounted directly for only 8% of the non-participation in the above study. However, the researchers showed that stigma worked through other variables as well, such as education level of the household head. Stuart found in his 1975 study of assistance recipients in Hartford, Connecticut, that stigma was significantly related to the particular program in which the individual was participating (X2 = 18.80, p < .025). When asked how distressed they had felt when applying for the program, 67% of the food stamp recipients said they had not been bothered at all, but only 33% of the AFDC recipients said it had not bothered them to apply for that program. Stuart's data showed that the greater stigma attached to the AFDC program might have been due, at least in part, to the respondents' perception of how well 25 their needs were met by the program and how fairly they felt they had been treated when originally applying. Only 23% of the AFDC recipients felt their needs were well met by that program and only 29% felt that the person taking the applications treated everyone equally. This was in contrast to the food stamp recipients, 67% of whom felt their needs were being met by the program and 77% of whom felt that there was no favoritism shown by workers taking applications. Additionally, Stuart asked participants in the study whether they thought the assistance they were receiving was a right they had as citizens or was charity. Almost two-thirds of both the AFDC and food stamp subjects stated that they felt it was a right to which they were entitled. When Goodban (1985) asked a sample of 100 African American, single mothers receiving AFDC whether they were ever embarrassed or ashamed about receiving AFDC or food stamps, sixty-one said they were at least sometimes ashamed of being on AFDC. However, only thirty-six replied that shame or embarrassment was a problem with food stamps. Goodban also found that those who were not embarrassed about being on AFDC were also not stigmatized by participation in the food stamp program (r = .60, p = .0001). Several women in the study voluntarily mentioned that they were not embarrassed by using food stamps because they knew that they were fulfilling a "basic need", ie.-food, for both themselves and their children. Although the studies by Stuart (1975) and Goodban (1985) only examined people who were already participating in the assistance programs, they appear to have uncovered the fact that there are differing levels of stigma attached to participation in the AFDC and food stamp programs. That such a high proportion of the AFDC participants in both studies felt stigmatized by that program is difficult to generalize to the rest of the low- income population. However, it can be hypothesized that the participating mothers might have been in such dire straits that the perceived social and psychological costs of being on welfare were outweighed by the utility of the benefits of participation (Moffitt, 1983). Choosing to participate, however, might not mitigate the non-economic costs. Moffitt also 26 found that a woman's initial decision to go on AFDC was affected by perceived stigma, but once the woman was on welfare there was no additional stigmatizing effect as a result of her participation. Household income can be a significant barrier to participation in the AFDC program, even if the family's earned income is still below the federal poverty level. An analysis of the program in Michigan (Shapiro & Greenstein, 1988) demonstrated that if the net income of a family of three was greater than $593.00/month (78.5% of the poverty threshold) in 1987, the family would not qualify for AFDC. If the family was already on AFDC and the mother started working, when her net income reached or exceeded $623.00 (82.4% of poverty) or more per month, the family would be removed from the AFDC rolls after four months. A study of 558 AFDC participants in Hennepin County, Minnesota, who were working when President Reagan's Omnibus Reconciliation Act (OBRA) tightened earnings disregardsl drastically for the program, demonstrated that when the families were dropped from the AFDC program because of the mother's earnings, the family was not likely to return to the welfare rolls (Moscovice & Craig, 1984). Of the 357 subjects (64%) who had their grants terminated because of earned income, 303 (84.9%) were still working and off AFDC six months later. Even though they had increased their participation in the work force over this time by increasing the number of hours worked per week and by frequently taking on second jobs, these women still experienced an overall drop in net income of 6%. At the same time, the percentage of net income nwded to meet basic needs went from 73% to 85% for this group of working mothers. Additionally, this group was no longer eligible for Medicaid. Despite the serious negative consequences of choosing work over AFDC, only one person out of the twelve who were on AFDC and not working at the end of the study period said that she stopped working so she would not lose her AFDC grant. It 1 That portion of earned income overiooked in the calculation of program benefits. 27 should be noted that the results, although dramatic, were based on transitions occurring over a fairly short period of time. However, the results of the above study were confirmed by Feaster, Gottschalk, and Jakubson (1986) when they compared the beginning and ending work status of two randomly selected panels of AFDC participants. The data for the first panel were analyzed for a twelve month period prior to the implementation of the OBRA. The OBRA was implemented four months into the year covered by the data from the second panel. Although 84% of the cases in the first panel that started out the year with earned income were still open at the end of the twelve months that the cases were followed, only 54% of similar cases in the second panel were still open at the end of the time they were studied Therefore, a large number of cases terminated in the second panel due to earned income did not return to AFDC. One reason women might choose work instead of accepting AFDC, even though the family might be worse off, is the significant effect that personal income has been found to have on the self-efficacy of single mothers (Downey & Moen, 1987). Women who work might feel that they are more in control of their lives than those who do not. Also, the women might perceive that even low-paying jobs carry less stigma than being on AFDC. However, some women might view the significant disadvantages of working, such as lack of health insurance and a potential decrease in an already low household income, as incentive to stay on the AFDC rolls until they can be sure of adequately supporting their families. Although this section of the literature review on social welfare resource management has concentrated primarily on families whose incomes were at or below poverty level, it must be remembered that families with earned incomes above poverty still qualify for many in-kind, food-related programsl. Their food and food-buying resources 1 Above poverty income cut-offs for selected programs: 130% of poverty--food stamps, free school breakfast and lunch; 185% of poverty--WIC, reduced price school lunch, TEFAP. 28 also would be enhanced by participation in one or more of the programs for which they might be eligible. 5.15 ”1151.1“. Low-income households, when asked to whom they would turn for help if they had no money or food, are likely to state that they would turn first to their families for assistance. Forty-seven percent of the respondents in a survey of randomly selected low- income households in Utah said that they considered their families their primary resource under these circumstances (Fairchild & Ernst, 1986). This demonstrated reliance by the low-income respondents on their informal social support network, or that part of their social system consisting of family and friends. The type of support that a person receives from her informal social support network generally falls into two categories: 1) instrumental assistance-cg, money, child-care, food, advice, information; and 2) socioemotional assistance-cg, security, sympathy and understanding, a sense of worth, and companionship (Thoits, 1982). A person's formal social support network consists of those professionals and agencies which a that individual might use for help or support. This component of social support includes doctors, ministers, lawyers, social service agencies, etc. Structural analysis of the informal support network involves examination of obser- vable aspects of the linkages in the network, including the number of members in the network (size), the interactions among members independent of the central person (density), frequency of contact between the central person and network members, accessi- bility of network members, and strength of network ties (eg., Thoits, 1982; Tolsdorf, 1976; Vernon & Roberts, 1985 ; Walker et a1, 1977). A qualitative study based on 45 in- depth, semi-structured interviews (McLanahan, Wedemeyer, & Adelberg, 1981) found that the informal support networks of single mothers appeared to fall into three basic structures: 29 1) small, very dense networks based on the woman's family of originl; 2) large, extended networks usually involving a number of new female friends (particularly other single mothers) and community support organizations; and 3) dense or extended networks where the principle provider of informal support was a key male. A dense network is one in which there is a great deal of interaction between the members of the network independent of the central individual (Walker, McBride, & Vachon, 1977). In the McLanahan et al. study, the dense family of origin network was found to supply the woman with a sense of security and personal worth, as well as a great deal of material support in the form of financial assistance and help with domestic responsi- bilities and job problems. However, family of origin networks also appeared to isolate the woman from intimate relationships outside the network and from community supports. The extended, less dense networks, consisting primarily of new friends, appeared to be characteristic of women who were attempting to increase their independence. These women, however, were more likely to exhibit low self-esteem and be more distressed than women with dense family of origin networks. Members of a support network can directly affect the help-seeking behavior of an individual in several ways. They can buffer the psychological stress of a negative experience or provide adequate material or informational support, thereby reducing the need for seeking assistance outside the network. At other times they might take on the role of screencr and referral agent to professional services. Additionally, a person's informal support network often establishes the values and norms for help-seeking behavior of its members (Gourash, 1978). A study of two groups of low-income mothers by Birkel and Reppucci (1983) attempted to determine whether persons with dense networks were less likely to engage in help-seeking behavior than those with open networks. The researchers argued that there 1 Family of origin — a person's original family--ie. parents, brothers and sisters--as opposed to the family into which that person marries. 30 was likely to be less encouragement and referral from the informal support network to the formal support network if the values of a dense network did not agree with those of the available existing formal support structure. Also, a dense network might not allow information to reach the central person in the network easily or might exert pressure on the individual to adhere to the help-seeking norms and values of the network. An example of this might be when a woman needs clothes for her children which she cannot afford, but her family and relatives have a very negative attitude toward accepting "charity" and discourage her from going to the local Salvation Army for assistance or do not offer information about other sources of help. In each group examined in the Birkel and Reppucci study, the frequency of contact per month that each mother had with network members was measured, as was the density of her network, the geographical proximity of network members and the degree of overlap of the mother's kin and friendship networks. The fnst group examined consisted of low- income women at high-risk for child abuse enrolled in a special parenting group. The number of monthly contacts these mothers had with kin was found to be significantly associated with the number of parenting group sessions attended (F [3,27] = 3.23, p < .05). When the group was divided into low-users (S 4 sessions attended) and high- users (2 6 sessions attended), low-users were younger (t = 2.28, p < .05), had larger kin- networks (t = 4.84, p < .01), made more monthly contacts with kin (t = 4.29, p< .001), and had denser networks overall (t = 2.86, p < .01) than high users. Thirty-eight percent of the high-users, as opposed to 7% of the low-users, stated that they had no contact at all with any family members. For the second sample-a group of mothers receiving WIC--use of professional consultation for child-rearing concerns was negatively associated with overall network density (r = -.49, p < .05) and with number of monthly contacts with kin (r = -.42, p < .05). In both groups, dense, family-oriented networks negatively affected the help- and information-seeking activities of the low-income mothers. However, this study did not 31 determine why this was the case. The researchers did not ascertain whether these activities were influenced by lack of referral, pressure to adhere to network norms, or through sufficient provision of necessary assistance and advice from network members. McKinlay (1973) studied 83 low-income women in Aberdeen, Scotland, relative to their informal support networks and use of prenatal care services. Women who were classified as underutilizers of the professional services were more likely to live in close proximity to relatives (X2 = 8.49, p < .005) and have more frequent interactions with them (X2 = 53.05, p < .001) than women who regularly used the prenatal care services (utilizers). Utilizers had more frequent interaction with their friends than underutilizers (X2 = 12.79, p < .005); one-third of the underutilizers stated that they had no friends outside of their family of origin. Some women, mostly underutilizers, reported anecdotally that the first person with whom they discussed their pregnancy was their mother, who encouraged them not to seek prenatal care until absolutely necessary because they themselves had not done so. After the birth of their child, when the mothers in the study were asked whom they consulted before having their baby seen by the family doctor, utilizers were more likely than underutilizers to consult no one first (X2 = 12.15, p < .005), possibly indicating greater independence from their support networks. When investigating informal social support, it is important to include measures which obtain separate information on both the subject's family and on her friends. This is because the relative number of members from each group in the physical structure of the network appears to have direct and indirect influence on the woman's behavior, as demonstrated in the research findings discussed. It is also important to study both family and friends because support from family and support from friends appear to help to mitigate different problems with which single mothers must cope. Gladow and Ray (1986) found in their study of low-income, rural single mothers in Washington state that both the scale of family support and scale of friend support entered into a stepwise regression model predicting total problems faced by the mothers (friend 32 support: F = 12.64, p < .001; family support: F = 9.42, p < .01). When the responses to questions concerning specific individual problems were correlated with the responses to the emotional support question from the friend and family support scales, emotional support from friends was negatively correlated with problems related to dating, lack of emotional support, transportation and forming close friendships. Emotional support from family was negatively correlated with problems related to recreation and finances. Overall friend support was also found to be predictive of decreased loneliness (F = 5.19, p < .05). The researchers concluded that support from family and from friends both influence the well-being of a single mother, but in different ways. Gladow and Ray also suggested that the woman who uses both her friends and family for support would probably be better off than the woman who relies on only one of the two groups. In summation, although a support system can be important in helping a low-income single mother through a crisis, having a dense, family-oriented network might hinder her in seeking needed assistance from outside sources. Having a more loose network, including involvement with friends, appears to provide a woman with more information about outside resources and to exert less pressure on her than does having a dense support network which might apply pressures for adherence to norms and values of the network. A loose, extended network might also be indicative of the single mother who is in the process of increasing her independence from her family. However, the research does not appear to adequately demonstrate the reasons a woman with a dense family-of—origin network might not seek assistance from the formal sector. It might simply be because she is receiving sufficient and appropriate assistance from her family. Support from family and from friends appears to decrease the number of problems that a low-income, single mother might have to face. However, each group influences different problems. Therefore, women who can rely on mth family and friends are likely better off than women who rely more heavily on only one informal support group. 33 Statementntthefimhlem From the literature reviewed it is apparent that single-parent, female-headed families are a significant, vulnerable sub-group of low-income Americans. There are many factors «including income, shopping behaviors, barriers to welfare participation, and social support networks, to name only a few-—continually interacting to affect the food security of these women and their children. Therefore, many aspects of the lives of families must be investigated in concert and not in isolation. (See Appendix C for a conceptual model derived from these factors and used in the initial design of the study.) In order to determine: 1) what, if any, characteristics or behaviors differ between families that do not use the food bank and families that do; 2) what appear to be the most prevalent chronic factors present in a family or household which might lead up to food bank use; and 3) if there are there families who should be turning to the food bank in times of distress who are not doing so, and if not, why not, the following hypotheses were proposed for study. Wares The following hypotheses were tested using the data collected in this exploratory study. H01: Demographics Food bank users, non-users and past users will not differ demographically in terms of household or family size , transience, income, age, race, marital status, education or employment status. H02: Domestic Resource Management H02a: Food bank users, non-users and past users will purchase most of their food at large grocery stores and will shop for food with equal frequency. All groups will be equally likely to report using a shopping list, plan menus before big trips to the grocery store, purchase national brand foods and use a car to access the grocery store. 34 H021). Users, non-users, and past users will have the same number of working major appliances, utilities and amount of food storage space. H02c: Food bank non-users, users and past users will have the same total domestic resource management scores. H03: Cash Value Available to Purchase Food H03a: There will be no difference between any of the groups in the amount of money, including food stamps but not WIC, spent on food in a month. H031): For users, non-users and past users who receive food stamps, the number of weeks food stamps last the household and the amount of money added to the food stamps to purchase groceries will be the same . H04: Assistance Program Participation H0421: No difference will be found between food bank non-users, users and past users in participation in individual assistance programs or in total assistance program participation. H041): No group will be less informed about particular assistance programs or attach more stigma to assistance program participation than any other group. H05: Ingham County Food Bank (ICFB) H053: Non-users will know of the ICFB as often as users and past users. H051): Non-users who know of the food bank, users, and past users will be equally as likely to choose the ICFB as their first avenue of assistance in a food crisis. H06: Informal Social Support Network H063: Non-users, users and past users will interact as often with close friends as with family members or relatives. H061): Overall social support network scores will not vary among users, non- users and past users of the ICFB. H07: Meal Skipping Due to Lack of Food The frequency of meal skipping due to lack of food in the home will be the same in non-user, user, and past user families. CHAPTERIII Methods Sampling The criteria for a woman's inclusion as a subject in this study were that: 1) she was a single mother (divorced, separated, or never manied); 2) the household in which she was living contained at least one child under age six; and 3) her family's income did not exceed 185% of the federal poverty level. Because it was determined that one means of ceping with inadequate income is to live with another adult or family, the woman was not required to be the head of the household in which she resided. A subject's food bank use status was determined by whether she reported using the ICFB never (non-user); at least once within the last year (user); or at one time, but not within the last twelve months (past user) (Q#48B & D). A final sample of 74 subjects--twenty-one non-users, thirty-seven users and sixteen past users--was obtained. Only eight percent of all the households in Lansing are headed by poor, single mothers with children under the age of six years (US Bureau of the Census,l983). Additionally, there was no appropriate existing sampling frame available to use with this population, which includes families that have no phone or that are not involved in the social welfare system. Therefore, a non-probability sampling method was used to maximize the likelihood of contacting members of the target population. It was determined that a door- to-door census technique was the only available means of contacting potential subjects who were not a part of the normal socioeconomic system. 35 36 Three neighborhoods, based on the boundaries of Gier Park, Walnut, and Bingham elementary schools (see Appendix C), were selected for inclusion in the study because of the high proportion of students in those schools from families receiving AFDC (Gier Park-- 41%, Walnut-43%, Bingham-49%) (personal communication, P. Peterson, March, 1989). Although AFDC is not used exclusively by female-headed, single parent households, the majority of recipients fit that profile. There were a total of 813 female, single heads of families with children under 18 years living in these three neighborhoods (personal communication, Lansing City Planning Department, March, 1989). This was the best census information available at the time the sampling process occurred. Thirty-one percent of these families lived in the Gier Park neighborhood, 31% in the Bingham neighborhood, and 38% resided in the Walnut school neighborhood. Therefore, including a small over-sampling to allow for unusable interviews, it was decided that 36 interviews would be conducted in the Gier Park neighborhood, 36 in the Bingham area, and 43 interviews in the Walnut area. One hundred usable interviews was set as the desired number of interviews for the final sample based on time and resource constraints, the fact that it was an exploratory study, and the minimum number necessary to be able to use discriminant analysis (personal communications, Dr. J Gill and Dr. H. Perlstadt, April, 1989). However, because the study took longer than anticipated, only the Walnut and Bingham neighborhoods were surveyed. A final sample of 74 usable interviews was obtained. Within the two neighborhoods surveyed, the blocks to be sampled were randomly selected through a draw of street names and block numbers. This allowed a homogeneous sampling of the neighborhood residents and avoided possible concentration on a group of blocks where senior citizens, married couples or some other distinctive population not fitting the study profile had clustered. Blocks were drawn in groups of five and each group was assigned a consecutive letter of the alphabet. Groups A, C, E, etc. were assigned to one principal interviewer and the remaining blocks were assigned the the second principal 37 interviewer. Each principal interviewer was instructed that she and her partner could sample the blocks within each group in any order, to be able to move logically through the neighborhood, but the group of blocks as a whole had to be sampled before the next group of five blocks. The interviewers were instructed to knock on every door on both sides of the street on the randomly chosen blocks. If no one was at home, the interviewers proceeded to the very next house on the block. In those households where someone was found at home, at the conclusion of the prescreen in non—eligible or refuser households or the at end of interview in subject households, the interviewers asked whether a single mother lived next door to the person to whom they were speaking. If the respondent said "yes" or did not know, the adjacent house(s) were sampled. If the interviewers were told that a single mother did not live in a particular house, that house was not sampled. Interviewers returned a minimum of three times to contact someone in a house where they had been told a single mother lived before they considered it a non-respondent household. At houses where household headship was unknown, if no one was home at the time of initial contact, no return calls were made unless there was evidence of children in the home. These procedures were used to minimize the amount of time neekd to cover the houses on a block, while maximizing the amount of initial information obtained about the households. Large commercial apartment buildings were not sampled due to problems with access. These procedures were followed on each of the randomly chosen blocks until the necessary number of interviews for that neighborhood was completed. I"El Two to three days before the survey began, on each group of randomly chosen blocks, one page flyers (see Appendix D) printed on bright gold paper announcing that the survey was occurring were placed in the doors or behind mailboxes of all houses and 38 apartments to be screened for potential respondents. In addition to brief, rather generic information about the survey itself, the flyer included a phone number for people to call if they had any questions or required more information. The operations department of the Lansing Police Department was notified when the interviewers began in each neighborhood. This was done not only to let the police patrolling the neighborhoods know what the interviewers were there for, but to provide central operations with information in case the police received phone calls concerning strangers going door-to—door in the area. The interview staff over the course of the study consisted of the principal investigator and four to six paid interviewers recruited from graduate and senior undergraduate students at Michigan State University. The interviewers received a minimum of ten hours of training and practice in basic interviewing techniques, presentation of the questionnaire, and personal safety. To help assure personal safety, all canvassing and interviewing activities were conducted in pairs during daylight hours. When the interviewers found someone at home through the sampling procedures described in the previous section, the interviewers introduced themselves and proceeded with a series of pre-screening questions (see Appendix E) to determine if the family (represented by the single mother) or another family in the household was eligible to participate in the survey. If there was no single mother in the household, or if the respondent became ineligible to participate based on one of the pre—screening questions, the interviewers asked the respondent if there were single mothers living on either side of them, thanked the respondent for his/her time, and moved on to the next appropriate house. If the family met the criteria of the study, the woman was asked to participate in a forty minute interview to be conducted in her home. She was told that she would receive a five dollar gift certificate to a local grocery store upon completion of the interview. If the woman wished to participate, but could not do the interview at the time of the initial contact, an appointment was made for the interviewers to return. All respondents were 39 required to sign an informed consent form before the interview took place (see Appendix F). Approval for the project was received from the University Committee on Research Involving Human Subjects after expedited review (see Appendix G). 110" A standardized questionnaire was used for all interviews (see Appendix H). It consisted primarily of close-ended questions covering demographics, domestic resource management, social welfare resource management, social support, and selected hunger indicators. All questions were read by the interviewers to the respondents to control for the unknown literacy levels of the subjects. Some of the questions used were selected, with or without adaptation, from questionnaires used in other studies (Contra Costa County Hunger Task Force, 1987; Fairchild & Ernst, 1986; Interim Study Committee on Hunger and Nutrition in South Carolina, 1986; Mid-Columbia Community Action Council, 1987; Minnesota Food and Education Resource Center, 1985; NHANES III [draft], 1988; Oregon Food Share, 1986; Social Science Research Bureau and Department of Resource Development, 1987). Other questions were developed from recommendations given by experts in the various areas of interest. The third source of material for the questionnaire was the research literature (Anderson, 1988; Block and Kellerman, 1977; Coe, 1971; Goodban, 1985; Goodman, 1968; McKinlay, 1973). The questionnaire was pro-tested with a group of seven volunteer, low-income mothers after initial editing by the researcher's thesis committee members1 . It was then re- edited and presented to the head of the Ingham county EFNEP program and the thesis committee members for further comment. Final editing took place after the pilot study, based on the data and other information obtained. 1 Three professionals in nutrition, one in sociology and survey research, and the director of the Ingham County Food Bank. 40 A pilot study consisting twenty interviews was conducted in a neighborhood similar to the neighborhoods chosen for the study. The procedures to be used in the actual survey were followed as closely as possible, to locate any inherent problems and also to determine a reasonable response rate. Sixteen usable surveys were obtained (80% response rate) from the pilot. Data analysis was inconclusive in determining which questions discriminated best between food bank users and non-users. Based on findings from the pilot study, some of the original questions were rewritten for clarification and others were added to the questionnaire. DataAnalxsis All data analysis was performed using a version of the Statistical Package for the Social Sciences (SPSS/PC+ V3.1) (SPSS, Inc., 1989) on an IBM/PC compatible computer. To increase the efficiency of the analysis process, oneway AN OVA was used to screen for interval-level variables where the means were not equal among the three groups-- users, non-users and past users. The ANOVA technique allows the researcher to control the level of alpha when comparing more than one pair of means. However, if the F—value is statistically significant, it does not allow for determination of which pair(s) of means are different. Therefore, for each interval-level variable that achieved significance at p S .10 with ANOVA, the means of each possible pair of groups (users vs. non-users; ex-users vs. non-users; ex-users vs. users) were tested for equality using the Tukey Multiple Comparison method (Tukey MC). This controls for the increased probability of committing a Type I error when conducting multiple comparisons (Glass & Hopkins,l984). Bonferroni chi-square was used to evaluate the ordinal data, again to control for an increased probability of Type I error with multiple comparisons (W ickens, 1989). For both the Tukey MC and Bonferroni chi-square, a maximum error rate of p S. 10 was set for each group of comparisons. 41 Incomefialculatinns Yearly income for the families in the study was calculated by multiplying their income for the previous month by twelve. Although this method might over-estimate yearly income for some families and under-estimate it for others, it was the only means available to reach at least a rough determination of yearly income. Other income calculations were computed using the following formulas: (p. 54) Per capita family income: family's total income in the month before the interview number of persons in the fanTrIy (p. 61) Average yearly per capita income of all families in each group: average yearly family income of each gro_up_ average family size of group (p.61) To convert 1985 dollars to 1989 dollars, the 1985 dollar figure was multiplied by the ratio of the 1989 CPI to the 1985 CPI, i.e, $10,398.00 x 124 107.6 IndezLScQtes Index scores can sometimes be used to examine a larger underlying concept which is difficult or impossible to quantify using only one or two variables. Combining the results of several observed variables, each of which obtains information on a different aspect of the concept, allows the investigator to better view the "total picture". In this case, the "total picture" is the overall ability of the family to manage food resources in the home (domestic resource management or DRM index) and the overall informal social support network of the single mother (SSN index). These composite indices can also increase the efficiency of the data analysis when the index scores are treated as individual variables in analyses in place of the individual variables which comprise the index. In the analysis of this study, an attempt was made to construct a DRM index from questions #2, 2A, 3, 6, 7, 10-1 1, 31, and 32 (see Table 3.1) and an SSN index from questions #3943 (see Table 3.2). Before any difference in mean scores could be tested for either of these indices, the validity of the indices had to be examined (Carmines & Zeller, 42 1979). After a search of the relevant literature and examination by experts, it was presumed that each of the included questions was valid on its face in contributing to a description of the named underlying concepts (Allen & Yen, 1979, p. 96), ie. domestic resource management and the informal social support network. In the next step of index creation, the appropriate correlations were run between the variables in each of the above designated indices to examine all possible bivariate relationships between the items (Babbie, 1989). The correlation matrix for the DRM index is presented in Table 3.3. The matrix for the SSN index is laid out in Table 3.4. Items thought to measure varying aspects of the same underlying concept should exhibit at least moderate correlations (Crocker & Algina, 1986, p. 223). Those questions which consistently correlated r S .20 with the other items in the index should be dropped from further consideration. When two items correlated r 2 .80, one of the items should be selected to remain in the index and the other dropped, because they both apparently measured the same dimension of the underlying concept. Because the responses to the various questions to be used in the indices were scored in several different metrics--there were nominal, ordinal, dichotomous, and interval measures--factor analysis could not be used to examine the cohesiveness of the hypothesized group relationships. Factor analysis requires interval data or at least ordinal data where there is a strong belief that the numbers assigned to the answer categories reflect the true distance between the categories (Kim & Mueller, 1978, 73-74). The correlations between the variables included in the DRM index were weak at best (see Table 3.3). The one exception was the correlation between total number of times shopping (SHOP####) and number of times shopping at the convenience store (MSQD) (r = .79), a relationship which exhibits a high degree of multicollinearity. Overall shopping frequency and number of times the household shopped at Quality Dairy were also the only variables included in the DRM index which discriminated between food bank use categories. Given the weak bivariate relationships between variables and the lack of 43 discriminating power of the individual variables, it was felt that nothing would be gained by further attempts to combine the variables into a single DRM index score. Additionally, it was found that with response categories of the variables in differing metrics, it was difficult to determine how to weight the answers to the individual variables in relation to the other variables to be used in the final index. This particular problem was also an obstacle in the creation of the SSN index. When the correlation matrix for the social support network variables was examined (Table 3.4), it could be seen that the correlations between the family network variables were quite good, the correlations between the friend network variables were not quite as strong, and the correlations between the family and friend network variables were relatively weak and scattered. It appeared that these family and friend network variables were not measuring aspects of the same overall underlying concept. When the next step in the index derivation was undertaken, a friend variable-- FNDFIFl‘N--was removed from further consideration because of its strong correlation with CLOSEFND. It was decided to remove a second friend variable--FNDSMEET--from consideration because only a small subgroup, those women who had more than one friend and whose friends knew each other, were asked that question. As more friend variables were removed, the family variables potentially gained more weight in the final score simply because of the larger number of family variables which would remain in the index. Additionally, the only variables which discriminated significantly among any of the groups were three family variables: FAMFUN, GLADHEIP, and FAMFIFI'N. Given the above findings , it did not seem feasible or practical to combine the SSN variables into an overall SSN index. Within the SSN variables there appeared to be a strong family network component and possibly a friend network component, which were evaluated as separate sub-indices. First, frequency of interactions with close friends and with family members (SUPPFND and SUPPFAM) were calculated for each subject by summing the points of each chosen response 44 category in the respective family and friend matrices (Q#35 & 38) after recoding so the points ranged from 0=never to 5=everyday. A maximum of 30 points was possible. SUPPFND and SUPPFAM were then analyzed as individual and distinct continuous variables. The family network score (FAMNET) for each subject was then the sum of SUPPFAM, CALLFAM, GLADHELP, FAMCLOSE and FAMFIF'I'N. The friend network score (FNDNET) was the sum of SUPPFND, CLOSEFND and FNDSKNOW. To more equally weight all questions used to create FAMNET and FNDNET, further recoding was done so that all values assigned to response choices were within the range of 0 to 4. Interval variables were divided as closely as possible into quintiles based on frequency of responses by the entire sample. The response categories of "Never" and "Less than once a month" in the matrices (Q#35 and 38) were combined to reduce the number of answer categories to five. The dichotomous variables were assigned a value of 0 for the least desirable response choice and 4 for the most desirable. With the variable CALLFAM, the response choices were assigned the values of -4, -2, 0, 2, and 4. A maximum of 40 points was possible for FAMNET and a maximum of 32 points was possible for FNDNET. 45 Table 3.1. Questions considered for inclusion in the domestic resource management index. Q#2. (IIMESQD) Thinking about all the times someone has gone to the store to buy food for your household in the last 4 weeks or month, how many times would you say someone went to buy food at Quality Dairy, the Magic Market,orthe 7-11? Q#2A.(mQSIQB.E) In the last month, out of all the times someone went to the store to buy food for the household, how many times would you say someone went to Shoprite, Krogers, or Meijers? W is the sum of the above two questions plus Q#ZC concerning frequency of shopping at any other stores] Q#3. (SIQRMQSI) At which store did your household buy most of its food in the last 4 weeks? Q#6. (51121.51) How often do you use a shopping list when grocery shopping? Would you say you never, almost never, sometimes, frequently, almost always, or always use a shepping list? Q#7. W) How often does someone in your household plan menus before big trips to the grocery store are made? Would you say that menus are never, almost never, sometimes, frequently, almost always, or always planned? Q#10. (EKQSIZE) When food items come in different size packages, do you usually buy the small, medium, or large size? Q#ll. WEED) Do you and your neighbors or friends ever share or trade food to help each other out when you don't have enough food in the house and can't afford to buy more? Q#31. (AEESQQRE) Let's take a look now at some of the things you have to work with in your home. Which of the following working appliances do you have in your home right now? Do you have a working refiigerator? oven? freezer? microwave? stove or range? Q#32. (quSIQRQ) Which of the following things do you have in your home right now? Enough room to store food? running water? hot water? electricity? a kitchen sink drain that works? Table 3.2. Questions considered for inclusion in the social support network index. Q#34. W) Thinking about all your friends first, how many of them would you consrder close friends? Q#34A. (mm) How many of your close friends live within fifteen minutes of you, either driving or walking? Q#35. With your close friends, how many times a week or month do you: Less than 1 to 3 About Several Don’t oncea timesa oncea times Every recall Never month month week a week day or NA Get or ive help W) 1 2 3 4 5 6 0 et or give support (31251122) 1 2 3 4 5 6 0 ‘scuss aroblems (ENDERQBJ 1 2 3 4 5 6 O T xchange advice (ENDAILV) 1 2 3 4 5 6 0 Get together for 5n or relaxation (1511123111) 1 2 3 4 5 6 0 Talk on the phone (ENDEHQNE) 1 2 3 4 5 6 0 (51mm is the sum of the chosen responses in the above matrix, after recoding so the responses run from 0=never to 5=everyday.) Q#36. (FNDSKNQE) Do your close friends know each other? Q#36A. (FNDSMEEI) How often would you say any of your close friends get together when you can't make it? Would you say they get together often, sometimes, hardly ever or never? Q#37. (ENDEAM) Are any of your close friends also good friends with any other members of your family, other than your children? 47 Table 3.2 (con't) Q#38. Think about your family and relatives now. With family members or relatives, how many times a week or a month do you:... Less than 1 to 3 About Several Don't once a times a once a times Every recall Never month month week a week day or NA Get or five help (EAMHELE) 1 2 3 4 5 6 0 et or give support (EAMSHEE) l 2 3 4 5 6 0 'scuss problems (EAMERQB) 1 2 3 4 5 6 0 change advice W) 1 2 3 4 5 6 O et together for fun or relaxation W) l 2 3 4 5 6 0 Talk on the phone (EAMEHQNE) 1 2 3 4 5 6 0 (film is the sum of the chosen responses in the above matrix, after recoding so the responses run from 0=never to 5=everyday.) Q#39. 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