Differences in the Neighborhood Retail Food Environment and Obesity Among US Children and Adolescents by SNAP Participation

OBJECTIVE: To understand the association between children’s neighborhood food access and overweight/obesity in a national sample of U.S. households, and whether it differs by Supplemental Nutrition Assistance Program (SNAP) participation or household purchases. METHODS: Data were from the National Household Food Acquisition and Purchase Survey (2012–2013; n=3,748 children ages 2–18). We used logistic regression to examine associations between neighborhood retail food access (<1-mile from home), food purchases (including sugary beverages), and overweight/obesity, stratified by SNAP status (1,720 participants, 453 eligible non-participants, 1,575 SNAP ineligible). Store types included: supermarkets/grocery, combination grocery/other (independent drug, dollar, and general stores), convenience, fast food, and non-fast food restaurants. RESULTS: Odds of childhood overweight/obesity (OR [95% CI]) were higher with greater access to combination grocery/other stores overall (1.10 [1.03, 1.17]) and for children in SNAP (1.14 [1.05, 1.24]). Eligible non-SNAP children had higher odds of overweight/obesity with greater access to convenience stores (1.11 [1.04, 1.18]). The average child lived in a household with 6.3% of total spending at food outlets on sugary beverages (SNAP: 8.3%, eligible non-SNAP: 7.7%, SNAP ineligible: 5.5%). CONCLUSIONS: Greater neighborhood access to combination grocery/other stores is associated with higher obesity prevalence for children overall and those in SNAP.