title: The unhealthy food environment does not modify the association between obesity and participation in the Supplemental Nutrition Assistance Program (SNAP) in Los Angeles County.
abstract: Participation in the Supplemental Nutrition Assistance Program (SNAP) has been linked to an increased risk of obesity, but not much is known about the mechanisms behind this association. The objective of this study was to determine if the neighborhood density of unhealthy food outlets modifies the association between obesity and participation in SNAP.
  
  
  
  Data comes from the first wave of the Los Angeles Family and Neighborhood Survey; included are a subsample of adults (18+ years) who were SNAP participants or eligible non-participants (N = 1,176). We carried out multilevel analyses with obesity (BMI ≥ 30 Kg/m2), SNAP participation, and the neighborhood density of unhealthy food outlets as dependent, independent and modifying variables, respectively, controlling for age, gender, race/ethnicity, marital status, working status, mental health, and neighborhood poverty.
  
  
  
  SNAP participants had double the odds of obesity compared to eligible non-participants (OR = 2.02; 95%CI = 1.44-2.83). However, the neighborhood density of unhealthy food outlets did not modify this association.
  
  
  
  SNAP participation was associated with higher odds of obesity in our primarily Hispanic sample in Los Angeles County, with no effect modification found for the unhealthy portion of the food environment. More research is needed with additional food environment measures to confirm our null findings. Additional research is needed to elucidate the mechanisms linking SNAP participation and obesity as they remain unclear.
authors.affiliation: Institute for Social and Economic Research (ISER), University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK.
authors.forename: M Pia
authors.initials: MP
authors.lastname: Chaparro
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, 90095, USA.
authors.forename: Gail G
authors.initials: GG
authors.lastname: Harrison
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, 90095, USA.
authors.forename: May C
authors.initials: MC
authors.lastname: Wang
authors.affiliation: Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, Office: HSB F-226C, Box: 357234, Seattle, WA, 98195, USA. eseto@uw.edu.
authors.forename: Edmund Y W
authors.initials: EY
authors.lastname: Seto
authors.affiliation: Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA, 90095, USA.|Department of Sociology, University of California Los Angeles (UCLA), Los Angeles, CA, 90095, USA.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Pebley
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data; D005260:Female; D063105:Food Assistance / Q000706:statistics & numerical data*; D005523:Food Supply / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D009765:Obesity / Q000453:epidemiology*; D011203:Poverty / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data*
keywords: Effect modification; Food environment; Los Angeles County; Multilevel analysis; Obesity; SNAP