The Impact of Supplemental Nutrition Assistance Program and Acculturation on Obesity among Adult Immigrant Groups in the United States

INTRODUCTION: Obesity is a dangerous, costly and common condition that has more than doubled worldwide since 1980 and affects greater than one-third (~37%) of adults in the United States. Studies have shown that minority groups have disproportionately high rates of obesity and that there is an overall positive association between immigrant length of residency in the U.S. and obesity. Immigrant families are incredibly likely to experience poverty in their new host environment—limiting them to low-cost high-density foods. The Supplemental Nutrition Assistance Program (SNAP) was implemented to promote behaviors that can reduce the impact of obesity and improve nutrition levels among low-income families in America. The trend of obesity has been examined across demographic groups. However, less is known about the pattern among immigrant groups. This study aimed to investigate the association between acculturation and obesity among immigrant groups and to assess if SNAP participation modifies this association. METHODS: Data from the cross-sectional study, the National Health and Nutrition Examination Survey 2009-2014, was used on 3,759 non-U.S. born individuals ≥ 20 years. Obesity was assessed using BMI and acculturation was measured by length of residency in the United States along with self-reported nativity. Chi-square analyses were performed for bivariate comparisons between acculturation status and sociodemographic variables, including obesity and SNAP participation status. Following this, a univariate analysis of obesity and all variables in the study was performed. After that was the computation of logistic regression models among the sample population testing for the effect of acculturation on obesity. RESULTS: Of the 3,759 study participants, 2358 (62.7%) were acculturated. Significantly more participants who were acculturated were obese, older (median=53), had less than a high school education, had an income-poverty ratio greater than 5, could afford to eat balanced meals and do not perform physical activities. When analyzing the direct association between acculturation and obesity, there was a positive significant association between the variables (OR= 1.365; 95% CI 1.177, 1.585). This association remained positive after controlling for all covariates and SNAP participation did not affect the relationship between acculturation and obesity, but it did, however, increase the risk of obesity overall. DISCUSSION: Results from this study agreed with the majority of the literature that there is a positive association between acculturation and obesity. The study reflected that acculturated immigrants did not have difficulty providing balanced meals for their families, but they also did not perform physical activities. To control the obesity epidemic in America, it is important that the trend of the condition is also thoroughly examined among immigrant groups. Further research performing a comprehensive investigation that includes all known risk factors of obesity and a more extensive measure of acculturation to most accurately assess their association is needed. There also needs to be an additional assessment of the SNAP-Ed programs because the overall association of why SNAP participation increases the risk of obesity is concerning