Food Choices and Coping Strategies During Periods of Perceived Food Shortage: Perspectives from Four Racial/Ethnic Groups

Introduction

Changing demographics is a topic of importance for the Cooperative Extension Service across the nation (ECOP, 2002). As demographic profiles change, Extension professionals are challenged to adjust traditional programming in ways appropriate for the needs of diverse audiences. Disparities in health exist based on race and ethnicity, gender, age, and socioeconomic status. Of particular interest to Extension professionals in the field of nutrition are the relations between food insufficiency and the burgeoning obesity epidemic in women (Basiotis & Lino, 2003; Townsend, Peerson, Love, & Achterberg, 2001). African American, Hispanic American and Native American women are disproportionately affected having particularly high rates of obesity (USDHHS, 2000).

To effectively address obesity, we must first understand and develop programs that reflect on the complexities surrounding eating behaviors (Heresy, Anliker, Miller, & Mullis, 2001; Kempson, Keenan, Sadani, & Ridlen, 2002), such as social and cultural factors influencing aspects of food purchasing and consumption habits. Response to food shortage by different ethnic groups is an area that has received scant attention, but warrants investigation.

The aim of the study reported here was to examine ethnic differences and similarities in food purchase and consumption behaviors of limited resource women during perceived periods of food shortage. A better understanding of food choices in various ethnic groups is essential for development of appropriate and culturally sensitive nutrition education materials that inform research and practice (Devine, Sobal, Bisogni, & Connors, 1999).

Methodology

Individuals from four racial/ groups, ethnic African-American, Hispanic, Native American, and Whites, were recruited from a metropolitan area in Oklahoma by Nutrition Education Assistants (NEAs) and Area Coordinators employed by the Oklahoma Cooperative Extension Service Community Nutrition Education Programs (CNEP) to participate in focus groups exploring food coping strategies. CNEP encompasses two programs targeting limited resource families in Oklahoma, the Food Stamp Nutrition Education Program (FSNE) and the Expanded Nutrition Education Program (EFNEP).

In order to participate in the study, women had to be 18-35 years of age and could not be pregnant, lactating, or have a disease affecting their diet at the time of the interview. Participants of this age range were selected because women of childbearing age were the primary focus of CNEP programming at the time of the study. Participants did not have to be members of the Community Nutrition Education Programs (CNEP) at the time of the study, but they were all recruited from organizations targeting limited resource audiences. Participants were offered a gift of kitchen utensils worth $10 for participation in the study. This project was approved by the Oklahoma State University Institutional Review Board for Human Subjects prior to data collection.

Focus groups (Satterfield, & Mitchell, 1997) were used to investigate food choices during periods of perceived food shortage. A semi-structured interview guide was designed based on a review of the literature and previous research to determine food-purchasing patterns and food management strategies during periods of perceived food shortage (Beto, Sheth, & Rewers, 1997; Hampl & Hall, 2002; Heresy, Anliker, Miller, & Mullis, 2001). A semi-structured interview format was used to allow for the creation of questions during the interview whereby the moderator has the flexibility to discuss unanticipated issues of relevance that emanate from group discussions.

Focus group questions were piloted with NEAs and an Area Coordinator because of their experience working with limited income participants who have experienced food shortage. The NEAs provided input to help modify the questions to make them more relevant for participants. Following the pilot testing of the interview script, questions were added relating to use of convenience stores, stores where participants did most of their grocery shopping, the importance of school feeding programs for participants with children, the use of food stamps, and the use of the food guide pyramid when grocery shopping. The final semi-structured interview guide is presented in Table 1. Because the interview script was semi-structured, the number of questions asked was not constant in all focus groups, and discussions varied depending on responses from focus group participants.

Two focus group interviews (2-10 women per group) were conducted with each ethnic group for a total of eight focus groups. Two individual interviews were conducted with Hispanic participants who came in at times different from other participants due to time conflicts. Results from these two interviews were treated as focus group result for data analysis. For the Hispanic focus groups and interviews, a single translator translated questions asked by the moderator as well as responses given by participants. The moderator was an Extension specialist trained in qualitative field methods.

All focus group interviews were approximately 1 hour in duration. Interviews were audio taped, and the Bureau of Social Research at Oklahoma State University created verbatim transcripts. For the Hispanic focus group and individual interviews, only English portions of the interviews were transcribed. The moderator, assistant moderator, and nutrition faculty reviewed transcripts to identify major themes. Frequency of answers from verbatim transcripts was noted in each group using analysis worksheets and summaries.

Results

A total of 64 women participated in eight focus group interviews conducted between March and September 2003. Demographic data collected on participants' age and ethnicity are presented in Table 2.

Content analysis of transcripts indicated both differences and similarities with respect to how women from each ethnic group perceived food insufficiency and their coping strategies (Table 3). In general, African American and Native American respondents perceived food shortage as less common than either White or Hispanic respondents. The perception of less food shortage may be due in part to stronger proximal familial ties among Native American and African American respondents, as indicated by an African American woman who coped with food shortage by dropping "kids off at a relative's house, if we were to run out of food. I get rid of my kids, and take them to where the food is."

Native American participants reported fewer occasions of food shortages than the other ethnic groups in the study. In addition to family assistance during times of food shortage, Native Americans considered commodity foods as beneficial during this time. These foods were stated to have shown an improvement in quality and an increase in variety over the years. An additional strategy reported by Native Americans was a variation in food intake throughout the month. This finding was best summarized by a woman who stated, "When there is not a lot to eat you eat what is there, but when there is more you can eat what you want, what you are craving for in the taste when there is more food."

Hispanic respondents mentioned that, as women, they would seek work outside the home and men would work extra to make more money to cope with food scarcity. Hispanic respondents also expressed immense gratitude for the support of food pantries and churches in the United States as compared to the help they received during times of food shortage in their home countries. In their home countries they relied on their extended family for help during episodes of food shortage.

Shopping locale (Table 4) was similar for all ethnic groups with the exception of Hispanics, who did not patronize convenience stores as frequently as other ethnic groups. Hispanic respondents relied more on Mexican food stores, where traditional foods were more readily available. Native American, White, and African American respondents indicated using convenience stores when purchasing snacks like chips, soda, coffee, and candy as "treats for children." Most participants agreed prices for food products were higher at convenience stores, but sometimes these were the only option due to time of day or proximity to home.

Native American and Hispanic American respondents reported eating less frequently at fast food restaurants. Hispanic American respondents did not frequent fast food places because of lack of familiarity with food items, whereas Native American respondents indicated cost was a reason for not eating out, as indicted by statements such as "some people don't have any money; no room on your credit card" and "they don't take checks."

White and African American respondents reported eating at a variety of fast food restaurants more frequently. Fast food choices were varied and ranged from restaurants serving burgers to Chinese food or pizza. For African American respondents, fast food was often discussed in terms of child preferences, as indicated by one woman who stated, "When they have done their chores and get good grades in school I take them to (fast food place)." Another African American woman echoed the value children place on fast food places, reflecting upon her son's requests to a grandmother as she stated, "he [son] will call in and be like 'Grandma I want McDonald's' and when the Cadillac is pulling up he knows he is getting some."

Value was also placed on the ability to eat at fast food restaurants, as indicated by an African American woman who indicated "when you have money in the bank then it is okay to run up and have good Chinese food or something like that. But when you are broke then you can't do that." For all ethnic groups except Hispanics, eating out was indicated as a form of relief or entertainment. When reflecting on reasons her family ate out, one participant stated, "Sometimes you gotta splurge".

For all ethnic groups, the bulk of food was purchased at larger chain grocery stores. These stores were used because of larger variety of food and other products available, good quality of produce and meats, close proximity to home, and acceptance of coupons.

A noteworthy difference in staple foods (Table 5) was that fruits were only reported as staple foods among the Hispanic participants. These participants also stated that fresh fruit, tortillas, beans, rice, and milk were considered the basic Hispanic foods.

Foods mentioned by respondents when asked what they would purchase if they only had $10 for food until payday are noted in Table 5. Respondents coping strategies if they only had $10 for food until payday were similar across all ethnic groups, and the most common answers were they would eat less, eat cheaper foods or off-brands, and buy foods in bulk that would last longer. Foods chosen during this time were referred to as filling foods. Consideration of children's needs in the household was a high priority when food resources were scarce. The most noteworthy quote indicating the need to meet the needs of children was stated by a Native American woman who purchased food that "fills the cavity. It's food for hungry kids."

For the most part, respondents from all ethnic groups seldom used the food guide pyramid or a food list when shopping. A majority of members of the African American, White, and Native American ethnic groups stated they did not carry a shopping list because they purchased the same foods all the time. Hispanic American respondents stated they carried a shopping list to the store because of the tendency to purchase food items only one time per month.

School feeding programs were very important to Native American, African American, and White study participants with children. Participants considered school meals to be nutritious, guaranteed, and most important, free. However, it was the unanimous opinion that portions should be larger and also a larger variety of food and drinks should be offered to choose from at school.

One limitation of school feeding programs was the perception that foods provided at school are not familiar to children, as indicated by an African American woman when talking about her child, "when my eleven-year-old comes home she is just ravishing through the cabinets looking for something to eat. She just stands in front of the refrigerator, and I want her to just get something and go on, but she says that I'm hungry, their food doesn't taste like yours, they can't cook, I want you to come up to the cafeteria." Among Hispanic participants, respondents stated their children did not eat the foods at school and took home-cooked meals with them to school most days.

Food Stamp benefits were mentioned as being very important for all ethnic groups. There was a general feeling that the amount allotted from the Food Stamp Program was inadequate to meet the entire food needs of the family. African American and White respondents indicated a belief that they should not have to use personal cash for food and that food stamps should be adequate to meet the food needs of a family for the entire month.

Discussion and Implications

Findings from the study reported here support those of Walker, Dobson, Middelton, Beardsworth, and Keil (1995), who surmised that "budgeting wisely often and necessarily involves some dietary sacrifice." A comparison of the responses to the question about having only $10 until payday the next week indicated sacrifice in that the majority of participants stated they would eat less, eat cheaper foods or off-brands, and buy foods that would last longer. Since dietary sacrifice may be common among those facing periodic episodes of food shortage, we found satiety is highly revered in times of food insufficiency as compared to nutrient content. As such, taste versus nutrition may be an important concept to emphasize when working with limited resource audiences.

Some research has indicated higher fast food consumption among limited resource populations (Story, Neumark-Sztaine, Resnick, & Blum, 1998). We suggest that food could be an affordable form of entertainment for those who are lacking in monetary resources. Results of this study support this view and indicate a strong need to fulfill the needs of children within the household in that food was often mentioned as a treat. It could be that food is the most affordable treat for limited resource families in the study.

Additionally, the study revealed many similarities among ethnic groups, with the exception of Hispanic respondents. The degree of acculturation is most likely the reason for such differences among Hispanic American respondents in this study. Geographical location and the situation of poverty may be reasons for similarities among groups. Building Cooperative Extension Service programs upon group similarities may be an effective way to address multiethnic programming because group education is observably more common in many FSNE and EFNEP programs (Food and Nutrition Service, 2003). Cooperative Extension Service is challenged to develop culturally sensitive materials for multicultural environments. Given the similarities noted in this study and the reality that Extension professionals using group educational methods in metropolitan areas seldom reach only one ethnic group, development and testing of multicultural curricula is essential.

Preston (1997) posed that individuals may "choose which health messages they can comfortably identify with and disregard the rest." The data from the study taken in concert with that of Preston's indicate Extension professionals need to take into consideration other life circumstances that may have an impact upon food choices, including but not limited to socioeconomics. Factors such as responsibility to other household members, time, and purchasing locale are additional life circumstances Extension professionals might want to consider.

An example of how life circumstances may influence educational strategies is a divergence from promotion of cooking from scratch as a strategy for budgeting food dollars. Since many of the foods identified as staple and emergency foods were convenience or processed foods for all ethnic groups except Hispanics, it may be important for educators to reconsider the appropriateness of cooking from scratch for the current generation. Promoting cooking from scratch may not be meaningful to this generation of limited resource individuals; educational opportunities may be missed if programming does not work with foods being used by diverse populations. Findings from the study indicate it is important to identify staple, emergency, and convenience foods purchased by various ethnic groups for the identification of appropriate foods to target in educational programming.

Cooperative Extension professionals work to solve problems of high national priority and provide information access and dissemination to diverse audiences. The results of the study reported here have important implications for the development of culturally appropriate and financially realistic educational programming. Additional research is necessary to confirm the findings of the study. Some limitations of the study reported here are the small sample size of each ethnic group and concentration of research in a metropolitan area, where ethnic groups may be more assimilated than in rural areas (Slama, 2004). Despite the limitations, results from the study may serve as a foundation for formative evaluation to be used in Cooperative Extension programming across disciplines.

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