Resistant to the Recession: Low-Income Adults’ Maintenance of Cooking and Away-From-Home Eating Behaviors During Times of Economic Turbulence

摘要

Objectives. We examined the effects of state-level unemployment rates during the recession of 2008 on patterns of home food preparation and away-from-home (AFH) eating among low-income and minority populations. Methods. We analyzed pooled cross-sectional data on 118?635 adults aged 18 years or older who took part in the American Time Use Study. Multinomial logistic regression models stratified by gender were used to evaluate the associations between state-level unemployment, poverty, race/ethnicity, and time spent cooking, and log binomial regression was used to assess respondents’ AFH consumption patterns. Results. High state-level unemployment was associated with only trivial increases in respondents’ cooking patterns and virtually no change in their AFH eating patterns. Low-income and racial/ethnic minority groups were not disproportionately affected by the recession. Conclusions. Even during a major economic downturn, US adults are resistant to food-related behavior change. More work is needed to understand whether this reluctance to change is attributable to time limits, lack of knowledge or skill related to food preparation, or lack of access to fresh produce and raw ingredients. The obesity epidemic in the United States exhibits a steep social gradient according to socioeconomic status (SES) and race, 1–4 with the poor, Hispanics, and non-Hispanic Blacks bearing a disproportionate burden of overweight and obesity. 5,6 This disparity stems in part from substantial barriers to achieving a healthful diet, including food insufficiency, food deserts, and the preponderance of cheap, high-energy foods. 7–10 However, a growing body of evidence indicates that time scarcity, as opposed to money, is the most significant barrier to achieving the nutritional targets set by nutrition allotment programs such as the Thrifty Food Plan, which typically necessitate cooking from scratch to meet financial constraints. 11–14 For many resource-scarce households, the struggle to manage the competing demands of work, transportation, social services, and child care limits the time available to prepare healthy meals 15–19 and prompts the purchase of quick, convenient foods 20–23 such as away-from-home (AFH) foods or processed foods, which tend to be energy dense and nutrient poor. 9,10,24–26 In fact, the Institute of Medicine recently recognized the importance of such time limitations, calling for the US Department of Agriculture to incorporate the value of time in calculating adequate nutrition program allotments. 27 Notwithstanding the growing recognition of time as a major limitation to home food preparation, it is less clear how food preparation and consumption patterns have been influenced by recent economic downswings. The Great Recession of 2008 was characterized by an increase in the national unemployment rate from 5.0% in December 2007 to 9.5% in June 2009. 28 Historically, low-SES adults have been more likely to suffer recession-related effects, including layoffs, earnings reductions, and human capital losses, 29,30 and this was also the case during the Great Recession, with younger, less educated, and minority workers experiencing steeper increases in unemployment. 31,32 Previous economic downturns have been linked to shifts in food preparation patterns and diets. For example, during Russia’s economic collapse in 1998, low-income households increased the amount of food they prepared at home with basic ingredients as a strategy to decrease the cost per calorie of food and preserve a diet comparable to their precrisis diet. 33 In fact, recent studies have shown that, in developed countries, recessionary periods are associated with better health behaviors, including increases in physical activity, increased fruit and vegetable intake, and decreases in obesity. 34–39 These effects occur outside of individual employment status, with increases in aggregate unemployment rates changing the way people in the affected area make decisions about money and time. For example, wage rate increases are dampened during economic downturns, affecting household income and consequently food shopping and preparation. Similarly, volatility in the job market 40 decreases the opportunity cost of time, making it less costly to undertake health-promoting activities such as exercise and cooking. Persistent elevated stress associated with the increased likelihood of unemployment can also affect the amount and healthfulness of food that people buy and consume. 41,42 However, previous work on recessions and health has neglected to consider the impact of a recession on the sociodemographic groups most affected, including low-SES and minority populations. One possibility is that these groups might save money by reverting to cooking with basic ingredients, similar to the situation in Russia in 1998. Alternately, households struggling to find and maintain resources in an economically precarious environment might choose to save time and spend money by