Cancer control needs of clients in the Supplemental Nutrition Assistance Program (SNAP)

For Americans living in poverty, meeting basic needs is often a more urgent priority than cancer prevention and screening. When basic needs are addressed, the likelihood of engaging in cancer control behaviors increases. New strategies to eliminate cancer disparities must recognize this by extending beyond traditional health care settings and working within existing systems to promote health programs. The purpose of this study was to work within an existing social service system to describe the cancer control behaviors among a sample of Food Stamp clients (N=685; M age=36.2; 74% female; 82% racial/ethnic minority) and identify opportunities to more effectively reach this population. We formed a cancer communication research partnership with a local office of the Missouri Food Stamp program to conduct a large random sample survey of Food Stamp clients. When compared to 2008 BRFSS data, Food Stamp clients were significantly less likely to have ever been screened for breast and colon cancer, to have a personal doctor, to have health insurance, or to report a positive health status (p<.001). Clients were significantly more likely to have ever smoked or to be current smokers (p<.001). Using multivariate segmentation analysis we identified population subgroups that were homogeneous with respect to cancer control behaviors and determined which types of variables were best associated with subgroups' status on key cancer prevention and screening behaviors. Results highlight the feasibility of promoting health within existing systems that attend to basic needs and suggest new strategies for targeted interventions that address unique characteristics of this population.