Optimizing the combination of strategies used by food insecure households to ensure sufficient food

Households without consistent access to sufficient and nutritious food show sustained disadvantages. Food insecure households utilize three types of coping strategies: governmental feeding and financial assistance programs (“safety-nets”); nongovernment providers; and individually developed informal strategies. To understand the interdependencies among strategy types, we conducted a mixed-methods longitudinal study on a sample (n=320) of food insecure households. We dichotomized variables related to use of nongovernmental providers and safety net programs, grouped informal strategies by risk posed (physical, nutritional, food safety, legal, financial) and dichotomized each strategy type. We employed log-linear models to evaluate interdependencies among strategy types, and assessed influences. Supplemental Security Income or Social Security Disability Income altered the association between soup kitchen use and nutritionally risky behaviors (with p < 0.03, without p<0.001, 3-way p=0.11). Participation in school food programs (with p= 0.001, without, p= 0.03; 3-way p= 0.08) modified the association between use of risky food safety practices and food pantries. SNAP did not affect the association between soup kitchen users and food safety risky behaviors (with p=0.001, without p=0.043; 3-way p=0.93). The models supported the hypothesis that use of risky behaviors would be reduced with an increase in participation in public and/or private programs. Maintaining and strengthening public and private assistance programs specifically through increasing benefit amounts, performing outreach activities to improve participation, and enhancing summer food benefits could reduce food insecurity, lessen employment of risky behavioral strategies used to improve food sufficiency, and thus improve health outcomes.