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Salem Food Assessment 2022 Johan Arango-Quiroga, Maggie Jaeger, Sara B. Moore, Esmeira Morel, Kerry Murphy, Joel Simonson, Carmen Tejeda, and Linda Werbner ---PAGE BREAK--- Contents • 2018 Food Assessment Findings and Limitations • 2022 Food Assessment – Methods and Participants – Findings • Knowledge • Affordability • Access • Culture and Family Life • Food Safety – Recommendations ---PAGE BREAK--- Community Snapshot: Race and Ethnicity 0 10 20 30 40 50 60 70 80 90 White Black Asian Hispanic/Latino Salem Population by Race/Ethnicity 2012-2016 2017-2021 Source: American Community Survey ---PAGE BREAK--- Community Snapshot: Race, Ethnicity, and Poverty 0 5 10 15 20 25 30 35 White Black Hispanic/Latino Salem Poverty Level by Race/Ethnicity 2015-2019 2017-2021 ---PAGE BREAK--- Community Snapshot: Race, Ethnicity, and SNAP Usage 0 5 10 15 20 25 30 35 40 45 50 White Black Hispanic/Latino SNAP Participants by Race/Ethnicity 2015-2019 2017-2021 ---PAGE BREAK--- Salem Food Assessment 2018 Research Methods • Resident Food Survey • Emergency Food Provider Survey • Convenience Story Survey • Restaurant Survey • Resident Focus Groups • Stakeholder Interviews • Existing Data ---PAGE BREAK--- Salem Food Assessment 2018 Findings • Resident experiences – Residents have a hard time finding affordable fresh produce and lean meats close to home – The biggest barriers to healthy eating are family schedules, food preferences, and food costs – Larger stores with more affordable food options are hard to get to without a car • Emergency food providers – There is a lack of collaboration among emergency food providers – Emergency food providers don’t always have appropriate foods • Culturally appropriate • Medically appropriate ---PAGE BREAK--- Salem Food Assessment 2018 More Findings • Community agriculture – Salem has many community gardens – Residents are interested in growing their own food • Food waste – Food waste isn’t an issue for many local restaurants – Food waste reduction efforts are uneven in local institutions like Salem Public Schools and Salem Hospital ---PAGE BREAK--- Salem Food Assessment 2018 Outcomes • Greater collaboration among emergency food providers • Events like community meals and the Salem Food for Thought Festival • Expanded community gardens • Mack Park Food Farm • Farm-to-school advocacy • Revision to Salem’s Urban Agriculture Ordinance ---PAGE BREAK--- Salem Food Assessment 2018 Limitations • White non-Hispanic people were overrepresented – 70% of the population, but 90% of the respondents • People with high household incomes were overrepresented • Survey responses didn’t give us enough information – “Would you be interested in participating in a community nutrition education program?” • Limited social networks for survey distribution, focus groups, and interviews ---PAGE BREAK--- The 2022 Approach: Community-Based Participatory Research (CBPR) • Community-based participatory research engages the community to conduct research for the purpose of action – Democratic and equitable process – Entails power-sharing and co-learning – Respects individuals’ knowledge, experiences, and perspectives – Allows for disagreement • What do researchers get out of CBPR? – A better understanding of the opportunities and challenges that exist in their own community – An opportunity to learn new skills – An opportunity to play an active role in improving conditions in their community – Partnerships for future research and action ---PAGE BREAK--- Salem Food Assessment 2022 • Used some of the same tools as the 2018 assessment – Existing data from local hospitals and community partners – Convenience store observations • Integrated elements of community-based participatory research – Focus groups with community members and service providers facilitated by community health researchers hired by the city – Additional community engagement efforts via bulletin board prompts • Salem Public Library • Salem YMCA • Salem CultureHouse ---PAGE BREAK--- The Research Process (November 2021-August 2022) • Held bi-weekly research team meetings with “homework” in between • Participated in human-subjects research training at Salem State University and submitted the research proposal to the university’s Institutional Review Board • Determined the research methods and research instruments to be used • Collected data via community focus groups and bulletin boards that asked for community members’ opinions about barriers to healthy eating • Analyzed data using the process of qualitative coding • Reported findings (ongoing) ---PAGE BREAK--- The Research Question What are some of the social, cultural, environmental, and economic barriers low-income Salem residents face when it comes to accessing nutritious food? ---PAGE BREAK--- Community Member Focus Groups and Interviews ---PAGE BREAK--- Participant Demographics (Community Members) • 68 people participated in focus groups • Participants were much more diverse compared to those in the 2018 assessment • Participants were diverse in terms of age – 7% ages 18-24 – 17% ages 25-34 – 17% ages 35-44 – 8% ages 45-54 – 17% ages 55-54 – 34% 65 or older ---PAGE BREAK--- Participant Demographics (Community Members) • 80% of participants identified as female, 20% as male, and 1 participant identified as non-binary/gender non- conforming • Most participants who specified their race identified as white (38%) though 18% of respondents chose not to specify race at all • 60% of participants identified as Hispanic, Latino, or of Spanish origin, with Spanish and English being the languages spoken most frequently at home ---PAGE BREAK--- Respondent Demographics (Community Members) • Most participants reported being permanently housed in a home they own or rent though 3 participants reported being temporarily housed • In terms of employment, many participants work either full-time (22%) or part-time though 18% reported being unemployed and 34% are retired • Most respondents live in households with other people, with the mode being two people; fewer households included people under the age of 18 or over the age of 65 • More than half of all participants had household incomes less than $20,000 per year with 32% having household incomes between $20,000 and $35,000 • No participants reported a household income over $75,000 ---PAGE BREAK--- Food Insecurity Among Participants (Community Members) • 25% of participants reported they or someone in their household ate smaller meals or skipped meals in the last year because there was not enough money for food • Of those participants, 10 reported having to do so only one or two months, and 9 reported having to do so some months, but not every month • Participants reported having used several supplemental nutrition programs in the last year – SNAP: 65% – WIC: 12% – Salem Summer Meals Program: 2% – Community and congregate meals: 1% – Food pantries: 40% ---PAGE BREAK--- Findings: Knowledge about Nutrition and Food Preparation • Some participants reported having difficulty determining what’s healthy and what isn’t – Some people lack knowledge about what’s considered healthy, especially given all the conflicting information about carbohydrates, fats, etc. – Some people are unable to read and evaluate nutrition labels because of language barriers • People generally want to prepare healthy meals, but they don’t always know how to do that – For Hispanic and Latino families, they want to incorporate American foods into their diet, but with flavors that appeal to them – Participants want to learn how to cook foods in new and healthier ways – Participants want pantries to provide information about how to prepare the foods they’re distributing ---PAGE BREAK--- Findings: Knowledge about Food Assistance Programs • Participants get information about food assistance programs from many different places – Friends, family, and neighbors – Salem Public Schools – Council on Aging and other social service agencies • Participants reported that many community members, including themselves, do not know about food assistance programs – Pandemic EBT cards – Community meals programs • Some community members don’t realize they’re eligible for food assistance program; service providers want to better collaborate to build awareness of these programs ---PAGE BREAK--- Findings: Affordability of Nutritious Foods • Participants reported food is getting more and more expensive, which results in their buying less • Some participants use coupons, but those coupons are often for unhealthy foods • Participants would like to be able to purchase organic foods, but they are often much more expensive – Participants prefer organic fruits, vegetables, milk, eggs, and meat – Some people still choose to buy organic foods, but their money doesn’t go as far ---PAGE BREAK--- Findings: Food Access and Transportation • Participants cited transportation as an issue when it comes to grocery shopping – People tend to make big grocery shopping trips 2-3 times a month, though some reported going weekly – Market Basket is a popular destination for shoppers due to its affordability and grocery items being in one place, but it’s only accessible via car or bus – Some participants shop in convenience stores or bodegas as an alternative, but recognize their SNAP or WIC benefits won’t go as far as they would in stores like Market Basket • Some participants reported having to pay for taxis to get around town, which limits their ability to regularly access affordable grocery stores or food distribution sites ---PAGE BREAK--- Findings: Accessing Food Assistance Programs and Other Resources • Participants reported various personal reasons for not wanting to use food assistance programs – Shame about needing food assistance like SNAP and WIC – Stigma about using food pantries – Language barriers when applying for assistance or accessing resources • People’s schedules don’t always allow for access to food pantry distributions or community meals • The pandemic changed the food assistance landscape – Highlighted the need for robust food assistance programs – Brought more people to food pantries, which may have destigmatized pantry use somewhat ---PAGE BREAK--- Findings: Culture and Family Life • Participants reported many food distribution sites are not offering foods community members traditionally use – Among the items participants are looking for are white rice, red beans, plantains, and cooking oils they are familiar with – This could be addressed by sharing information about how to substitute or prepare pantry foods • Parents find it difficult to find foods their children and families will eat – They sometimes eat out rather than cook, which can be more expensive – Preparing nutritious meals can be time consuming and not everyone has the time to spend cooking – When people cook at home, they tend to cook healthier foods ---PAGE BREAK--- Findings: Food and Water Safety • Some participants reported expired food being distributed at some food distribution sites – Participants reported this is especially the case for meat, which may have been frozen prior to distribution, but also for canned goods – This makes residents feel they are not respected or being afforded the dignity they deserve • Water issues – Participants perceive tap water as less healthy than bottled water, but buying bottled water is expensive – Parents reported their children are not given access to water in schools (though this may be an issue about access to refillable bottles) ---PAGE BREAK--- Additional Insights from Community Bulletin Boards • Prompt in English and Spanish: What are some of the barriers Salem residents face when it comes to accessing healthy food? • Locations: Salem Public Library, Salem YMCA, Salem CultureHouse • Responses – Affordability of good quality foods – Too many cheaper but unhealthy options available – Lack of time to plan, shop, and cook – Affects of climate change on food systems – Limited transportation, especially for big shopping trips – Lack of knowledge about how to prepare foods in a healthy way – Nutritional information on packaging is usually only in English – Meal delivery services are expensive but necessary for many people who can’t leave their home – Lack of appliances and materials to prepare food more healthily ---PAGE BREAK--- ---PAGE BREAK--- Emergency Food Provider Focus Groups and Interviews ---PAGE BREAK--- Organizational Challenges • Providers face several challenges when it comes to providing emergency food services – Reliable access to food – Increasing costs of food, especially nutritious food – Limited availability when it comes to culturally appropriate foods – Transportation issues ---PAGE BREAK--- Community Knowledge about Food Assistance Programs • Salem has a robust network with multisector partners who share information and resources • Collaboration and soliciting clientele feedback helps bridge the knowledge gap • Many residents have little knowledge about programs until they are faced with the need to access them • Knowledge gaps persist – Eligibility – Types of services and support available – How to access services ---PAGE BREAK--- Perceived Barriers Community Members Face When Trying to Access Food Programs • Cultural and language barriers • Post-COVID emotional barriers • Days and times pantries are open, which often conflict with work schedules • Stigma and feelings of personal failure • Physical barriers – Accessibility – Parking – Utilities such as a cart for those who walk ---PAGE BREAK--- How COVID Changed How People Eat and Access Food • Many pandemic resources were given to food assistance organizations • The pandemic raised people’s awareness of food insecurity and fostered empathy in terms of how food insecurity affects residents • Generated more unique partnerships between organizations that are addressing food issues • More people started eating at home and engaging in bulk buying when items are on sale • More people began seeking food assistance and accessing assistance more regularly • Encouraged the City of Salem, Salem Public Schools, and local organizations to share information about food programs ---PAGE BREAK--- What Can Food Assistance Organization and Community Leaders Do? • Continue to work, collaborate, advocate, listen, and adapt • Build and expand partnerships • Share resources and knowledge about community demographics to ensure all efforts are equitable and inclusive, especially in terms of culture, age, and ability • Collect feedback from clients about how to best meet their needs • Strengthen efforts to reduce stigma • Explore ways to reduce shared barriers like transportation, language, and knowledge about programs • Continue to publish a multilingual calendar that describes what resources are available and where ---PAGE BREAK--- Recommendations and Next Steps • Continue to develop the municipal Food Policy Council – Food Policy Council (Salem Food for All) established December 2022 – Obtained grant funding to hire consultants for the purpose of strategic planning – Increased focus on health equity and food justice • Expand urban agriculture education and opportunities – Salem’s urban agriculture ordinance was revised in Summer 2022 – Plan community events focused on resources, education, and support for backyard growers ---PAGE BREAK--- More Recommendations and Next Steps • Develop programs and opportunities for community members to learn more about food assistance options • Build awareness about water safety and availability in Salem ---PAGE BREAK--- Thank you! Special thanks to the groups who supported this work: • CultureHouse • Root • The Salem Pantry • Salem Public Library • Salem YMCA • Salvation Army For questions or comments, contact Salem Health and Wellness Coordinator, Kerry Murphy at [EMAIL REDACTED]