Abstract
The COVID-19 pandemic and its related economic challenges exacerbated food insecurity across New York State (NYS). Approximately one third of New York City residents reported use of emergency food services in the pandemic’s first year and, in 2021, approximately 1 in 10 NYS residents was food insecure, with rates among Hispanic and Black New Yorkers more than double that of White residents. Although these numbers have decreased following the acute phase of the pandemic, disparities by race and ethnicity persist and use of emergency food services remain elevated for New Yorkers born outside of the United States. Despite this, few policies and interventions that aim to improve the charitable and emergency food systems focus on the cultural relevance and appropriateness of foods provided. In 2022, researchers conducted 12 interviews with key stakeholders from organizations and institutions providing food distribution services to culturally diverse New Yorkers to understand barriers and facilitators related to providing culturally appropriate foods and elicit lessons learned and recommendations to inform future programs and policies. Findings from this study indicate that organizations serving diverse communities recognize the importance of providing culturally appropriate food services and make efforts to tailor these services accordingly. However, they face challenges that limit their capacity to offer foods consistent with the dietary needs and preferences of their clients. Additional funding, policies, and support are needed to improve the availability of culturally inclusive food distribution services within the emergency and charitable food systems.
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Abstract
Objective:This study focuses on barriers to Supplemental Nutrition Assistance Program (SNAP) enrollment and retention for Latine immigrant families in New York City and the value of facilitated access to SNAP provided by community-based organizations (CBOs).
Methods: Between 2021 and 2023, we conducted surveys and interviews with Latine parents of children under 18 who received SNAP-related assistance from a CBO in the past year (250 surveys, 15 interviews). We also conducted interviews with staff from this same CBO (3 interviews with 6 participants).
Results: Findings underscore the importance of SNAP to immigrant families with low incomes, the specific challenges immigrant families face in accessing the program, and the value of CBOs in facilitating access to SNAP for these families – by providing information, instilling trust, and addressing administrative burdens.
Conclusions: Current SNAP enrollment and recertification processes create access barriers for eligible immigrants. Potential policy approaches to increase access include adjustments to documentation requirements, including reducing reliance on third parties; coordinated enrollment across benefit programs; improving language services; clarifying eligibility requirements that may cause fear among immigrants; and providing consistent and sufficient funding to CBOs facilitating access.
Abstract
Patient race/ethnicity data collection in most U.S. health systems abide by federal standards, determined by the federal Office of Management and Budget. Yet, decades of research show that reliance on these categories alone limits understanding of within-group health disparities, systematically erasing key groups from health data. Because granular race/ethnicity data is complex and patients may be hesitant to disclose this personal information, it is important for health leaders to consider community perspectives when making decisions about race/ethnicity data procedures. As such, this study uses community focus groups to understand: (1) how individuals representing different racial/ethnic identities perceive the collection of race/ethnicity in healthcare settings; (2) differences in opinions between disaggregated race/ethnicity data collection instruments and those using federal standards; and (3) recommended practices for collecting race/ethnicity from patients. Participants self-selected into 13 focus groups and one key informant interview based on the race/ethnicity with which they most closely identified. Audio recordings from these groups were transcribed and evaluated using thematic content analysis. Among the 83 total participants in this study, there was a strong preference for more flexible and specific options for self-identifying race/ethnicity in healthcare settings. Participants also felt comfortable disclosing granular race/ethnicity to health providers but expressed discomfort with disclosing this information for other purposes. Recommendations for healthcare leaders include ensuring patients receive detailed communication about race/ethnicity data use and purpose, allowing multiple category selection, keeping the list of disaggregated response options short so as to not overwhelm patients, and providing a free text option to ensure inclusivity.
Community-based organizations (CBOs) are crucial institutions within immigrant communities, providing a variety of supports that ease the transition into a new land, including concrete services focused on health, education, housing, financial security, and language access; facilitation of social support and community connections; and mobilization and advocacy to promote civic engagement and community well-being.1, 2 CBOs, including those serving low-income immigrant communities, also provide outreach, navigation, and facilitated enrollment into benefit programs, assisting community members in accessing vital programs and services to which they are entitled.3 Benefit programs often come with complex regulations and requirements, including the provision of documentation, which exacts a toll on applicants and may delay or restrict access, even to those who are eligible.3–5 For low-income immigrants, these challenges are commonly exacerbated by limited English language skills, lack of familiarity with benefit programs,6 and fear of legal consequences related to their immigration status.
The study described here was conducted between 2021 and 2023, and focuses on administration of, and facilitated access to, benefit programs provided by Make the Road New York (MRNY), a community-based organization that builds the power of Latine and other immigrant and working-class communities across NYC and surrounding counties through an array of health, education, legal, and survival services, as well as community organizing and advocacy at the local, state, and federal levels.
New York Academy of Medicine conducts focus groups on selected topics, gathering community perspectives to inform the work of the PHIP and its partners. In 2016, the focus group topic was mental health, including access to mental health care and relevant barriers and facilitators. The findings presented here are intended to be used by the NYCDOHMH to improve access to care in NYC, to shape programs that are tailored to the needs of the communities served, and to help improve the mental health of New York City residents.
This report is intended to be used by the NYCDOHMH in its efforts to bridge the health and housing sectors in order to promote healthy housing in low income NYC neighborhoods and tailor programs and policies to meet the needs of specific communities and populations. It is being made publicly available to be of use to those working at the intersection of housing and health.
This report focuses on approaches to prevent chronic disease across NYC, particularly in those communities identified as experiencing the greatest burden. The findings are intended to provide the PHIP Steering Committee and the Designing a Strong and Healthy NYC Workgroup with community member perspectives, in order to inform physical activity and healthy eating program development and implementation.
This report supports those objectives by presenting community perspectives on primary care, particularly in those communities identified as having significant need. The findings described in this report are intended to provide the PHIP Steering Committee and its Advanced Primary Care Workgroup with patient perspectives to inform ongoing development and implementation of the APC model.
This report describes “public deliberation,” a method we utilized recently in collaboration with Maimonides Medical Center, a South Brooklyn hospital serving an extremely diverse community. Public deliberation is unusual in its intensity, significant educational component, and focus on providing guidance around a specific—often value-laden—question. We describe it here, as it represents an important option for community engagement in public health