(P35-11-26) Is Participation in Food and Income Assistance Programs Associated With Overweight and Obesity in Low-Income California Adults? Results From a State-Wide Survey

Objectives: Food and income assistance programs are central components of the social safety net aimed at reducing poverty and food insecurity among economically vulnerable populations. Participation may influence weight status through changes in dietary intake, food purchasing behaviors, and energy balance. However, the relationship between participation and weight status remains unclear. We examined associations between participation in the Supplemental Nutrition Assistance Program (SNAP), Supplemental Security Income (SSI), California Work Opportunities and Responsibilities to Kids (CalWORKs) and weight status.

Methods: We conducted a cross-sectional analysis using 2019–2024 California Health Interview Survey (CHIS) data among adults aged ≥18 years with annual household income ≤130% of the federal poverty level. The primary independent variables were participation in SNAP, SSI, and CalWORKs. Outcomes included body mass index (BMI), overweight (25.0–29.9 kg/m²) and obesity (BMI ≥ 30.0 kg/m2). Survey-weighted descriptive statistics estimated distributions of BMI and prevalence of overweight and obesity. Weighted linear logistic regression models estimated adjusted mean differences in BMI, adjusted prevalence ratios (APRs) and 95% confidence intervals (CI). Analyses were conducted overall and stratified by sex to evaluate potential sex-specific associations. Models adjusted for sociodemographic characteristics, smoking status, health insurance status, and food insecurity.

Results: Among 16,918 participants, SNAP participation was associated with higher prevalence of obesity (APR 1.28, 95% CI: 1.13–1.45) but not overweight; this association was observed among females (APR 1.41, 95% CI: 1.21–1.65) but not males. CalWORKs participation was associated with both overweight (APR 1.27, 95% CI: 1.04–1.55) and obesity (APR 1.29, 95% CI: 1.06–1.57), with higher overweight prevalence among males (APR 1.58, 95% CI: 1.05–2.36) and higher obesity prevalence among females (APR 1.29, 95% CI: 1.04–1.60). SSI participation was not associated with either outcome.

Conclusions: Associations between public assistance participation and weight status may vary by program type and sex. Further research is needed to elucidate underlying mechanisms and to inform policies that support both food security and healthy weight.

Funding Sources: N/A