Cabarrus County REACH Farmers Market Evaluation. Sally Lawrence Bullock, MPH September 15, 2016 NCPHA 2016 Fall Educational Conference

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1 Cabarrus County REACH Farmers Market Evaluation Sally Lawrence Bullock, MPH September 15, 2016 NCPHA 2016 Fall Educational Conference

2 Financial Disclosures This presentation was supported by the Grant or Cooperative Agreement Number, 1 U58 DP , funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

3 Acknowledgements University of North Carolina, Charlotte Elizabeth Racine, DrPH, RD Erica Cline, BSPH Student Emily Emery BSPH Student Cabarrus Health Alliance REACH Meghan Charpentier, MS, MPH Jennifer West, MS, ACSM Farmers Market Managers

4 Outline Background Purpose Evaluation Overview Results Next Steps Questions

5 Cabarrus County Population of 192,103 Majority White population (69%) African American (17%) and Hispanic (10%) Of persons age % have a high school diploma 25% have a Bachelor's degree higher Median household income is $53, % SNAP participants US Census, 2014 and USDA Food Atlas 2014

6 Minority Health in Cabarrus County Heart disease mortality rate among Africans Americans 15% higher than white males and 25% higher than white females % of Hispanics and 19.7% of African Americans live below the poverty line vs. 12.7% Whites 2 39% of residents living in food deserts are African American and Hispanic North Carolina State Center for Health Statistics, US Census,2014

7 Purpose Increase healthy food accessibility by increasing the number of farmers markets that accept Supplemental Nutrition Assistance Program (SNAP/EBT) benefits

8 SNAP/EBT at Markets SNAP/EBT in North Carolina Increase in SNAP authorized farmers markets: 13 in 1995 vs. 110 in 2015 SNAP redemption at farmers markets: $56,082 in 1995 vs. $199,312 in 2015 (both in 2015 dollars) SNAP/EBT at Cabarrus Farmers Markets Prior to 2010, 0 farmers markets in Cabarrus County were SNAP authorized After 2010 and before the REACH intervention, 1 market SNAP authorized As a results of the REACH intervention, in 2016, 2-3 vendors at 4 other markets now accept SNAP/EBT

9 Evaluation Objectives: Estimate the percentage of African American and Hispanic shoppers using the farmers' markets in Cabarrus County Estimate the percentage of market users that are SNAP/EBT recipients Identify trends in shopping and food consumption among market shoppers.

10 Methods Farmers market customer counts Intercept survey Market audits

11 Results: Customer Counts 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Population Distribution 89% 73% 17% 10% 8% 3% Cabarrus County Farmers Markets African American Hispanic Other

12 Results: Survey Demographics 273 surveys collected Race 2% Hispanic 9% African American 3% Multiracial Gender 83% Female Education 60% College Educated Age 50% Below 50

13 Results: SNAP & WIC Participants Recipients 5% (13) of survey participants SNAP recipients 11 White and 2 Hispanic 4% (11) WIC recipients 7 White, 2 Hispanic, 1 African American, and 1 Unknown Use of Benefits Ever at Farmers Markets 1 survey participant had used SNAP 7 survey participants had used WIC

14 Results: Fruits and Vegetables Markets offered: 3-8 varieties of fruit varieties of vegetables 48% survey participants reported eating 6+ servings of fruits and vegetables per day Fruit and vegetable consumption did not differ significantly by: Race/ethnicity SNAP or WIC participation Education Age

15 Conclusion and Next Steps Results provide a better understanding of use of farmers markets in Cabarrus County Questions remain about reaching target population and use of SNAP at markets Research needed to better understand barriers to SNAP use at farmers markets and use of SNAP benefits by target population

16 Questions? Sally Bullock UNC Chapel Hill

17 References Behavioral Risk Factor Surveillance System (BRFSS). (2014). North Carolina State Center for Health Statistics. Cabarrus County Community Needs Assessment. (2012). Available at: Accessed January 21, Cabarrus County Planning Council Cabarrus County Needs Assessment Process Review and Priority Selection. (2012). Available at: 20Documents/2012%20Community%20Needs%20Assessment%20Nov.%205%20BOCC%20Meetin g.pdf. Accessed January 21, Economic Research Service, U.S. Department of Agriculture. Food Environment Atlas. (2014) Available at: Accessed September 13, United States Census. American Fact Finder, Cabarrus County, North Carolina. Available at: Accessed January 21, 2016.