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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="1.3" xml:lang="en" article-type="brief-report"><?properties open_access?><processing-meta base-tagset="archiving" mathml-version="3.0" table-model="xhtml" tagset-family="jats"><restricted-by>pmc</restricted-by></processing-meta><front><journal-meta><journal-id journal-id-type="nlm-ta">Prev Chronic Dis</journal-id><journal-id journal-id-type="iso-abbrev">Prev Chronic Dis</journal-id><journal-id journal-id-type="publisher-id">PCD</journal-id><journal-title-group><journal-title>Preventing Chronic Disease</journal-title></journal-title-group><issn pub-type="epub">1545-1151</issn><publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">35772037</article-id><article-id pub-id-type="pmc">9258448</article-id><article-id pub-id-type="publisher-id">21_0412</article-id><article-id pub-id-type="doi">10.5888/pcd19.210412</article-id><article-categories><subj-group subj-group-type="heading"><subject>GIS Snapshots</subject></subj-group><series-title>Peer Reviewed</series-title></article-categories><title-group><article-title>Expansion of Grocery Delivery and Access for Washington SNAP Participants During the COVID-19 Pandemic</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Beese</surname><given-names>Shawna</given-names></name><degrees>MBA</degrees><degrees>BSN</degrees><degrees>RN</degrees><xref rid="aff1" ref-type="aff">
<sup>1</sup>
</xref><xref rid="aff2" ref-type="aff">
<sup>2</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Amram</surname><given-names>Ofer</given-names></name><degrees>PhD</degrees><degrees>MSc</degrees><xref rid="aff3" ref-type="aff">
<sup>3</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Corylus</surname><given-names>Acacia</given-names></name><degrees>MPH</degrees><degrees>RD</degrees><xref rid="aff2" ref-type="aff">
<sup>2</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Graves</surname><given-names>Janessa M.</given-names></name><degrees>PhD</degrees><degrees>MPH</degrees><xref rid="aff1" ref-type="aff">
<sup>1</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Postma</surname><given-names>Julie</given-names></name><degrees>PhD</degrees><degrees>RN</degrees><xref rid="aff1" ref-type="aff">
<sup>1</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Monsivais</surname><given-names>Pablo</given-names></name><degrees>PhD</degrees><degrees>MPH</degrees><xref rid="aff3" ref-type="aff">
<sup>3</sup>
</xref></contrib><aff id="aff1">
<label>1</label>College of Nursing, Washington State University, Spokane, Washington</aff><aff id="aff2">
<label>2</label>College of Agricultural, Human, and Natural Resource Sciences, SNAP-ED, Snohomish, Washington</aff><aff id="aff3">
<label>3</label>Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington</aff></contrib-group><author-notes><corresp id="cor1">Corresponding Author: Shawna Beese, MBA, BSN, RN, Washington State University &#x02014; College of Nursing, 103 E Spokane Falls Blvd, Spokane, WA 99202. Telephone: 509-844-4729 Email: <email xlink:href="Shawna.Beese@wsu.edu">Shawna.Beese@wsu.edu</email>.</corresp></author-notes><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>30</day><month>6</month><year>2022</year></pub-date><volume>19</volume><elocation-id>E36</elocation-id><permissions><copyright-year>2022</copyright-year><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/" specific-use="textmining" content-type="ccbylicense">https://creativecommons.org/licenses/by/4.0/</ali:license_ref><license-p>Preventing Chronic Disease is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.</license-p></license></permissions></article-meta></front><body><fig position="float" id="Fa" fig-type="figure"><caption><p>Online grocery delivery access for Washington State Supplemental Nutrition Assistance Program (SNAP) beneficiaries increased between May and July 2021, during the COVID-19 pandemic. The 2017 food insecurity rates spotlight the counties most vulnerable to food insecurity. Sources: Walmart delivery data, <ext-link xlink:href="https://www.walmart.com/store/directory" ext-link-type="uri">https://www.walmart.com/store/directory</ext-link>; Amazon delivery data, <ext-link xlink:href="https://www.amazon.com" ext-link-type="uri">https://www.amazon.com</ext-link>; SNAP benefit data, <ext-link xlink:href="https://www.ers.usda.gov/data-products/food-access-research-atlas/download-the-data" ext-link-type="uri">https://www.ers.usda.gov/data-products/food-access-research-atlas/download-the-data</ext-link>; Washington 2010 census tract shapefile, <ext-link xlink:href="https://ofm.wa.gov/washington-data-research/population-demographics/gis-data/census-geographic-files" ext-link-type="uri">https://ofm.wa.gov/washington-data-research/population-demographics/gis-data/census-geographic-files</ext-link>. </p></caption><long-desc>Online delivery services of groceries to homes in May 2021 were concentrated in the Puget Sound region and outlying communities of Vancouver and Yakima. Expansion of online delivery services to homes by July 2021 included counties in the eastern and southeastern part of the state. However, many rural counties with high food insecurity rates in northeastern Washington State and counties along the western coastline still lacked access to home delivery.</long-desc><graphic xlink:href="PCD-19-E36s01" position="float"/></fig><sec sec-type="other1"><title>Background</title><p>The COVID-19 pandemic ushered in an unprecedented food security crisis that will have long-term health effects (<xref rid="R1" ref-type="bibr">1</xref>). As society shut down to slow the spread of SARS-CoV-2, the interruptions tested the limits of our current food supply chain to meet supply and demand (<xref rid="R2" ref-type="bibr">2</xref>). Exigencies on our food system, particularly safety-net resources like food banks, increased by 50% nationwide (<xref rid="R1" ref-type="bibr">1</xref>). Inequities in access to healthy food became magnified, exacerbating disparities that existed before the pandemic, such as increased risk of food insecurity for people without college degrees and unemployed people (<xref rid="R3" ref-type="bibr">3</xref>).</p><p>The pandemic generated shifts toward home-based meal preparation and online grocery purchases with home delivery (<xref rid="R4" ref-type="bibr">4</xref>,<xref rid="R5" ref-type="bibr">5</xref>). State-level pilot programs for online grocery purchase and home delivery for Supplemental Nutrition Assistance Program (SNAP) beneficiaries were already mandated by the 2014 Farm Bill (<xref rid="R6" ref-type="bibr">6</xref>), but the pandemic accelerated these initiatives. Modernization of SNAP mirrors efforts spurred on by the pandemic, including national vendors&#x02019; investments in online grocery delivery infrastructure and expanded delivery services (<xref rid="R2" ref-type="bibr">2</xref>). Because of the rapid responses on behalf of private and governmental entities, evaluation of access to delivery services and beneficiary awareness of new online delivery services availability was needed.</p><p>The purpose of this GIS Snapshot was to present the results of a geospatial assessment of access to online grocery purchase and home delivery for SNAP beneficiaries in Washington State. A secondary aim of this study was to identify potentially vulnerable populations resulting from the current level of access.</p></sec><sec sec-type="other2"><title>Data Sources and Map Logistics</title><p>We mapped the online grocery purchase and delivery coverage for SNAP recipients for Washington State in May 2021 and July 2021. Data sources included the GIS (geographic information system) census tract shapefile from the Washington Office of Financial Management (<xref rid="R7" ref-type="bibr">7</xref>). Census tract&#x02013;level SNAP household data were obtained from the 2015 American Community Survey (ACS), accessed from the US Department of Agriculture Food Environment Atlas website (<xref rid="R8" ref-type="bibr">8</xref>).</p><p>The approved SNAP Electronic Benefits Transfer (EBT) delivery vendors were confirmed on the Food and Nutrition Service website in May 2021 and July 2021 (<xref rid="R9" ref-type="bibr">9</xref>). In July 2021, the 2 approved SNAP EBT online vendors were Amazon and Walmart delivery centers. One other retailer with a single location was also approved for online purchases, but this retailer did not have widespread delivery services, so its 1,530-person catchment was not included. The final analysis and reporting of the evaluation are at the county level.</p><p>We used ArcMAP Desktop version 10.8 (Esri) to overlay census tract data with the number of SNAP household units per census tract and the delivery areas of participating vendors. Each census tract was also identified as urban or rural; areas with populations under 2,500 people were classified rural and those with 2,500 people or more were classified urban (<xref rid="R10" ref-type="bibr">10</xref>). Delivery areas for Walmart were created with a 9-mile buffer around georeferenced Walmart distribution outlet points for Walmart. We selected a 9-mile radius based on Walmart&#x02019;s delivery area, confirmed on their website in July 2021 and by telephone during confirmation calls to each store (<xref rid="R11" ref-type="bibr">11</xref>). The delivery area for Amazon Fresh was created using zip code polygons. All zip codes of the Amazon Fresh delivery services were confirmed on the Amazon Fresh website in July 2021 (<xref rid="R12" ref-type="bibr">12</xref>). The number of SNAP households was spatially analyzed by census tract population-weighted centroids within the defined delivery area boundaries.</p><p>We mapped the 2017 food insecurity rates by using a choropleth (shaded enumeration of prevalence rates) by county (<xref rid="R13" ref-type="bibr">13</xref>). Equal interval data breaks were used to categorize the food insecurity rates, expressed in percentages (<xref rid="R13" ref-type="bibr">13</xref>). The data sources for the 2017 food insecurity rates were from the Hunger in Washington website (<xref rid="R14" ref-type="bibr">14</xref>). The overall prevalence of food insecurity in Washington State was 11.5% and ranged from 7.1% (Franklin County) to 18.3% (Whitman County) (<xref rid="R14" ref-type="bibr">14</xref>).</p></sec><sec sec-type="other3"><title>Highlights</title><p>According to 2015 American Community Survey data, 376,467 (11.8%) Washington households were receiving SNAP benefits. In July 2021, during our final analysis, 298,839 (79.4) households receiving SNAP benefits had access to online grocery purchases and delivery (<xref rid="T1" ref-type="table">Table</xref>). The number of Washington State residents receiving food assistance increased during the COVID-19 pandemic. According to Washington State Economic Services Administration reporting, the number of people on food assistance increased by 16% from September 2019 to July 2020, as reported through management accountability and performance statistics (Economic Services Administration, Management Accountability and Performance Statistics [ESA/EMAPS], the state SNAP client eligibility system).</p><table-wrap position="float" id="T1"><label>Table</label><caption><title>Washington State Supplemental Nutrition Assistance Program Online Grocery Delivery Access, May&#x02013;July 2021</title></caption><table frame="hsides" rules="groups"><col width="103" span="1"/><col width="90" span="1"/><col width="126" span="1"/><col width="148" span="1"/><thead><tr><th valign="bottom" align="left" scope="col" rowspan="1" colspan="1">County</th><th valign="bottom" align="left" scope="col" rowspan="1" colspan="1">Number of households in county in 2015</th><th valign="bottom" align="left" scope="col" rowspan="1" colspan="1">Number of households with SNAP benefits in 2015</th><th valign="bottom" align="left" scope="col" rowspan="1" colspan="1">Number (%) of households with SNAP benefits with online delivery access</th></tr></thead><tbody><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Adams</td><td valign="top" align="left" rowspan="1" colspan="1">6,443</td><td valign="top" align="left" rowspan="1" colspan="1">1,265</td><td valign="middle" align="left" rowspan="1" colspan="1">962 (76.0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Asotin</td><td valign="top" align="left" rowspan="1" colspan="1">9,989</td><td valign="top" align="left" rowspan="1" colspan="1">1,782</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Benton</td><td valign="top" align="left" rowspan="1" colspan="1">73,896</td><td valign="top" align="left" rowspan="1" colspan="1">10,176</td><td valign="middle" align="left" rowspan="1" colspan="1">8,992 (88.4)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Chelan</td><td valign="top" align="left" rowspan="1" colspan="1">36,890</td><td valign="top" align="left" rowspan="1" colspan="1">3,161</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Clallam</td><td valign="top" align="left" rowspan="1" colspan="1">36,526</td><td valign="top" align="left" rowspan="1" colspan="1">4,860</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Clark</td><td valign="top" align="left" rowspan="1" colspan="1">175,854</td><td valign="top" align="left" rowspan="1" colspan="1">25,515</td><td valign="middle" align="left" rowspan="1" colspan="1">24,652 (96.6)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Columbia</td><td valign="top" align="left" rowspan="1" colspan="1">2,156</td><td valign="top" align="left" rowspan="1" colspan="1">352</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Cowlitz</td><td valign="top" align="left" rowspan="1" colspan="1">44,178</td><td valign="top" align="left" rowspan="1" colspan="1">8,908</td><td valign="middle" align="left" rowspan="1" colspan="1">7,280 (81.7)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Douglas</td><td valign="top" align="left" rowspan="1" colspan="1">16,592</td><td valign="top" align="left" rowspan="1" colspan="1">2,280</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Ferry</td><td valign="top" align="left" rowspan="1" colspan="1">4,485</td><td valign="top" align="left" rowspan="1" colspan="1">728</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Franklin</td><td valign="top" align="left" rowspan="1" colspan="1">27,035</td><td valign="top" align="left" rowspan="1" colspan="1">5,073</td><td valign="middle" align="left" rowspan="1" colspan="1">4,291 (84.6)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Garfield</td><td valign="top" align="left" rowspan="1" colspan="1">1,245</td><td valign="top" align="left" rowspan="1" colspan="1">95</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Grant</td><td valign="top" align="left" rowspan="1" colspan="1">36,385</td><td valign="top" align="left" rowspan="1" colspan="1">6,434</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Grays Harbor</td><td valign="top" align="left" rowspan="1" colspan="1">35,816</td><td valign="top" align="left" rowspan="1" colspan="1">5,901</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Island</td><td valign="top" align="left" rowspan="1" colspan="1">41,239</td><td valign="top" align="left" rowspan="1" colspan="1">3,161</td><td valign="middle" align="left" rowspan="1" colspan="1">2,251 (71.2)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Jefferson</td><td valign="top" align="left" rowspan="1" colspan="1">18,257</td><td valign="top" align="left" rowspan="1" colspan="1">1,773</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">King</td><td valign="top" align="left" rowspan="1" colspan="1">900,236</td><td valign="top" align="left" rowspan="1" colspan="1">86,369</td><td valign="middle" align="left" rowspan="1" colspan="1">86,019 (99.6)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Kitsap</td><td valign="top" align="left" rowspan="1" colspan="1">110,715</td><td valign="top" align="left" rowspan="1" colspan="1">12,208</td><td valign="middle" align="left" rowspan="1" colspan="1">11,996 (98.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Kittitas</td><td valign="top" align="left" rowspan="1" colspan="1">23,054</td><td valign="top" align="left" rowspan="1" colspan="1">2,431</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Klickitat</td><td valign="top" align="left" rowspan="1" colspan="1">10,181</td><td valign="top" align="left" rowspan="1" colspan="1">1,205</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Lewis</td><td valign="top" align="left" rowspan="1" colspan="1">34,759</td><td valign="top" align="left" rowspan="1" colspan="1">6,373</td><td valign="middle" align="left" rowspan="1" colspan="1">3,381 (53.1)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Lincoln</td><td valign="top" align="left" rowspan="1" colspan="1">5,962</td><td valign="top" align="left" rowspan="1" colspan="1">484</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Mason</td><td valign="top" align="left" rowspan="1" colspan="1">33,172</td><td valign="top" align="left" rowspan="1" colspan="1">4,103</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Okanogan</td><td valign="top" align="left" rowspan="1" colspan="1">22,901</td><td valign="top" align="left" rowspan="1" colspan="1">3,328</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Pacific</td><td valign="top" align="left" rowspan="1" colspan="1">16,036</td><td valign="top" align="left" rowspan="1" colspan="1">1,940</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Pend Oreille</td><td valign="top" align="left" rowspan="1" colspan="1">8,163</td><td valign="top" align="left" rowspan="1" colspan="1">1,215</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Pierce</td><td valign="top" align="left" rowspan="1" colspan="1">339,501</td><td valign="top" align="left" rowspan="1" colspan="1">44,959</td><td valign="middle" align="left" rowspan="1" colspan="1">43,334 (96.4)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">San Juan</td><td valign="top" align="left" rowspan="1" colspan="1">13,908</td><td valign="top" align="left" rowspan="1" colspan="1">619</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Skagit</td><td valign="top" align="left" rowspan="1" colspan="1">52,846</td><td valign="top" align="left" rowspan="1" colspan="1">7,445</td><td valign="middle" align="left" rowspan="1" colspan="1">5,439 (73.1)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Skamania</td><td valign="top" align="left" rowspan="1" colspan="1">5,777</td><td valign="top" align="left" rowspan="1" colspan="1">727</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Snohomish</td><td valign="top" align="left" rowspan="1" colspan="1">302,639</td><td valign="top" align="left" rowspan="1" colspan="1">33,385</td><td valign="middle" align="left" rowspan="1" colspan="1">31,871 (95.5)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Spokane</td><td valign="top" align="left" rowspan="1" colspan="1">210,709</td><td valign="top" align="left" rowspan="1" colspan="1">33,984</td><td valign="middle" align="left" rowspan="1" colspan="1">31,890 (93.8)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Stevens</td><td valign="top" align="left" rowspan="1" colspan="1">21,524</td><td valign="top" align="left" rowspan="1" colspan="1">3,485</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Thurston</td><td valign="top" align="left" rowspan="1" colspan="1">113,750</td><td valign="top" align="left" rowspan="1" colspan="1">12,767</td><td valign="middle" align="left" rowspan="1" colspan="1">11,656 (91.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Wahkiakum</td><td valign="top" align="left" rowspan="1" colspan="1">2,118</td><td valign="top" align="left" rowspan="1" colspan="1">322</td><td valign="middle" align="left" rowspan="1" colspan="1">&#x02014;</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Walla Walla</td><td valign="top" align="left" rowspan="1" colspan="1">24,346</td><td valign="top" align="left" rowspan="1" colspan="1">3,556</td><td valign="middle" align="left" rowspan="1" colspan="1">3,355 (94.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Whatcom</td><td valign="top" align="left" rowspan="1" colspan="1">94,338</td><td valign="top" align="left" rowspan="1" colspan="1">12,460</td><td valign="middle" align="left" rowspan="1" colspan="1">8,360 (67.1)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Whitman</td><td valign="top" align="left" rowspan="1" colspan="1">20,381</td><td valign="top" align="left" rowspan="1" colspan="1">1,844</td><td valign="middle" align="left" rowspan="1" colspan="1">1,252 (67.9)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Yakima</td><td valign="top" align="left" rowspan="1" colspan="1">87,809</td><td valign="top" align="left" rowspan="1" colspan="1">19,794</td><td valign="middle" align="left" rowspan="1" colspan="1">11,858 (59.9)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Washington State total</td><td valign="top" align="left" rowspan="1" colspan="1">Not applicable</td><td valign="top" align="left" rowspan="1" colspan="1">376,467</td><td valign="top" align="left" rowspan="1" colspan="1">298,839 (79.4)</td></tr></tbody></table><table-wrap-foot><p>Abbreviation: &#x02014;, no delivery available; SNAP, Supplemental Nutrition Assistance Program.</p><p>Sources: </p><p>Amazon. Amazon Fresh delivery [interactive database]. <ext-link xlink:href="https://www.amazon.com" ext-link-type="uri">https://www.amazon.com</ext-link>. Accessed July 20, 2021.</p><p>Hunger in Washington. Food insecurity rate: by county. 2017. [interactive map]. <ext-link xlink:href="https://www.livestories.com/statistics/hunger-in-washington/washington/food-insecurity" ext-link-type="uri">https://www.livestories.com/statistics/hunger-in-washington/washington/food-insecurity</ext-link>. Accessed November 1, 2021.</p><p>US Census Bureau. National, state, and county housing unit totals: 2010&#x02013;2019. Published April 20, 2022. Accessed April 27, 2022. <ext-link xlink:href="https://www.census.gov/data/datasets/time-series/demo/popest/2010s-total-housing-units.html" ext-link-type="uri">https://www.census.gov/data/datasets/time-series/demo/popest/2010s-total-housing-units.html</ext-link>
</p><p>US Department of Agriculture Food Atlas. 2015 Food Access Research Atlas published April 27, 2021. <ext-link xlink:href="https://www.ers.usda.gov/data-products/food-access-research-atlas/download-the-data/" ext-link-type="uri">https://www.ers.usda.gov/data-products/food-access-research-atlas/download-the-data/</ext-link>. Accessed July 20, 2021.</p><p>Walmart. Walmart Store Directory [interactive databasehapefile]. <ext-link xlink:href="https://ofm.wa.gov/washington-data-research/population-demographics/gis-data/census-geographic-files" ext-link-type="uri">https://ofm.wa.gov/washington-data-research/population-demographics/gis-data/census-geographic-files</ext-link>. Accessed November 1, 2021.</p><p>Washington Office of Financial Management. Washington 2010 Census County [shapefile]. <ext-link xlink:href="https://ofm.wa.gov/washington-data-research/population-demographics/gis-data/census-geographic-files" ext-link-type="uri">https://ofm.wa.gov/washington-data-research/population-demographics/gis-data/census-geographic-files</ext-link>. Accessed November 1, 2021.</p></table-wrap-foot></table-wrap><p>A preliminary survey conducted in May 2021 confirmed that most online grocery delivery access was concentrated in the Puget Sound region, the state&#x02019;s largest metropolitan area. In July 2021, Walmart launched a delivery service expansion into other urban areas of the state. The expansion increased access from 169,507 (45.0%) of SNAP households statewide in May 2021 to 261,752 (69.5%) of SNAP households statewide. The July 2021 Walmart expansion substantially increased access to home delivery of groceries for Washington State by offering access to areas beyond the Puget Sound region and outlying communities of Vancouver and Yakima. In July 2021, administrative data from the ESA/EMAPS indicated that 2.3% of SNAP benefits were redeemed with online retailers.</p><p>Rural counties that were previously designated as food insecure continue to lack access to home delivery. Most households receiving SNAP were included in the new delivery coverage from Walmart&#x02019;s expansion. However, Walmart&#x02019;s expansion of online delivery services is concentrated in more densely populated areas of the state. The 2017 food insecurity rates indicate some of these counties without online delivery access, especially the northeastern Washington counties and the counties along the western coastline, are also food insecure (<xref rid="R14" ref-type="bibr">14</xref>).</p></sec><sec sec-type="other4"><title>Action</title><p>Our analyses show the expansion of online grocery delivery serving SNAP recipients in Washington State. However, gaps in broadband coverage and lack of home computer technology may still serve as potential barriers to online purchases for rural populations in the state (<xref rid="R15" ref-type="bibr">15</xref>,<xref rid="R16" ref-type="bibr">16</xref>).</p><p>Using administrative data for geographic assessment to quantify access to online grocery delivery services was an essential step, but our analyses did not include assessment of other food assets such as food retail locations, food banks, pantries, and mobile markets (<xref rid="R17" ref-type="bibr">17</xref>,<xref rid="R18" ref-type="bibr">18</xref>). On the basis of the geographic assessment presented here, next steps include community-based approaches that allow for broader inventory of local food assets, which may be important for food access, particularly in communities with limited online grocery delivery. This involves asset-based inquiry to ground realities from rural food system leaders seeking innovative strategies to provide efficient and equitable solutions for food delivery.</p><p>Program administrators and municipal policy makers can use these maps to target underserved areas and strategize building partnerships with local vendors such as farmer&#x02019;s co-ops and regional-based grocery outlets to fill the delivery needs for rural areas.</p></sec></body><back><ack><title>Acknowledgments</title><p>Washington State University is an equal opportunity provider. This study was funded by the US Department of Agriculture&#x02019;s SNAP.</p></ack><fn-group><fn><p>The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions.</p></fn><fn><p>
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