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Introduction: Although a requirement for the health and hygiene of young children, millions of US families with low-incomes have unmet needs for diapers. The present study explored retail options in Durham County, NC for purchasing diapers in low-income neighborhoods in effort to increase our understanding of the overall context of diaper need. Methods: During June 2018, we visited 63 retailers selling 2460 child diaper products in 29 census tracts with a median household income ≤200% of the federal poverty guideline. Corner stores were the only retailers to sell products without original packaging, including one corner store selling loose diapers for $1.49 each. Next, we calculated bus routes to determine accessibility of the retailer with the lowest prices and greatest selection. One-way bus travel from all other census tracts to a big-box store required taking two buses combined with an average of 11 min walking for an average travel time of 43 min. We deemed census tracts as "priority areas for diaper access" when they were characterized as: (1) low income and (2) low access with no retailer selling all of the 10 most common child diaper sizes. Results: Nearly half (n=13) of the census tracts in our sample met our criteria for priority areas. We compared neighborhood characteristics of priority areas with all other county census tracts. Families living in priority areas were statistically significantly more likely to: identify as Black or African American, face challenges affording housing costs, have homes or automobiles in need of repair, experience neighborhood violence, and have less educational attainment.
RESUMEN
Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers. Results Families experience regularly a range of challenges meeting basic needs. These difficulties include high unmet needs for transportation, food, and nonfood essentials such as personal hygiene items. Families experiencing the greatest difficulty in paying utility or medical bills were significantly more likely to have a high level of diaper need compared to families facing these challenges less often (AORs ranging from 3.40 to 9.39). As a result of receiving diapers, families reported positive health, social, and economic outcomes. Families reported positive changes in parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to divert household finances toward other basic needs, including utilities and medical care. Conclusions for Practice The monetary value of the supplemental provision of diapers is a small investment in affected families' economic, social, and health outcomes. The positive effects continue far longer than the diapers provided. We demonstrate the social value of such an operation, and recommend the expansion of federal, state, and local safety net programs to help low-income families secure a steady supply of diapers.