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Author ORCID Identifier

https://orcid.org/0009-0009-7027-7623

Date Available

7-13-2026

Year of Publication

2026

Document Type

Master's Thesis

Degree Name

Master of Science (MS)

College

Agriculture, Food and Environment

Department/School/Program

Agricultural Economics

Faculty

Thomas Keene

Faculty

Yoko Kusunose

Abstract

Poor diet quality and physical inactivity are common health issues in the United States. To remedy these issues among low-income households, the United States Department of Agriculture created the Supplemental Nutrition Assistance Program Education Program (SNAP-Ed), which promoted healthy eating and physically active lifestyles through multiple avenues. The social marketing approach of SNAP-Ed uses marketing strategies to relay information to the public. In Kentucky, a statewide billboard campaign was launched in 2018 encouraging residents to focus on nutrition and physical activity. This study investigates the impact of that campaign on health outcomes in counties throughout the state. Using billboard location data from KYNEP in conjunction with county-to-county commuting flow data from the U.S. Census Bureau, this study creates a novel exposure variable that captures county-level exposure to the campaign. Using a continuous treatment difference-in-differences framework, this study approximates the campaign’s effect on short- and long- term health outcomes using data from County Health Rankings & Roadmaps. Results show statistically significant but small in magnitude changes in the Poor or Fair Health, Poor Physical Health Days, and Diabetes outcome variables. All other results are statistically insignificant.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2026.346

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