A Proposal for Improvements in the Supplemental Nutrition Assistance Program

Abstract

T he health of Americans is less than optimal, with alarming rates of chronic diseases such as Type 2 diabetes, obesity, and heart disease. The Supplemental Nutrition Assistance Program has the potential to improve the health of its 45 million recipients, yet the program has no nutritional guidelines. In fact, research suggests the program negatively affects the health of many of its users. The Special Supplemental Nutrition Program for Women, Infants, and Children, on the other hand, has a history of beneficial outcomes for its users, in large part because of its nutritional guidelines and program limitations. The Supplemental Nutrition Assistance Program program may benefit from following the model of a large-scale federal food program that improves the health of its beneficiaries. THE HEALTH OF A NATION Many Americans are in less than optimal health. Approximately two thirds of adults are overweight, half of whom are obese. 1 Diabetes prevalence continues to climb, with 29.1 million Americans suffering from the disease and approximately 86 million more with prediabetes. 2 Economically disadvantaged people are at heightened risk, with approximately 70% higher prevalence of diabetes 3 and 19% higher prevalence of hypertension, 4 compared with the highest-income population. Such chronic diseases are directly related to lifestyle, especially poor dietary choices. NUTRITION FOR BETTER HEALTH To promote better health, the U.S. government issues nutritional guidelines and related educational materials. The Dietary Guidelines for Americans, currently the 2015À2020 Dietary Guidelines for Americans, 5 serve as the blueprint for federal food programs and nutrition policies that, in turn, affect large programs, such as the National School Lunch and Breakfast Programs, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Child and Adult Care Food Program. These recommendations generally emphasize plant-based foods; more than three quarters of MyPlate, the government's representation of the dietary guidelines, is dedicated to vegetables, fruits, and grains. Although its remaining section on protein sources includes meat, MyPlate recommendations also encourage Americans to think beyond meat and poultry and incorporate more legumes, including soy products, nuts, and seeds, into their diets to meet protein needs. Additionally, the Dietary Guidelines for Americans cite vegetarian and Mediterranean diets, both of which are rich in plant-based foods, as examples of healthful dietary patterns Americans could follow for optimal health. 5 Diets focused on foods from plant sources are associated with lower rates of obesity, diabetes, cardiovascular disease, hypertension, and certain forms of cancer, among other health problems, 6,7 all of which currently exact a large personal toll, as well as an enormous financial burden on individuals, governments, and businesses.

Can targeted policies reduce obesity and improve obesity‐related behaviours in socioeconomically disadvantaged populations? A systematic review

“…Many initiatives have therefore been proposed to modify SNAP, and the US federal government has provided substantial funds to evaluate the impact of incentivizing FV purchases amongst SNAP recipients , with preliminary indications of success . Nevertheless, whether and how policies pertaining to SNAP and similar nutritional support programs in other jurisdictions should incentivize and/or restrict particular food purchases remains an active area of inquiry . Beyond questions of their effectiveness, such proposals also raise multiple moral, ethical and practical concerns .…”

Association of Funding and Meal Preparation Time With Nutritional Quality of Meals of Supplemental Nutritional Assistance Program Recipients

“…18,19 A related proposal is to allow only items from a specific list to be purchased with SNAP funds. 20 However, restricting food purchases using SNAP has met opposition due to concerns regarding fairness. 21,22 Other proposals include making hot prepared food eligible for purchase with SNAP benefits 23 and providing discounts or rebates on fruits and vegetables purchased via SNAP, 24 although the success of such rebate schemes has been limited.…”

Effect of Change in the Supplemental Nutrition Assistance Program Guidelines on Vendor Participation and Availability of Fresh Produce

“…SNAP benefits, which average $126 per person per month, can be redeemed at any SNAP-authorized food vendor nationwide (1). A common concern regarding SNAP vendors has been low availability of healthy foods (2,3). In low-income communities in particular, SNAP vendors are usually convenience stores and small grocers (4–6), where the availability of fresh fruits and vegetables (FFV) is low (5,7,8).…”