Improving Fruit and Vegetable Consumption Among Low-Income Customers at Farmers Markets: Philly Food Bucks, Philadelphia, Pennsylvania, 2011

Abstract

IntroductionWe evaluated whether Philly Food Bucks, a bonus incentive program at farmers markets, is associated with increased fruit and vegetable consumption and Supplemental Nutrition Assistance Program (SNAP) sales at farmers markets in low-income areas.MethodsA convenience sample of 662 customers at 22 farmers markets in low-income neighborhoods in Philadelphia, Pennsylvania, was surveyed via face-to-face interviews. Questions addressed shopping characteristics, self-reported change in fruit and vegetable consumption, whether customers tried new fruits or vegetables, use of Philly Food Bucks, and demographic information. Market-level SNAP sales and Philly Food Bucks redemption data were also collected to monitor sales patterns.ResultsPhilly Food Bucks users were significantly more likely than nonusers to report increasing fruit and vegetable consumption (OR, 2.4; 95% CI, 1.6–3.7; P < .001) and to report trying new fruits or vegetables (OR 1.8; 95% CI, 1.2–2.7; P = .006). At the market level, average SNAP sales more than doubled at farmers markets in low-income areas in the first 2 years of the Philly Food Bucks program. At the city’s largest farmers market in a low-income area, the program was associated with an almost 5-fold higher increase in annual SNAP sales compared with baseline.ConclusionResults from this study demonstrate that a bonus incentive program tied to SNAP was associated with self-reported increases in fruit and vegetable consumption and increased SNAP sales at participating farmers markets in low-income communities. More research is warranted to evaluate the long-term impact of bonus incentives on farmers market use, dietary behaviors, and health outcomes.

Farmers’ market shopping and dietary behaviours among Supplemental Nutrition Assistance Program participants

“…However, these associations may also be a result of a healthier eating identity among those who shop at farmers markets (36) compared with those who do not shop at farmers' markets. Previously mentioned, Young et al (22) suggest that when incentive programmes are provided at farmers' markets in low-income areas, providing greater financial access to markets, participants report eating more FV than nonparticipants. However, in the current study, neither objectively measured nor perceived access (distance) to farmers' markets was associated with farmers' market use.…”

“…'Double Bucks' and similar interventions, whereby low-income individuals' SNAP benefits are multiplied when used at local farmers' markets, have shown promise. In Philadelphia, Young et al found that when SNAP participants were given incentives to spend $US 5 of SNAP benefits at a local farmers' market, SNAP transactions increased and participants reported consuming more FV (22) . In New York City, 'Health Bucks' resulted in greater SNAP benefit redemption in markets (23) .…”

“…As part of a large initiative funded by the Centers for Disease Control and Prevention, North Carolina's Community Transformation Grant Project (NC CTG-Project) is seeking to increase farmers' market use among North Carolina residents and particularly among those at greatest risk for obesity (24) . Research suggests a relationship between voucher programmes, farmers' market use and improved diet (22,23) , yet more evidence in a variety of settings is needed.…”

Receiving Assistance and Local Food System Participation

“…Private charities have long provided services like food pantries, food banks, and soup kitchens. Prior to the 1980s these programs were small in scale and scope, but the recession of the 1980s, coupled with a steep decline in social spending, led to a dramatic expansion of private charities [12]. During the recent Great Recession, private charities similarly played an important role in aiding households suffering from food insecurity [22,23].…”

“…For instance, Jones and Bhatia discuss the introduction of EBT terminals in farmers' markets, and the subsequent increase in money spent at farmers' markets [11]. Other research has examined the role that bonus buck programs have played in improving Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) sales at farmers' markets in low income areas [12]. Still other research has examined the effectiveness of different ways of accepting food assistance programs.…”