Should government food assistance programs have nutritional requirements?

Some of the foods you can purchase through WIC.

Probably.

There’s good reason to believe that adding nutritional requirements to government food programs is a better use of money and leads to better health outcomes for the people in said programs.

WIC (Women, Infants, and Children) is a state-run program that helps low-income women and children purchase healthy food. WIC has specific guidelines for the quantities and types of food recipients can purchase, all of which have to meet certain health standards. In this program there is no way to purchase soda, candy, pizza, baked sweets, ice cream, etc. SNAP (Supplemental Nutrition Assistance Program, often referred to as “food stamps”) is a federally-funded program helping low-income people purchase almost any food.

The USDA explains that SNAP is for purchasing any food or food product for home consumption and that this definition includes “soft drinks, candy, cookies, snack crackers, and ice cream” and similar items. Data suggest these types of purchases make up at least 17% of SNAP spending .[ref]To get this number I added the percentages for the following categories: soft drinks, candy – packaged, frozen pizza, ice cream ice milk & sherberts, cookies, cakes, bacon, baked sweet goods, candy – checklane, sweet goods, ramen, frozen desserts, popcorn, dry mix desserts, pies, cookie/cracker multi packs, cocoa mixes, sweet goods & snacks, salty snacks, refrigerated desserts, single serve sweet goods, single serve cookie/cracker, and cake decor. There were many other categories that could arguably be categorized as unhealthy food or “junk food,” but if they were debatable I left them out.[/ref] In 2017, about 42 million people used SNAP at an average of $125.79 per person per month, meaning the government spent about $11.3 billion that year buying junk food for low-income people. What are the arguments for spending so much on junk rather than using those funds to ensure low-income people have high quality food?

Opponents of SNAP nutritional requirements give many reasons for why nutritional requirements are not feasible or effective: we can’t come up with clear standards for what is “healthy,” it would be too complicated and costly to implement such standards, restrictions wouldn’t stop people from buying unhealthy food with their own money, and people in higher income brackets purchase similar amounts of unhealthy food.[ref]Whether this last argument is true or not is a bit tangential. Research shows lower SES people have poorer nutrition and health outcomes than people with higher income. Improving nutrition is one (important) approach to bridging that gap.[/ref]

Yet WIC has managed to define what constitutes healthy food and implement a program based on those boundaries. In fact the USDA describes WIC as “one of the nation’s most successful and cost-effective nutrition intervention programs.” There is evidence to suggest people participating in WIC (especially children) have better nutrition and health outcomes than their peers. Conversely, there is evidence to suggest people who receive SNAP benefits have worse nutrition than income-eligible people who don’t participate in SNAP. For example:

Changing WIC changes what children eat – May 2013

Comparing July to December in 2008 and 2011, increases were observed in breastfeeding initiation (72.2-77.5%); delaying introduction of solid foods until after 4 months of age (90.1-93.8%); daily fruit (87.0-91.6%), vegetable (78.1-80.8%), and whole grain consumption (59.0-64.4%) by children aged 1-4 years; and switches from whole milk to low-/nonfat milk by children aged 2-4 years (66.4-69.4%). In 1-year-old children, the proportion ≥95th percentile weight-for-recumbent length decreased from 15.1 to 14.2%; the proportion of children 2- to 4-year-old with body mass index (BMI) ≥95th percentile decreased from 14.6 to 14.2%.

Trends in Obesity Among Participants Aged 2–4 Years in the Special Supplemental Nutrition Program for Women, Infants, and Children – November 2016

The prevalence of obesity among young children from low-income families participating in WIC in U.S. states and territories was 14.5% in 2014. This estimate was higher than the national estimate (8.9%) among all U.S. children in a slightly different age group (2–5 years) based on data from the 2011–2014 National Health and Nutrition Examination Survey (7). Since 2010, statistically significant downward trends in obesity prevalence among WIC young children have been observed overall, in all five racial/ethnic groups, and in 34 of the 56 WIC state agencies, suggesting that prevention initiatives are making progress, potentially by impacting the estimated excess of calories eaten versus energy expended for this vulnerable group (8).

The Supplemental Nutrition Assistance Program – September 2015

Child SNAP recipients consume more sugary beverages, processed meats, and high-fat dairy products, but fewer nuts, seeds, and legumes than income-eligible nonparticipants. Similarly, adult SNAP recipients consume more fruit juice, potatoes, red meat, and sugary beverages, but fewer whole grains than income-eligible nonparticipants. In another study, SNAP participants had lower dietary quality scores overall, and consumed significantly fewer fruits, vegetables, seafood, and plant proteins, but significantly more added sugar than income-eligible nonparticipants.

The study specifically compares SNAP nutrition to WIC nutrition:

In one study comparing the grocery store purchases of SNAP and WIC households in New England, SNAP households purchased more than double the amount of sugary beverages per month (399 ounces) than WIC households (169 ounces), 72% of which were paid for with SNAP dollars. In a 3-month study, new SNAP participants significantly increased their consumption of refined grains compared with low-income people who did not join. In a study of Hispanic Texan women, SNAP participants consumed 26% more sugary beverages and 38% more sweets and desserts than low-income nonparticipants.

Furthermore, most of the people who use SNAP believe the program should not allow recipients to purchase unhealthy food:

54% of SNAP participants supported removing sugary drinks from SNAP eligibility. In another survey of 522 SNAP stakeholders, 78% of respondents agreed that soda, and 74% agreed that “foods of low nutritional value” such as candy and sugar-sweetened fruit drinks should not be eligible for purchase with benefits. Seventy-seven percent of respondents believed that SNAP benefits should be consistent with the DGAs [Dietary Guidelines for Americans], and 54% thought that SNAP should be reformulated into a defined food package similar to WIC.

I want to live in a society where people are healthy and no one goes hungry. SNAP can and should serve both goals.

2 thoughts on “Should government food assistance programs have nutritional requirements?”

  1. It’s distressing to me to realize how much of my opposition to any such plan has to do with utter distrust of elected Republicans. I can think of lots of ways to pursue such goals which would seem to me quite positive, but I don’t think our current Republican Party can do them. Instead of a dignity- and liberty-respecting piece of a larger program of doing well by all our people, I expect that this would be a political ploy to cut spending on the poor, to make those low-income people (especially disfavored minorities) who accept government assistance suffer, to create a sinecure for an incompetent party loyalist, and to solicit bribes from food producers. In fairness, that last would apply equally to Democrats. But the Republican Party seems to have abandoned any commitment to good government.

    Here’s a way of promoting these goals which seems similar to President Trump’s proposal, but more in tune with conservative principles: let the free market provide food delivery subscription services, and explicitly advertise SNAP eligibility, at government expense, for those which meet nutritional standards set by an independent panel. If necessary, raise SNAP benefits to cover whatever it actually costs to run such a service profitably. If it works well, I would even support paperwork changes to make such a service the default, with an opt-out for those who seek it.

    Getting to grocery stores, getting food home, and the time spent doing all that can be serious burdens for people on tight budgets. I’m all for making their lives easier and healthier with their consent. But Trump’s Party seems like it would do things like deliberately avoid including halal food, or put in lots of corn products to win the Iowa caucuses, or inflict creamed corn on innocent people.

  2. >>let the free market provide food delivery subscription services, and explicitly advertise SNAP eligibility, at government expense, for those which meet nutritional standards set by an independent panel. If necessary, raise SNAP benefits to cover whatever it actually costs to run such a service profitably.<<
    I like this idea very much. I’d want to know the costs associated, but I would rather spend more on SNAP and have it all be healthy then spend what we spend now and have such a sizeable chunk of it be contributing to pervasive health problems.

    Also, to be clear, this post was not specifcally in reference to the Trump administration’s recent overhauls. I’m very skeptical the government could provide boxes of food in a timely and reliable way and I am also suspicious of their ability to fill those boxes with nutritious and useful food. I prefer the WIC model to the mailed-boxes model certainly, and your idea of letting private businesses mail food even more.

Comments are closed.