Defending and Strengthening SNAP: Leveraging Evidence to Improve Public Health
By Craig Willingham, Deputy Director, CUNY Urban Food Policy Institute
43 million Americans utilize SNAP benefits and about 1.7 Million of them live in New York City. In Fiscal Year 2015, the federal government spent about $75 billion on SNAP. The impact of this program is both large in the number of people it reaches and in its purchasing power. A recent USDA study looked at the foods typically purchased by SNAP households. It found many similarities between the diets of SNAP and non-SNAP recipients but in some categories SNAP recipients spent a higher portion of their food dollars on unhealthy food than did non-SNAP recipients. As we move into the Trump era we as advocates need to be careful about what we take away from studies like this and how we can use them to our advantage.
One of the key findings of this study showed that unhealthy food items were common purchases for SNAP participants, which may lead some to argue that the program promotes unhealthy eating. My sense is that the number of Americans that truly believe that SNAP on the whole is harmful to its participant’s health is probably quite small. However, if the proliferation of distorted and false information characterized by the election coverage is any indication, I think there is a real chance that studies like this one may be used to question the effectiveness of the program. To address this I believe that it’s important to provide some context for how consumers use SNAP. That will be an important role for us as health and nutrition professionals as the national debate on SNAP unfolds.
Diet-related chronic diseases are the leading causes of disability and premature death in the United States. Heart disease, diabetes, high blood pressure, etc. are all well know outcomes of a poor diet. This is why it is important to consider the role food programs do and don’t play in promoting healthy eating. Food programs like SNAP are often by implication, thought to be a mechanism for encouraging good health, and there are some indications that this is true. People who are more food insecure are likely to be effected by a host of health issues and studies have shown that SNAP can have a positive impact on changing that. However, food security includes both the availability of food but also its quality. Getting enough calories to avoid hunger is important but if those calories put you at risk of diabetes, you’ve jumped from the frying pan into the fire. Competing factors that affect health outcomes for SNAP participants once they achieve food security include poor diet quality, limited availability of healthy affordable food, and not having enough money to buy food all month after SNAP benefits are expended. One NYC Department of health study showed that In the latter parts of the month, SNAP households manage with less food and as resources dwindle they rely on inexpensive, high-fat, and starchy food items—like sandwiches purchased at bodegas, cheese doodles, and cookies. This is an example of how valuable context is for understanding the results of the USDA’s study and others like it.
As public health professionals we must be able to walk and chew gum at the same time; supporting the absolute priority of insuring that those in need never go hungry, while also advocating for thoughtful action aimed at supporting improved health outcomes. Campaigning for the SNAP program to leverage its considerable influence in the marketplace to support health is a realistic way to make this happen. To affect change, concrete solutions like pushing for increased reformulation of unhealthy products is another way the federal government can have an impact on what SNAP participants buy. Furthermore, changes in government subsidies that would redirect funds from the five major "program" commodities of corn, soybeans, wheat, cotton, and rice towards fruits and vegetables would help equalize the prices of healthy and unhealthy food. Lastly, more support for incentive programs and SNAP-ED projects would help to create more pathways for SNAP participants to change the way they eat, without unfairly targeting or discriminating against the poor. Moreover, these solutions would improve the diets of SNAP recipients as well as the diets of Americans as a whole. When you make the healthy choice the easy choice consumers are bound to have healthier diets. If even some of these enhancements can happen over the next four years millions of people affected by diet related diseases would see improvements in health. To this end, advocates can play a role in ensuring that we don’t simply settle for program maintenance. We should stress the importance of the sorts of comprehensive public health goals in our food benefit programs as I’ve described here, even in the face of what are sure to be unprecedented challenges.
I believe that a majority of Americans don’t want to see their fellow citizens arbitrarily denied access to food assistance benefits and similarly don’t want to see them unnecessarily vulnerable to diet related diseases due to shortcomings in our food programs. If the federal government chooses to leverage the power of SNAP to make healthier food more available it will make America healthier, giving our country a better chance at becoming a more just and equitable society.