As a complement to our recent blog on proposed federal changes to state waiver criteria for work requirements in the Supplemental Nutrition Assistance Program (SNAP), this blog focuses on strategies to improve the nutritional status of SNAP beneficiaries. It also serves as an update to our August 2017 fact sheet that touched on efforts by states to restrict SNAP purchases, as well as the available evidence on strategies to incentivize healthier purchases by SNAP beneficiaries.
Additionally, it comes on the heels of a second effort by the Arkansas General Assembly to restrict SNAP purchases which, like the first effort two years earlier, was not successful. Sponsored by Representative Mary Bentley, the 2017 bill would have restricted SNAP purchases to foods and beverages with “sufficient nutritional value” based on other federal food program standards. A 2019 bill — also sponsored by Bentley — would have excluded soft drinks, energy drinks, and candy from eligible items for purchase with SNAP benefits.
As we noted in our 2017 fact sheet, a November 2016 study showed improvements in the nutritional quality of SNAP beneficiary diets through incentive only (financial reward) or disincentive only (purchase restrictions). However, the observed improvements in nutritional quality were significantly better among SNAP beneficiaries when exposed to both incentives and disincentives.
An October 2018 study modeled the health effects and cost-effectiveness of the following strategies to incentivize healthier SNAP purchases:
- A 30% financial reward for fruit and vegetable purchase, which the authors estimated could prevent 303,900 cardiovascular events and save $6.77 billion in healthcare costs;
- A 30% financial reward for fruit and vegetable purchase plus exclusion of sugar-sweetened beverages (SSBs) from the list of eligible items for purchase with SNAP benefits, which the authors estimated could prevent 797,900 cardiovascular events and save $39.16 billion in healthcare costs; and
- A 30% financial reward for purchases of fruit and vegetables, nuts, whole grains, fish, and plant-based oils plus a 30% financial disincentive for purchase of SSBs, junk food, and processed meats, which the authors estimated could prevent 940,000 cardiovascular events and save $41.93 billion in healthcare costs.
Along these lines, the American Academy of Pediatrics recommended that federal nutrition assistance programs including SNAP “should aim to ensure access to healthful food and beverages and discourage consumption of sugary drinks.” While combined strategies including both incentives and disincentives may demonstrate optimal improvements in nutritional status for SNAP beneficiaries, restriction only strategies nonetheless show some limited nutritional improvement. Additionally, the viability of combined strategies may be more limited due to operational costs and political commitment.
