scholarly journals Cost-effectiveness of financial incentives and disincentives for improving food purchases and health through the US Supplemental Nutrition Assistance Program (SNAP): A microsimulation study

PLoS Medicine ◽  
2018 ◽  
Vol 15 (10) ◽  
pp. e1002661 ◽  
Author(s):  
Dariush Mozaffarian ◽  
Junxiu Liu ◽  
Stephen Sy ◽  
Yue Huang ◽  
Colin Rehm ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Financial Incentives ◽  
Supplemental Nutrition Assistance Program ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Food Purchases ◽  
The Us ◽  
Nutrition Assistance

Abstract 022: Cost-Effectiveness of Financial Incentives and Disincentives for Improving Diet and Health Through the Supplemental Nutrition Assistance Program

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Junxiu Liu ◽  
Dariush Mozaffarian ◽  
Stephen Sy ◽  
Yue Huang ◽  
Yujin Lee ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Financial Incentives ◽  
Cost Savings ◽  
Cost Effective ◽  
Supplemental Nutrition Assistance Program ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Life Years ◽  
Nutrition Assistance ◽  
Meta Analyses

Introduction: The 2018 Farm Bill represents a major opportunity to reduce disparities in diet and health. The largest component is the Supplemental Nutrition Assistance Program (SNAP), feeding 1 in 6 Americans. Potential options include subsidizing fruits & vegetables (F&V), restricting sugar-sweetened beverages (SSBs), or implementing a broader food incentive/disincentive framework that preserves choice. Their comparative health impacts and cost-effectiveness are not established. Methods: Using a validated microsimulation model (CVD PREDICT), we estimated changes in CVD events, quality-adjusted life-years (QALYs), costs, and cost-effectiveness of 3 policy scenarios in SNAP adults: 1) 30% subsidy on F&V; 2) 30% F&V subsidy + SSB restriction; and 3) 30% subsidy on F&V, whole grains, nuts/seeds, seafood, plant-based oils, and 30% disincentive on SSBs, junk food, and processed meats. Model inputs included national data from NHANES (2009-2014), policy effects from SNAP pilots and food pricing meta-analyses, diet-disease effects from meta-analyses, and policy, food subsidy, and healthcare costs. Results: From a societal perspective, all 3 scenarios were cost-savings at 5, 10, 20 y and lifetime ( Table ). At 5 y, a F&V subsidy would prevent 32,218 CVD events, gain 18,072 QALYs, and save $1.04B ($6.05B lifetime). Corresponding values for a F&V subsidy + SSB restriction were 63,898, 45,772, and $4.47B ($38.83B); and for a broader incentive/disincentive framework that preserved choice, 65,078, 26,663, and $3.98B ($29.90B). Government affordability varied by program duration and by whether subsidy costs for SNAP adults or all SNAP participants were included. Scenario 3 was generally most cost-effective or -saving, followed by scenario 2 and then scenario 1; all were cost-effective over a lifetime from a government affordability perspective. Conclusions: Financial incentives/disincentives through SNAP could generate substantial health benefits and be cost-effective or cost savings.

scholarly journals Policies affecting eligibility for the Supplemental Nutrition Assistance Program and HIV incidence in the United States

2021 ◽  
Author(s):  
Aaron Richterman ◽  
Jason P Block ◽  
Alexander C Tsai ◽  
Louise C Ivers
Keyword(s):  
Safety Net ◽  
The United States ◽  
Supplemental Nutrition Assistance Program ◽  
Hiv Incidence ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
The Us ◽  
State Income ◽  
Nutrition Assistance ◽  
Time Varying Covariates

Abstract Introduction The connection between food insecurity and HIV outcomes is well-established. The Supplemental Nutrition Assistance Program (SNAP), the primary food safety net program in the US, may have collateral impacts on HIV incidence. “Broad-based categorical eligibility” for SNAP is a policy that provides a mechanism for states to increase the income or asset limits for SNAP eligibility. Methods We estimated the association between the number of new HIV diagnoses 2010-2014 for each state and (1) state income limits and (2) state asset limits for SNAP eligibility. We fitted multivariable negative binomial regression models with number of HIV diagnoses specified as the outcome; SNAP policies as the primary explanatory variable of interest; state and year fixed effects; and time-varying covariates related to the costs of food, health care, housing, employment, other SNAP policies, and Temporary Assistance for Needy Families spending. Results HIV diagnoses within states had a statistically significant association with state income limits for SNAP eligibility (IRR 0.94 per increase in the income limit by 35% of federal poverty level, 95% CI 0.91-0.98), but no association with state asset limits (increased asset limit vs. no change, IRR 1.02, 95% CI 0.94-1.10; eliminated asset limit vs. no change, IRR 1.04, 95% CI 0.99-1.10). Conclusions State income limits for SNAP eligibility were inversely associated with the number of new HIV diagnoses for states between 2010-2014. Proposals to eliminate the use of broad-based categorical eligibility to increase the income limit for SNAP may undercut efforts to end the HIV epidemic in the US

scholarly journals Strengthening the Public Health Impacts of the Supplemental Nutrition Assistance Program Through Policy

2020 ◽  
Vol 41 (1) ◽  
pp. 453-480
Author(s):  
Sara N. Bleich ◽  
Alyssa J. Moran ◽  
Kelsey A. Vercammen ◽  
Johannah M. Frelier ◽  
Caroline G. Dunn ◽  
...  
Keyword(s):  
Public Health ◽  
Low Income ◽  
Safety Net ◽  
Supplemental Nutrition Assistance Program ◽  
Health Impacts ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
The Public ◽  
The Us ◽  
Nutrition Assistance

The US Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) is the cornerstone of the US nutrition safety net. Each month, SNAP provides assistance to 40 million low-income Americans—nearly half of them children. A number of changes could strengthen the public health impacts of SNAP. This review first presents a framework describing the mechanisms through which SNAP policy can influence public health, particularly by affecting the food security, the diet quality, and, subsequently, the health of SNAP participants. We then discusspolicy opportunities with the greatest potential to strengthen the public health impacts of SNAP, organized into three areas: ( a) food production and distribution, ( b) benefit allocation, and ( c) eligibility and enrollment. For each section, we describe current policy and limitations of the status quo, suggest evidence-based opportunities for policy change to improve public health, and identify important areas for future research.

scholarly journals How much does the Supplemental Nutrition Assistance Program alleviate food insecurity? Evidence from recent programme leavers

2011 ◽  
Vol 15 (5) ◽  
pp. 811-817 ◽  
Author(s):  
Mark Nord
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
Survey Data ◽  
Supplemental Nutrition Assistance Program ◽  
Cross Sectional Survey ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Adequate Food ◽  
The Us ◽  
Nutrition Assistance

AbstractObjectiveTo estimate the effect of the US Supplemental Nutrition Assistance Program (SNAP) on the food security (consistent access to adequate food) of recipients, net of the effect of the self-selection of more food-needy households into the programme.DesignThe food security of current SNAP recipients and recent leavers is compared in cross-sectional survey data, adjusting for economic and demographic differences using multivariate logistic regression methods. A similar analysis in 2-year longitudinal panels provides additional control for selection on unobserved variables based on food security status in the previous year.SettingHousehold survey data collected for the US Department of Agriculture by the US Census Bureau.SubjectsHouseholds interviewed in the Current Population Survey Food Security Supplements from 2001 to 2009.ResultsThe odds of very low food security among households that continued on SNAP through the end of a survey year were 28 % lower than among those that left SNAP prior to the 30-d period during which food security was assessed. In 2-year panels with controls for the severity of food insecurity in the previous year, the difference in odds was 45 %.ConclusionsThe results are consistent with, or somewhat higher than, the estimates from the strongest previous research designs and suggest that the ameliorative effect of SNAP on very low food security is in the range of 20–50 %.

scholarly journals The US Supplemental Nutrition Assistance Program – Education improves nutrition-related behaviors

2020 ◽  
Vol 9 ◽  
Author(s):  
Suzanne Ryan-Ibarra ◽  
Amy DeLisio ◽  
Heejung Bang ◽  
Omolola Adedokun ◽  
Vibha Bhargava ◽  
...  
Keyword(s):  
Low Income ◽  
Environmental Changes ◽  
Food Resource ◽  
Supplemental Nutrition Assistance Program ◽  
Fiscal Year ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
The Us ◽  
Post Test ◽  
Nutrition Assistance

Abstract The aim of this study was to measure whether participating in Supplemental Nutrition Assistance Program – Education (SNAP-Ed) interventions is associated with changes in meeting recommendations for healthy eating and food resource management behaviours, such as shopping, among low-income children, adolescents, and adults in eight states in the US Southeast. The study used a one-group pre-test post-test design, analysing aggregate data on nutrition and shopping behaviours collected during Federal Fiscal Year 17 from SNAP-Ed direct education in community settings. Twenty-five implementing agencies in Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee provided aggregated data on program participants. Because survey questions differed, agencies followed standard recoding guidelines. The number of participants varied depending on the indicator; the maximum number was n 43 303 pre-tests, n 43 256 post-test. Participants were significantly more likely to consume more than one kind of fruit (pooled relative risk (RR), 1⋅10; 95% confidence interval (CI), 1⋅09–1⋅11) and more than one kind of vegetable (pooled RR, 1⋅14; 95% CI, 1⋅12–1⋅15) after the intervention than before. On average, participants consumed 0⋅34 cups more of fruit per day (95% CI, 0⋅31–0⋅37), and 0⋅22 cups more of vegetables per day (95% CI, 0⋅19–0⋅25) after the intervention, compared to before. About 701 policy, systems, and environmental changes for nutrition supports were reported. This study suggests that SNAP-Ed direct education is associated with positive behaviour changes in the US Southeast. It provides a methodology that can inform data aggregation efforts across unique SNAP-Ed programs or other similar nutrition education programs to report on the collective impact.

The Supplemental Nutrition Assistance Program and frequency of sugar-sweetened soft drink consumption among low-income adults in the US

2017 ◽  
Vol 23 (3) ◽  
pp. 147-157 ◽  
Author(s):  
Jiyeun Park ◽  
Hsien-Chang Lin ◽  
Chao-Ying Peng
Keyword(s):  
Low Income ◽  
Soft Drink ◽  
Supplemental Nutrition Assistance Program ◽  
Poverty Level ◽  
Supplemental Nutrition ◽  
Assistance Program ◽  
Soft Drink Consumption ◽  
The Us ◽  
The Difference ◽  
Nutrition Assistance

Background: The Supplemental Nutrition Assistance Program (SNAP) was designed to help low-income people purchase nutritious foods in the US. In recent years, there has been a consistent call for banning purchases of sugar drinks in SNAP. Aim: The aim of this study was to examine the association between SNAP participation and the frequency of sugar-sweetened soft drink (SSD) consumption among low-income adults in the US. Method: Data came from the 2009–2010 National Health and Nutrition Examination Survey. Low-income adults aged ≥20 years with a household income ≤250% of the Federal Poverty Level ( N = 1200) were categorized into two groups based on the household’s SNAP receipt: SNAP recipients ( n = 393) and non-recipients ( n = 807). Propensity-score matching was used to minimize observable differences between these two groups that may explain the difference in SSD consumption, generating the final sample of 393 matched pairs (SNAP recipients, n = 393; non-recipients, n = 393). An ordinal logistic regression was conducted on the matched sample. Results: SNAP recipients were more likely to report higher levels of SSD consumption, compared with non-recipients (adjusted odds ratio (AOR) = 1.55, 95% confidence interval (CI) = 1.17−2.07). Male gender (AOR = 1.69, 95% CI = 1.17−2.46), younger age (AOR = 0.97, 95% CI = 0.96−0.99), lower education level (AOR = 2.28, 95% CI = 1.33−3.89), and soda availability in homes (AOR = 2.24, 95% CI = 1.77−2.83) were also associated with higher levels of SSD consumption among low-income adults. Conclusions: SNAP participation was associated with frequent SSD consumption. To reduce SSD consumption, strategic efforts need to focus on educating people about the harms of SSD and promoting nutritious food choices with SNAP benefits.

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