Supplemental Nutrition Assistance Program Benefits Research Articles

Are Supplemental Nutrition Assistance Program Restrictions on Sugar-Sweetened Beverages Effective in Reducing Purchase or Consumption? A Systematic Review

The participants in the Supplemental Nutrition Assistance Program (SNAP) consume greater amounts of sugar and sweetened beverages (SSBs) compared to non-eligible individuals, which could result in potential negative health outcomes. This can be attributed to the lack of restrictions on SSB purchases with SNAP benefits. In view of the increasing calls from advocates and policymakers to restrict the purchase of SSBs with SNAP benefits, we performed a systematic review to assess its impact towards SSB purchases and consumption. We searched articles from five databases—Cochrane, EBSCO, SCOPUS, Web of Science, and PubMed—and selected seven studies, four of which were randomized controlled trials (RCTs) and three were simulation modeling studies. All three simulation studies and one RCT reported outcomes in terms of consumption, while the other three RCTs reported outcomes in terms of purchases. All seven studies found that an SSB restriction led to a decrease in SSB consumption or purchases, with six studies reporting significant results. Nonetheless, limitations exist. These include limited studies on this subject, potential workarounds circumventing SSB restrictions, like making purchases using personal cash, potentially differed estimated effects when combined with incentives or other initiatives, and the limited geographical scope among the selected RCTs.

Whose Plate Is It? Awareness of MyPlate Among US Adults Over Time Since Implementation

BackgroundMyPlate is a tool designed to educate the general US population on how to eat in alignment with the Dietary Guidelines for Americans; yet, there is a lack of data on who has heard of MyPlate over time. ObjectiveThe objective of this analysis was to examine the prevalence of awareness of MyPlate within the US population and if awareness changes differentially over time. DesignThis study was a serial, cross-sectional survey. Participants/settingThree survey waves of data (2013-2018) were used from the National Health and Nutrition Examination Survey of adults aged 20 years or older (n = 17,023). Main outcome measuresPercentage of the US adult population who had heard of MyPlate was measured and stratified by gender, age, citizenship status, education, household food security status, income, receipt of SNAP, and receipt of WIC. Statistical analyses performedGlobal Wald tests were used to assess whether prevalence of awareness of MyPlate differed by sociodemographic characteristics. Tests of homogeneity using likelihood ratio tests of nested logistic regression models were used to assess whether differences in awareness of MyPlate by various sociodemographic characteristics changed over time from 2013 to 2018. ResultsTwenty percent (19.5%) (n = 875) of the analytic sample of participants aged 20 years or older had heard of MyPlate in 2013-14, 24.5% (n = 1,020) in 2015-16, and 24.6% (n = 1,086) in 2017-18. Awareness of MyPlate changed differentially over time (P value < .1) from 2013 to 2018 by income, household food security status, and receipt of Supplemental Nutrition Assistance Program benefits, with slower increases in awareness for households with lowest income over time, narrowing of differences in awareness by household food security status over time, and persistent differences in awareness by receipt of Supplemental Nutrition Assistance Program benefits over time. ConclusionsThese results highlight the current low awareness of MyPlate, disparities in awareness of MyPlate immediately after implementation by sociodemographic characteristics, and increases in awareness over time at differential rates within levels of income, food security status, and ever receipt of Supplemental Nutrition Assistance Program benefits. Given that the Dietary Guidelines for Americans 2025-2030 are currently in development, new strategies should be considered to disseminate tools that translate the updated Dietary Guidelines in such a way that reach the general population equitably upon implementation within the United States.

Changes in Health Care Workers’ Economic Outcomes Following Medicaid Expansion

The extent to which changes in health sector finances impact economic outcomes among health care workers, especially lower-income workers, is not well known. To assess the association between state adoption of the Affordable Care Act's Medicaid expansion-which led to substantial improvements in health care organization finances-and health care workers' annual incomes and benefits, and whether these associations varied across low- and high-wage occupations. Difference-in-differences analysis to assess differential changes in health care workers' economic outcomes before and after Medicaid expansion among workers in 30 states that expanded Medicaid relative to workers in 16 states that did not, by examining US individuals aged 18 through 65 years employed in the health care industry surveyed in the 2010-2019 American Community Surveys. Time-varying state-level adoption of Medicaid expansion. Primary outcome was annual earned income; secondary outcomes included receipt of employer-sponsored health insurance, Medicaid, and Supplemental Nutrition Assistance Program benefits. The sample included 1 322 263 health care workers from 2010-2019. Health care workers in expansion states were similar to those in nonexpansion states in age, sex, and educational attainment, but those in expansion states were less likely to identify as non-Hispanic Black. Medicaid expansion was associated with a 2.16% increase in annual incomes (95% CI, 0.66%-3.65%; P = .005). This effect was driven by significant increases in annual incomes among the top 2 highest-earning quintiles (β coefficient, 2.91%-3.72%), which includes registered nurses, physicians, and executives. Health care workers in lower-earning quintiles did not experience any significant changes. Medicaid expansion was associated with a 3.15 percentage point increase in the likelihood that a health care worker received Medicaid benefits (95% CI, 2.46 to 3.84; P < .001), with the largest increases among the 2 lowest-earning quintiles, which includes health aides, orderlies, and sanitation workers. There were significant decreases in employer-sponsored health insurance and increases in SNAP following Medicaid expansion. Medicaid expansion was associated with increases in compensation for health care workers, but only among the highest earners. These findings suggest that improvements in health care sector finances may increase economic inequality among health care workers, with implications for worker health and well-being.

Supplemental Nutrition Assistance Program and Adherence to Antihypertensive Medications

Nonadherence to antihypertensive medications is associated with uncontrolled blood pressure, higher mortality rates, and increased health care costs, and food insecurity is one of the modifiable medication nonadherence risk factors. The Supplemental Nutrition Assistance Program (SNAP), a social intervention program for addressing food insecurity, may help improve adherence to antihypertensive medications. To evaluate whether receipt of SNAP benefits can modify the consequences of food insecurity on nonadherence to antihypertensive medications. A retrospective cohort study design was used to assemble a cohort of antihypertensive medication users from the linked Medical Expenditure Panel Survey (MEPS)-National Health Interview Survey (NHIS) dataset for 2016 to 2017. The MEPS is a national longitudinal survey on verified self-reported prescribed medication use and health care access measures, and the NHIS is an annual cross-sectional survey of US households that collects comprehensive health information, health behavior, and sociodemographic data, including receipt of SNAP benefits. Receipt of SNAP benefits in the past 12 months and food insecurity status in the past 30 days were assessed through standard questionnaires during the study period. Data analysis was performed from March to December 2021. Status of SNAP benefit receipt. The main outcome, nonadherence to antihypertensive medication refill adherence (MRA), was defined using the MEPS data as the total days' supply divided by 365 days for each antihypertensive medication class. Patients were considered nonadherent if their overall MRA was less than 80%. Food insecurity status in the 30 days prior to the survey was modeled as the effect modifier. Inverse probability of treatment (IPT) weighting was used to control for measured confounding effects of baseline covariates. A probit model was used, weighted by the product of the computed IPT weights and MEPS weights, to estimate the population average treatment effects (PATEs) of SNAP benefit receipt on nonadherence. A stratified analysis approach was used to assess for potential effect modification by food insecurity status. This analysis involved 6692 antihypertensive medication users, of whom 1203 (12.8%) reported receiving SNAP benefits and 1338 (14.8%) were considered as food insecure. The mean (SD) age was 63.0 (13.3) years; 3632 (51.3%) of the participants were women and 3060 (45.7%) were men. Although SNAP was not associated with nonadherence to antihypertensive medications in the overall population, it was associated with a 13.6-percentage point reduction in nonadherence (PATE, -13.6 [95% CI, -25.0 to -2.3]) among the food-insecure subgroup but not among their food-secure counterparts. This analysis of a national observational dataset suggests that patients with hypertension who receive SNAP benefits may be less likely to become nonadherent to antihypertensive medication, especially if they are experiencing food insecurity. Further examination of the role of SNAP as a potential intervention for preventing nonadherence to antihypertensive medications through prospectively designed interventional studies or natural experiment study designs is needed.

Food Insecurity Among Graduate Students and Postdoctoral Trainees

Food insecurity on college campuses has emerged as an urgent public health priority; however, there has been a lack of studies focused on graduate students or postdoctoral trainees, particularly those enrolled at private academic institutions. To estimate the prevalence of and factors associated with food insecurity among graduate students and postdoctoral trainees at a private academic university in Boston, Massachusetts. In this cross-sectional survey study, a survey on food insecurity was sent to graduate students and postdoctoral trainees at 3 health-focused graduate schools at Harvard University during the end of the spring 2023 academic term (April to June). Participants were studying medicine, dental medicine, or public health. Data analysis was performed from July to September 2023. Sociodemographic characteristics of graduate students and postdoctoral trainees. The primary outcome was food insecurity as assessed using the US Household Food Security Survey Module. Food insecurity also encompassed low and very low food security. Bidirectional stepwise logistic regression models were conducted to estimate the factors associated with food insecurity for graduate students and postdoctoral trainees. The analytic sample included 1745 participants (response rate, 55%): 1287 were graduate students and 458 were postdoctoral trainees. The median age of respondents was 29.0 (IQR, 7.0) years, and more than half (1073 [61.5%]) identified as female. A total of 694 respondents (39.8%) identified as Asian, 625 (35.8%) as White, and 426 (24.4%) as being of other race or ethnicity. The prevalence of food insecurity was 17.4% (224 of 1287) among graduate students and 12.7% (58 of 458) among postdoctoral trainees. Among graduate students, factors associated with food insecurity included being Asian (OR, 1.06 [95% CI, 1.01-1.11]) or of other race or ethnicity (OR, 1.07 [95% CI, 1.02-1.13]), receiving financial aid (OR, 1.09 [95% CI, 1.05-1.13]), and having housing instability (OR, 1.53 [95% CI, 1.45-1.61]). Among postdoctoral trainees, factors associated with food insecurity included receiving Supplemental Nutrition Assistance Program benefits (OR, 1.59 [95% CI, 1.28-1.97]), having housing instability (OR, 1.33 [95% CI, 1.22-1.45]), and not owning a car (OR, 1.11 [95% CI, 1.04-1.18]). In this study, a substantial proportion of graduate students and postdoctoral trainees at a private academic institution experienced food insecurity during the academic year. These findings underscore the need for national and institutional interventions to address the complex, structural factors related to food insecurity in these distinct populations.

POSITION STATEMENT: Pass the RESTORE (Re-entry Support Through Opportunities for Resources and Essentials) Act.

Under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), current federal policy mandates a lifetime ban for individuals with a past felony drug conviction from receiving Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) benefits. Denying nutritional and financial assistance to individuals with a past felony conviction will widen existing structural health inequities, set back individuals' successful re-entry into society, and contribute to recidivism and poorer health outcomes. Therefore, the Society of Behavioral Medicine supports the RESTORE ACT (Re-Entry Support Through Opportunities for Resources and Essentials Act), which would repeal the lifetime ban on receiving SNAP and TANF benefits for individuals convicted of a drug felony.

Submitted and Denied: Understanding variation in case status across Supplemental Nutrition assistance program (SNAP) applications

Our study investigates the application process for the Supplemental Nutrition Assistance Program (SNAP) and barriers to successful SNAP participation among potentially eligible households. We know that only 84 percent of eligible individuals in the United States participated in SNAP prior to the COVID-19 pandemic. Our objective is to understand continued barriers to SNAP participation among eligible applicants by analyzing Indiana households that have formally engaged in the SNAP application process. We examine census-tract-level data from Indiana’s administrator of SNAP benefits, Family and Social Services Administration (FSSA), in combination with census-tract-level socioeconomic data from 2017 to 2019. We use existing methodologies in micro- and macro-level socioeconomic analysis of SNAP participation to examine not only the terminal participation rate (approved applications) but also the dynamics of the application process that starts with a larger pool of applicants (submitted applications) and may end with a non-participation case status (denied applications). Our linear and quantile regression analyses also seek to understand these socioeconomic factors as predictors of the response distribution of SNAP case status across communities with different rates of application submissions and denials. Our analysis of Indiana SNAP applications supports anecdotal findings that one of the most difficult hurdles in the application process is timely navigation of the paperwork and interview requirements with evidence of increased time in the application process for communities with high SNAP denial rates. We also find that broader socioeconomic trends in a community are associated with application submission rates while applicants’ personal circumstances better predict denial rates.

Longitudinal Associations of Diet, Food Insecurity, and Supplemental Nutrition Assistance Program Use with Global Cognitive Performance in Middle-Aged and Older Adults

BackgroundDiet quality, food access, and food assistance policies may be key modifiable factors related to cognitive decline. ObjectiveWe aimed to evaluate whether diet quality, food insecurity, and Supplemental Nutrition Assistance Program (SNAP) use are associated with longitudinal changes in cognition among older adults in the United States. MethodsFood intake data from the Health Care and Nutrition Study were linked with longitudinal health information from 5 waves of the Health and Retirement Study (2012–2020). The analytic sample (n = 6968) included community-dwelling United States adults aged ≥51 y without cognitive impairment. Global cognition was measured using a telephone-based cognitive status interview (range: 0–27). Diet quality was measured with the Healthy Eating Index, using participants’ average intake of 13 dietary components. Questions regarding food access and affordability were used to determine food insecurity and use of SNAP benefits. Linear mixed-effects regression models were used to estimate longitudinal associations between diet-related factors and cognitive score changes. ResultsPoorer diets [β: −0.24; 95% confidence interval (CI): −0.33, −0.15], food insecurity (β: −1.08; 95% CI: −1.31, −0.85), and SNAP use (β: −0.57; 95% CI: −0.82, −0.32) were associated with lower baseline cognitive scores. Poorer diets (β: −0.17; 95% CI: −0.29, −0.05) and food insecurity (β: −0.23; 95% CI: −0.47, −0.01) were associated with significantly steeper declines in cognitive scores over time, after 8 and 2 y of follow-up, respectively; however, SNAP use was not significantly associated with the rate of cognitive decline over time. Estimates were qualitatively similar when restricting the sample to participants aged ≥65 y. ConclusionsResults suggest that food access and adherence to healthy diet recommendations may be important elements to maintain cognitive health in aging. SNAP benefits may be insufficient to prevent negative cognitive effects of poor diet and limited access to nutritious foods.

Adequacy of SNAP Benefits for Indiana Households, 2022.

We investigated the adequacy of Supplemental Nutrition Assistance Program (SNAP) benefits for Indiana households. Methods included focus groups, interviews, and a statewide survey of 652 households. SNAP benefit-level increases over the course of the COVID-19 pandemic increased their adequacy overall yet were still inadequate for some households. As of June 2022, Indiana households reported their SNAP benefits lasting 13 days a month. The inadequacy of SNAP benefits reveals that some participating households still experience food insecurity, which has adverse public health implications. (Am J Public Health. 2023;113(S3):S224-S226. https://doi.org/10.2105/AJPH.2023.307408).

Abstract B059: Food insecurity among Asian Americans: A scoping review and recommendations for policy and practice

Abstract Background: Food insecurity is a critical social determinant of health and is associated with deleterious cancer-related health outcomes. Adults in households with food insecurity are more likely to forgo cancer screenings; they have also been found to have higher risks of cancer. In addition, patients with cancer have high rates of food insecurity. However, little is known about experiences of food insecurity among Asian Americans, including their experiences of food insecurity that are related to cancer prevention or care. We conducted a scoping review on food insecurity and strategies to cope with food insecurity among individuals of Asian origins living in the U.S.   Methods: In 2022, we searched peer-reviewed articles in MEDLINE, the Cochrane Library, Scopus, CINAHL, PsycINFO, and Google Scholar. Two authors screened each title and abstract of 900 records and the full text of 48 records. Thirty-five studies were selected and analyzed.   Results: Among the 35 studies included in the review, 9 studies reported disaggregated data by Asian origin group for food insecurity prevalence. We observed great heterogeneity in reported prevalence. For example, food insecurity ranges 8.3%-41.1% for Filipinos, 13.1%-28.2% for Vietnamese, 6.6%-22.2% for Koreans, and 2.3%-11.2% for Japanese. Only eight studies included standardized data collection instruments in Asian languages. Seven studies noted collaboration with community partners. Lower acculturation, limited English proficiency, and higher social isolation were significantly associated with food insecurity. Supplemental Nutrition Assistance Program benefits were seen as inadequate to remediate food insecurity. Barriers to nutrition assistance program participation involved negative experiences with social workers, burdensome application process, and confusion surrounding the program. Notably, no study focuses on how food insecurity influences cancer prevention or cancer treatment among Asian Americans.   Discussion: Our review found heterogenous food insecurity prevalence among Asian origin groups. We underscored a need for further research using disaggregated data by Asian origin group, employing multilingual data collection strategies, and involving community partners. Researchers should consider how social contexts and acculturation influences food insecurity. More research is needed on food insecurity as it relates to cancer prevention, screening, or management among Asian Americans. Future studies should investigate policy and interventions to ameliorate food insecurity and encourage nutrition program participation among Asian Americans living with food insecurity. Citation Format: Victoria Huynh, Nhat-Ha Pham, Suji Ro, Q. Eileen Wafford, Milkie Vu. Food insecurity among Asian Americans: A scoping review and recommendations for policy and practice [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B059.

Income and food insecurity among SNAP recipients: a consideration of the SNAP benefit formula

Abstract The Supplemental Nutrition Assistance Program (SNAP) has substantially reduced food insecurity in the USA, but almost half of the participants remain food insecure. We use the 2018 Survey of Income and Program Participation to examine the relationship between food insecurity and two components of benefit determination—gross income and deductions. For all SNAP recipients, in most specifications, gross income is inversely related to food insecurity, and deductions are positively correlated with food insecurity. When examining policy-relevant sub-categories, households with a senior or someone with a disability have positive associations between food insecurity and deductions, suggesting possible changes in benefit construction.

Association of emergency allotment discontinuation with household food insufficiency in Supplemental Nutrition Assistance Program participants: A quasi-experimental study

ObjectiveThe Supplemental Nutrition Assistance Program (SNAP) was modified to mitigate food insecurity faced by low-income families during the pandemic. These changes included enhancement of SNAP benefits via 2020 emergency allotments (EA). Despite the high food price inflation in 2022, 17 states ceased providing EA benefits by end of 2022. The objective of this research is to examine the impact of EA discontinuation on food insufficiency. MethodsUsing Household Pulse Survey data from December 2021–January 2023, SNAP participants (n = 57,556) from states that discontinued EA at some point during the study period and those from states that did not discontinue EA were included. The main analyses examined the impact of EA discontinuation on food insufficiency via staggered difference-in-difference models using two-way fixed effects (TWFE) regression. Additional analyses examined this association using Callaway-Sant'Anna approach for difference-in-difference analyses. ResultsUsing TWFE, EA discontinuation was significantly associated with increased food insufficiency in the overall sample, as well as in individuals who were non-Hispanic White and Hispanic, and who had annual family incomes of less than $25,000. Investigation of time-varying association of EA termination with food insufficiency suggested that EA discontinuation was significantly associated with greater food insufficiency in the second week following rollback. DiD analyses using Callaway-Sant'Anna approach suggested that states' rollback of EA was significantly associated with higher food insufficiency in non-Hispanic White individuals. ConclusionFindings imply that EA discontinuation, amidst the corresponding surge in inflation, could have contributed to increased rates of household food insufficiency.

The association of Supplemental Nutrition Assistance Program (SNAP) benefits and breast, cervix, and colorectal cancer screening.

131 Background: Food insecurity is associated with healthcare access and utilization. The Supplemental Nutrition Assistance Program (SNAP) was created to reduce food insecurity for low-income households and hence may enhance health-seeking behaviors. However, it is unknown whether receipt of SNAP benefits is associated with rates of cancer screening. Our objective was to quantify the relationship of SNAP benefit receipt with cancer screening among low income individuals at high risk for food insecurity. Methods: The National Health Interview Survey (NHIS) provided by the Center for Disease Control and Prevention was utilized to identify high-risk adults ages 21 to 74 years eligible for screening for female cervix (21-65 years), colorectal (40-74 years), and/or female breast cancer (40-74 years). Data was included from the 2019 and 2021 surveys, with 2020 excluded due to limited cancer screening information. High-risk was defined as low or very low food security, household income &lt; 125% federal poverty level, or having Medicaid insurance. Up to date cancer screening was defined as receipt of mammography within 2 years for breast cancer; receipt of a cervical cancer test within 5 years for cervix cancer; and receipt of sigmoidoscopy within the past 5 years, colonoscopy within 10 years, fecal immunohistochemistry (FIT) testing within 1 year, or sDNA-FIT testing within 3 years for colorectal cancer. We utilized logistic regression to compare screening rates by receipt of SNAP benefits and accounted for the complex survey design of the NHIS. Models were adjusted for covariates including age, race, ethnicity, sex (colorectal cancer screening only), income, education, marital status, insurance status, metropolitan residence status, survey year, food insecurity, and comorbidities. Results: A total of 6,111, 4,141, and 7,015 respondents were identified for cervix, breast, and colorectal cancer screening analyses, respectively. Among these respondents, 67%, 61%, and 60% were up to date on cervix, breast, and colorectal cancer screenings, respectively. Among this high-risk cohort, 43% of respondents reported receipt of SNAP benefits. Receipt of SNAP benefits was associated with increased odds of cervical cancer screening (OR = 1.18, 95% CI = 1.00 – 1.39, P=.046), which was limited to females ages 21-39 (OR = 1.36, 95% CI = 1.05 – 1.77, P=.022). Receipt of SNAP benefits was not associated with increased rates of breast or colorectal cancer screening. Conclusions: Receipt of SNAP benefits is associated with higher rates of cervical cancer screening among low-income females at high risk of food insecurity, particularly among young adults. These data suggest that efforts to address social determinants of health may improve access to care.

Policies to reduce child poverty and child maltreatment: A scoping review and preliminary estimates of indirect effects

This study includes a scoping review of prior studies investigating the effects of policy changes on child poverty rates. It further conducts an empirical analysis to estimate the relationship between child poverty rates and child maltreatment report (CMR) rates, utilizing national county-level data. The study then calculates the indirect effects of policy changes on CMR rates, mediated through child poverty rates, by integrating information from previous studies with its own empirical findings. Among the policy changes explored in prior studies, those related to a child allowance and a fully refundable Child Tax Credit demonstrate the largest indirect effects but also the highest costs. The expansion of in-kinds and near-cash benefits, such as the Supplemental Nutrition Assistance Program benefits and housing vouchers, shows moderate effects with moderate costs. Tax credits like the Earned Income Tax Credit exhibit lower effects and costs when targeted at the lowest earners, and moderate effects and costs for broader expansion. Focused tax credits, such as the Child and Dependent Care Tax Credit, had lower effects and costs, even if made fully refundable. Despite certain limitations, the study's approach yields consistent estimates with a recent simulation study, indicating its potential validity. While some proposed policy changes may seem expensive, implementing them is anticipated to substantially reduce CMR rates, with the benefits outweighing the associated costs. Overall, the findings suggest that addressing child poverty to reduce CMRs is an attractive strategy with numerous potential benefits.

Measuring take-up of the California EITC with state administrative data

The Earned Income Tax Credit (EITC) is the largest cash-based means-tested transfer program in the United States. In 2021, 31 million households received $64 billion from the federal EITC. Twenty-eight states also offer eligible taxpayers a supplement to the federal program. An estimated one-fifth of eligible households fail to claim the federal credit, but little is known about take-up of these state programs. We use administrative data from California on the population of Supplemental Nutrition Assistance Program (SNAP) recipients linked to state tax records to estimate the number of households who are eligible for California’s supplement to the federal EITC (CalEITC) but do not claim it. We find that over 400,000 households who received SNAP benefits and who were eligible for the state EITC in 2017 did not receive the credit. This includes approximately 40,000 eligible households who claimed the federal EITC but not the state credit; nearly 98,000 eligible households who filed a state tax return but did not claim the state or federal credit; and roughly 270,000 eligible households who did not file a state tax return. The corresponding take-up rate for the CalEITC among eligible SNAP-enrolled households was 54%. Altogether, these households left a total of $71 million in state EITC funds on the table. If received, these credits would have increased incomes among these households by 2.7% and increased total state EITC outlays by 20%.

The Supplemental Nutrition Assistance Program Online Purchasing Pilot’s impact on food insufficiency

Mandated under the 2014 Farm Bill, the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot (OPP) was initially intended to test the feasibility of allowing online SNAP benefit redemption for groceries. In early 2020, the OPP was rapidly expanded to address pandemic-induced barriers to food access among SNAP households in the United States. Using data from the Census Bureau's Household Pulse Survey and a difference-in-difference framework (that exploits state variation in OPP implementation), we examine the effects of the rapid initial expansion of OPP on food sufficiency among low-income families. Results obtained indicate the OPP decreased food insufficiency among low-income adults by 2 percentage points (an 8 percent decrease relative to mean food insufficiency). Additional analyses suggest online benefit redemption improved food sufficiency by mitigating food access barriers, especially affecting racial minorities and married individuals. Given the unprecedented food access barriers during the rollout period, future research should consider the effect of online benefit redemption in subsequent years on food hardship and accessibility.

Empathy through Data? Student Exploration of Elements of Diversity through Projects in an Introductory Statistics Course

A project involving data related to socioeconomic indicators was administered in an introductory statistics course. As part of this project, student groups investigated a data set from the United States Department of Agriculture Food and Nutrition Service website with information on recipients of Supplemental Nutrition Assistance Program (SNAP) benefits. Pre/post data from the Miville-Guzman Universality-Diversity Scale (M-GUDS) short form were collected to measure changes in diversity awareness. The survey administered also included demographic information and open-ended questions. Based on study results (n = 48), there was moderate evidence of a change in the diversity of contact subscale of the M-GUDS short form. Written feedback indicated that students demonstrated empathy for individuals with potentially different lived experiences. The focus of this paper is to describe the study results and provide information on the importance of incorporating elements of diversity into curriculum.

Food Craving Increases Unhealthy Food Purchases: A Study of SNAP Households

Analysis of actual transactions in a grocery store shows that households enrolled in the U.S. government's Supplemental Nutritional Assistance Program (SNAP) purchase more unhealthy hedonic food, compared with households that do not receive SNAP benefits. SNAP households purchased more unhealthy hedonic food regardless of whether they used government funds or cash to pay for their purchases. Three follow-up simulated grocery shopping studies were designed to understand the mechanisms underlying this food consumption pattern by SNAP households. SNAP households, compared with households that do not receive SNAP benefits, reported stronger food craving. Stronger food craving was associated with lower unhealthiness perception of hedonic food. Overall, the results suggest that food cravings can reduce perceptions of unhealthiness and thus increase unhealthy food purchases. Interventions that reduce the effect of food cravings on shopping decisions might reduce unhealthy consumption.

Food stamps and America's poorest

AbstractThis paper assesses the extent to which Supplemental Nutrition Assistance Program (SNAP)—one of America's largest antipoverty programs—has reached the poorest. We compute a novel measure of the floor of income, an estimated income level of the poorest individuals in society. We measure the floor with and without SNAP benefits included in family income using 29 years of Current Population Survey (CPS) data. We correct for underreporting of SNAP participation and benefits for a subset of years and examine alternative data to assess the robustness of our findings. The analysis reveals a long‐term decline in the income floor, whereas adding SNAP to income and correcting for underreporting has reversed this decline and lifted the income floor by more than 75% on average between 2011 and 2016. The declining floor and the remarkable increase in income for the poorest Americans from SNAP are not revealed by poverty headcounts, which focus on changes at the poverty threshold.

Skill Up Tennessee: Job training that works

Employment and training services offered through Extension are part of and continue a long tradition of policy-focused employment and job training. This paper chronicles the successes of UT Extension’s work as a third-party partner in the delivery of workforce development programming geared toward individuals receiving Supplemental Nutrition Assistance Program (SNAP) benefits. The paper begins with an overview of the federal program and a discussion of how Tennessee forged a state-level partnership for the delivery of workforce services. Data showing program success including number of participants served, supportive services offered, and economic impact are highlighted. Finally, lessons learned are outlined.