View this email in your browser

By Matthew Rees

Food and Health Fact #141: The federal food program failing its beneficiaries

Follow me on Twitter: @foodhealthfactsFind all previously published Food and Health Facts hereHappy new year. This week marks the start of an experiment: occasionally publishing only once a week and featuring longer commentary pieces, many of which build on short items previously published in Food and Health Facts.

A friend asked me recently what the federal government can do to reduce the U.S. obesity rate. I replied that while there’s no silver bullet solution, of course, one reform could have a far-reaching impact: limiting or eliminating the use of food stamps to purchase unhealthy foods and beverages. But that’s not likely to happen anytime soon, and the obstacles provide a window on America’s toxic food culture as well as how food and beverage companies influence this culture.

“Food stamps” is the shorthand term for the benefits the federal government provides under the Supplemental Nutrition Assistance Program. SNAP serves more than 41 million Americans – about 12 percent of the country’s total population. And 43 percent of the beneficiaries are children. Given the program's size, it could be a powerful vehicle for healthier eating and a lower obesity rate.

Instead, as I have written previously with Vanita Rahman, MD, SNAP is contributing to the obesity epidemic. Beyond a prohibition on the purchase of hot food, alcohol, tobacco products, vitamins, or medicines, virtually any other food or beverage item – including soda, candies, and processed meats – can be purchased with SNAP benefits.

The result is high levels of SNAP spending on many of the foods and beverages at the root of the nation's obesity epidemic. About 20 cents of every SNAP dollar goes toward sweetened beverages, desserts, salty snacks, candy, and sugar, according to a report commissioned by the U.S. Department of Agriculture (USDA). Soft drinks, potato chips, and processed meats are among the top ten items purchased with SNAP benefits. Consuming these foods brings a variety of health risks. Processed meat, for example, has been classified by the World Health Organization as a Group 1 human carcinogen, putting it in the same category as asbestos and tobacco.

While trying to mitigate short-term hunger, SNAP is doing long-term harm. It contributes to elevated obesity rates in lower-income individuals – rates that are nearly eight percentage points higher than among those with higher incomes, according to the CDC.

SNAP participation is also associated with increased body weight, and the program's beneficiaries have lower dietary quality and worse health indicators than those who are eligible for the program but don't participate. SNAP beneficiaries 60 and older have also been found to have a diabetes rate of 40 percent, which is twice as high as non-beneficiaries. “The government should not be in the business of making people sick,” as Duke University’s Kelly Brownell has said.

It seems self-evident that SNAP beneficiaries should only be permitted to purchase products that meet rigorous nutritional standards. And that’s far from a radical idea. In 2013, 18 mayors endorsed it. The mayors – including Michael Bloomberg, Cory Booker, and Rahm Emanuel – represented most of the country's largest cities.

Restrictions on benefits-eligible foods would not be unique to SNAP. Other federal programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), prohibit beneficiaries from purchasing candy, soda, or snack foods. Such restrictions are likely one reason why participation in WIC is not correlated with increased body mass index.

So why doesn’t SNAP have the same spending rules as WIC?

There are several different objections. A Nobel laureate economist at MIT, Abhijit Banerjee, recently wrote in the New York Times that “scolding” American lawmakers who want to restrict SNAP spending “are part of a long lineage that goes back to the Victorian workhouses, which made sure that the food was never inviting enough to encourage sloth.”

But with SNAP, like so many other things in life, it’s useful to follow the money. And here is where you see who has the greatest interest in preserving the SNAP program’s flexible spending rules: the food and beverage companies. Any restriction on what can be purchased with SNAP benefits means reduced sales by these companies. How much in reduced sales? IRI, a research company, says 12 percent of all U.S. food and beverage sales (online and in stores) came from SNAP benefits in 2020 – totaling $74 billion.

These figures wouldn’t be worrisome if the spending was going toward the purchase of carrots and kale. But that’s not the case. Indeed, the image below, from a fascinating IRI report, shows several food and beverage items and what percent of the total purchases comes from SNAP dollars. The figures are striking: energy drinks (64 percent), iced coffee (49 percent), non-chocolate chewy candy (38 percent), soft drinks (34 percent), handheld frozen breakfast (32 percent).

That tells you everything you need to know about why the food and beverage companies are ardently opposed to any SNAP restrictions and why they spent $63 million on SNAP-related lobbying connected to the 2013 farm bill. A food security advocate, Hank Herrera, has summed up the situation perfectly: “SNAP uses poor people as a pass-through intermediary to subsidize the food manufacturers. And in the process, poor people suffer and die from the toxic foods the manufacturers produce.”

But the food and beverage companies don’t limit their spending to lobbying. They are also generous funders of anti-hunger groups. Predictably, these groups have been vocal opponents of restrictions on SNAP purchases, which has swayed policymakers in Washington, and have cultivated the companies as allies. These groups have also tried to shut down debate on the issue, seeing it as a threat to the nutritional safety net.

Much of this is persuasively documented by Andrew Fisher, a long-time anti-hunger advocate, in his book, Big Hunger: The Unholy Alliance Between Corporate America and Anti-Hunger Groups. (The Hank Herrera quote above appears in Big Hunger.) Fisher writes that these groups “made a devil’s bargain, protecting the food security of tens of millions of poor persons in exchange for dropping the ball on addressing the obesity and diabetes epidemics among this same population.”

This is not an argument for reducing the level of SNAP benefits. Indeed, there are good arguments for raising benefit levels, to enable the purchase of more higher-priced products, which often have better nutritional profiles. And yes, determining what can and cannot be purchased with SNAP benefits would be complicated and would undoubtedly result in a massive lobbying campaign by the food and beverage companies to get the standards relaxed so their products would be eligible.

But just because such standard-setting would be difficult is not reason to scrap it altogether. The biggest losers from the status quo are the SNAP beneficiaries, and they seem to know it. A statewide survey of SNAP participants in California found 74% support for a ban on using the program's benefits for soda purchases. Another survey of more than 400 SNAP beneficiaries found 54% of respondents supporting such a ban.

One policy option is providing extra benefits to those who purchase healthy food. That idea was tested in a pilot project the USDA launched in Hampden County, Massachusetts in 2011. About 7,500 of households receiving SNAP benefits received an extra 30 cents for every dollar of assistance spent on fruits and vegetables at participating retailers. The effect? Consumption of fruits and vegetables was 26% higher among those in the pilot project relative to those who were not.

This experiment is a reminder that as the largest food program in the United States, SNAP could be a vehicle for healthy eating. As Fisher writes, “The status quo, in which SNAP is linked programmatically and politically to a disease-promoting food system, has created a tremendous missed opportunity to reverse the harm this system has done.”

But with no evidence of a change in the status quo, the food and beverage companies will continue to rack up billions in sales from ultra-processed junk food and sugar-laden beverages while the poor find themselves with higher obesity rates and declining health – an outcome that is emblematic of everything that’s wrong with America’s food system and the policies that govern it.