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Eric B Rimm - One of the best experts on this subject based on the ideXlab platform.
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improving the nutritional impact of the supplemental nutrition assistance program perspectives from the participants
American Journal of Preventive Medicine, 2017Co-Authors: Cindy W Leung, Aviva Musicus, Walter C Willett, Eric B RimmAbstract:Introduction The Supplemental Nutrition Assistance Program (SNAP) is the largest Federal Food assistance program designed to alleviate Food insecurity and improve dietary intake. This study assessed the opinions of SNAP participants and Food-insufficient nonparticipants on their perceptions of the program and strategies to improve its nutritional impact. Methods This study surveyed 387 individuals via Amazon Mechanical Turk, of whom 118 were SNAP participants and 269 were Food insufficient but not enrolled in SNAP (nonparticipants). Open-ended questions were coded and analyzed for thematic content. For closed-ended questions, response frequencies were compared using chi-square tests. Data were analyzed in 2016. Results SNAP participants reported that the program successfully served its primary purpose: to allow individuals to buy enough Food to make ends meet and reduce Food insecurity. Importance was placed on buying Food for their children/families and the ability to allocate money for other expenses. To improve the nutritional impact, SNAP participants suggested more nutrition education, increasing the benefit allotment, incentivizing healthful Foods, and excluding unhealthful Foods for purchase with SNAP. When participants and nonparticipants were asked to choose between SNAP and a nutritionally enhanced program combining healthy incentives with exclusions for sugary beverages (i.e., SNAP+), 68% of participants and 83% of nonparticipants chose SNAP+. Of those who initially chose SNAP, 68% of participants and 64% of nonparticipants chose SNAP+ if paired with a 50% increase in total benefits. Conclusions SNAP participants and Food-insufficient nonparticipants support policies that facilitate purchases of healthful Foods and limit purchases of unhealthful Foods, specifically sugary beverages.
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improving the nutritional impact of the supplemental nutrition assistance program perspectives from the participants
The FASEB Journal, 2016Co-Authors: Cindy W Leung, Aviva Musicus, Walter C Willett, Eric B RimmAbstract:The Supplemental Nutrition Assistance Program (SNAP) is the largest Federal Food assistance program in the United States designed to provide supplemental support to alleviate Food insecurity and im...
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household Food insecurity is positively associated with depression among low income supplemental nutrition assistance program participants and income eligible nonparticipants
Journal of Nutrition, 2015Co-Authors: Cindy W Leung, Walter C Willett, Eric B Rimm, Elissa S Epel, Barbara A LaraiaAbstract:Background: Food insecurity is associated with adverse mental health outcomes. Given that Federal Food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), aim to alleviate Food insecurity, there may be heterogeneity in the association between Food insecurity and depression by SNAP participation status. Objective: With the use of data from the 2005–2010 NHANES, we examined the associations between household Food security and depression and whether these differed by SNAP participation. Methods: The study population was restricted to 3518 adults with household incomes #130% of the Federal poverty level. Food insecurity was assessed with the 18-item US Household Food Security Survey Module; a score of $3 was considered Food insecure. Depression was assessed with the 9-item Patient Health Questionnaire and was defined as a score of $10. Multivariate logistic regression models examined the associations between Food insecurity and depression, adjusting for sociodemographic and health characteristics. Results:The overall prevalence of depression was 9.3%, ranging from 6.7% among SNAP nonparticipants to 12.8% among SNAP participants. For every depressive symptom, there was a dose-response relation, such that a higher prevalence was observed with worsening Food insecurity. After multivariate adjustment, Food insecurity was positively associated with depression (P-trend < 0.0001), but SNAP participation modified this relation (P-interaction = 0.03). Among low-income, eligible nonparticipants, very low Food security was significantly associated with higher odds of depression (OR: 5.10; 95% CI: 3.09, 8.41). Among SNAP participants, very low Food security was also associated with higher odds of depression but at a lower magnitude (OR: 2.21; 95% CI: 1.54, 3.17). Conclusion: The complex relation between Food insecurity and mental health may vary on the basis of SNAP participation status. Programmatic efforts to address the risk of depression among their beneficiaries may positively affect the mental health of low-income adults. J Nutr doi: 10.3945/jn.114.199414.
Tatiana Andreyeva - One of the best experts on this subject based on the ideXlab platform.
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Sugar-Sweetened Beverage Demand and Tax Simulation for Federal Food Assistance Participants: A Case of Two New England States
Applied health economics and health policy, 2018Co-Authors: Theepakorn Jithitikulchai, Tatiana AndreyevaAbstract:Excessive consumption of sugar-sweetened beverages is a major concern in the efforts to improve diet and reduce obesity in USA, particularly among low-income populations. One of the most commonly proposed strategies to reduce sugar-sweetened beverage consumption is increasing beverage prices through taxation. The objective of this study was to evaluate whether and how price-based policies could reduce sugar-sweetened beverage consumption among participants in the Federal Supplemental Nutrition Assistance Program. Using point-of-sale data from a regional supermarket chain (58 stores), we estimated the responsiveness of demand to sugar-sweetened beverage price changes among Supplemental Nutrition Assistance Program-participating families with young children. Own-price and cross-price elasticities for non-alcoholic beverages were estimated using a Quadratic Almost Ideal Demand System model. The study found evidence that a tax-induced sugar-sweetened beverage price increase would reduce total sugar-sweetened beverage purchases among Supplemental Nutrition Assistance Program participants, who were driven by purchase shifts away from taxed sodas and sports drinks to non-taxed beverages (bottled water, juice, milk). The substitution of non-taxed caloric beverages decreases the marginal effects of the sugar-sweetened beverage tax, yet the direct tax effects are large enough to reduce the overall caloric intake, with the average net reduction in monthly calories from sugar-sweetened beverages estimated at around 8% for a half-cent per ounce tax and 16% for a one cent per ounce tax. A beverage price increase in the form of an excise tax would reduce sugar-sweetened beverage consumption and increase healthier beverage purchases among low-income families.
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the healthfulness of Food and beverage purchases after the Federal Food package revisions the case of two new england states
Preventive Medicine, 2016Co-Authors: Tatiana Andreyeva, Amanda S TrippAbstract:Abstract Objective In 2009, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented new Food packages to improve dietary intake among WIC participants. This paper examines how the healthfulness of Food purchases among low-income households changed following this reform. Methods Point-of-sale data for 2137 WIC-participating and 1303 comparison households were obtained from a regional supermarket chain. The healthfulness of purchased Foods and beverages was determined per their saturated fat, sugar, and sodium content. A pre-post assessment (2009–2010) of the product basket healthfulness was completed using generalized estimating equation models. Data were analyzed in 2015. Results At baseline, healthy products accounted for most of the Food volume purchased by WIC participants, but beverages were dominated by moderation (less healthy) items. With new subsidies for fruit, vegetables and whole grains, the WIC revisions increased the volume of healthy Food purchases of WIC-participating households by 3.9% and reduced moderation Foods by 1.8%. The biggest improvements were reductions in moderation beverages (down by 24.7% in volume), driven by milk fat restrictions in the WIC Food package revisions. The healthfulness of the product basket increased post-WIC revisions; mainly due to a reduction in the volume of moderation Food and beverages purchased (down by 15.5%) rather than growth in healthy products (up by 1.9%). No similar improvements were seen in a comparison group of low-income nonparticipants. Conclusions After the WIC revisions, the healthfulness of participant purchases improved, particularly for beverages. Efforts to encourage healthy eating by people receiving Federal Food assistance are paying off.
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incentivizing fruit and vegetable purchases among participants in the special supplemental nutrition program for women infants and children
Public Health Nutrition, 2015Co-Authors: Tatiana Andreyeva, Joerg LuedickeAbstract:Objective: In 2009, the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began to provide participants with cash-value vouchers to purchase fruits and vegetables ($US 10 for women and $US 6 for children per month). The present paper assesses the potential effects of the new WIC incentives on fruit and vegetable purchases among WIC households in two New England states. Design: A pre–post assessment of changes in fruit and vegetable purchases after the WIC revisions in generalized estimating equation models. Setting: Scanner data on grocery purchases from a regional supermarket chain in New England, USA. Subjects: WIC-participating households (n 2137) that regularly shopped at the chain during January–September 2009 and January–September 2010. Results: After the WIC revisions, purchases of fresh and frozen vegetables increased in volume by 17·5% and 27·8 %, respectively. The biggest improvements were observed for fresh fruit, an increase of 28·6 %, adding almost a kilogram of fresh fruits per household per month. WIC households spent three times more of their WIC vouchers on purchasing fresh fruits than fresh vegetables. The magnitudes of substitution effects were relatively small: between 4 % (fresh fruit) and 13 % (canned vegetables) of the amounts purchased in 2009 with non-WIC funds were replaced by purchases made using WIC vouchers in 2010. Conclusions: The provision of fruit and vegetable benefits in the revised WIC Food packages increased overall purchases of fruits and vegetables among WICparticipating households in New England. Efforts to encourage consumption of fruits and vegetables by people receiving Federal Food assistance are paying off.
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Federal Food package revisions effects on purchases of whole grain products
American Journal of Preventive Medicine, 2013Co-Authors: Tatiana Andreyeva, Joerg LuedickeAbstract:Background In 2009, the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented revisions to the composition and quantities of WIC-provided Foods. New whole-grain products such as whole-wheat bread and allowable substitutes were added to encourage increased intake of whole grains and fiber among WIC participants. Purpose This paper assesses how the WIC revisions affected purchases of bread and rice among WIC-participating households in Connecticut and Massachusetts. Methods Scanner data from a regional supermarket chain were used to examine bread and rice purchases of 2137 WIC households. Purchased volume of bread and rice was compared before and after implementation of the WIC revisions (2009–2010) using generalized estimating equation models. Data were analyzed in 2013. Results Before the WIC revisions, when no bread or rice was provided through WIC, white bread dominated bread purchases among WIC households (78% of volume), and almost all rice purchased was white (94%). As a result of the WIC revisions, the share of 100% whole-grain bread in total bread purchases tripled (from 8% to 24%), replacing purchases of white bread; the share of brown rice rose to 30% of rice purchases. WIC households used WIC benefits to change some of their bread purchases, rather than to buy more bread overall, whereas total rice purchases increased. Conclusions The 2009 WIC revisions significantly increased purchases of whole-grain bread and rice among WIC-participating families. The likely increase in whole-grain and fiber intake among low-income communities could have important public health implications.
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grocery store beverage choices by participants in Federal Food assistance and nutrition programs
American Journal of Preventive Medicine, 2012Co-Authors: Tatiana Andreyeva, Joerg Luedicke, Kathryn E Henderson, Amanda S TrippAbstract:Background Sugar-sweetened beverages are a target for reduction in the 2010 Dietary Guidelines for Americans. Concerns have been raised about sugar-sweetened beverages purchased with Supplemental Nutrition Assistance Program (SNAP) benefits. Purpose This paper describes purchases of non-alcoholic refreshment beverages among participants in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and SNAP. Methods Grocery store scanner data from a regional supermarket chain were used to assess refreshment beverage purchases of 39,172 households in January–June 2011. The sample consisted of families with a history of WIC participation in 2009–2011; about half also participated in SNAP. Beverage spending and volume purchased were compared for WIC sampled households either using SNAP benefits (SNAP) or not (WIC-only). Analyses were completed in 2012. Results Refreshment beverages were a significant contributor to expenditure on groceries by SNAP and WIC households. Sugar-sweetened beverages accounted for 58% of refreshment beverage purchases made by SNAP households and 48% of purchases by WIC-only households. Soft drinks were purchased most by all households. Fruit-based beverages were mainly 100% juice for WIC-only households and sugary fruit drinks for SNAP households. SNAP benefits paid for 72% of the sugar-sweetened beverage purchases made by SNAP households. Nationwide, SNAP was estimated to pay at least $1.7 to $2.1 billion annually for sugar-sweetened beverages purchased in grocery stores. Conclusions Considerable amounts of sugar-sweetened beverages are purchased by households participating in WIC and SNAP. The SNAP program pays for most of the sugar-sweetened beverage purchases among SNAP households. The upcoming SNAP reauthorization could be a good time to reconsider the program priorities to align public funds with public health.
Joerg Luedicke - One of the best experts on this subject based on the ideXlab platform.
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incentivizing fruit and vegetable purchases among participants in the special supplemental nutrition program for women infants and children
Public Health Nutrition, 2015Co-Authors: Tatiana Andreyeva, Joerg LuedickeAbstract:Objective: In 2009, the US Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) began to provide participants with cash-value vouchers to purchase fruits and vegetables ($US 10 for women and $US 6 for children per month). The present paper assesses the potential effects of the new WIC incentives on fruit and vegetable purchases among WIC households in two New England states. Design: A pre–post assessment of changes in fruit and vegetable purchases after the WIC revisions in generalized estimating equation models. Setting: Scanner data on grocery purchases from a regional supermarket chain in New England, USA. Subjects: WIC-participating households (n 2137) that regularly shopped at the chain during January–September 2009 and January–September 2010. Results: After the WIC revisions, purchases of fresh and frozen vegetables increased in volume by 17·5% and 27·8 %, respectively. The biggest improvements were observed for fresh fruit, an increase of 28·6 %, adding almost a kilogram of fresh fruits per household per month. WIC households spent three times more of their WIC vouchers on purchasing fresh fruits than fresh vegetables. The magnitudes of substitution effects were relatively small: between 4 % (fresh fruit) and 13 % (canned vegetables) of the amounts purchased in 2009 with non-WIC funds were replaced by purchases made using WIC vouchers in 2010. Conclusions: The provision of fruit and vegetable benefits in the revised WIC Food packages increased overall purchases of fruits and vegetables among WICparticipating households in New England. Efforts to encourage consumption of fruits and vegetables by people receiving Federal Food assistance are paying off.
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Federal Food package revisions effects on purchases of whole grain products
American Journal of Preventive Medicine, 2013Co-Authors: Tatiana Andreyeva, Joerg LuedickeAbstract:Background In 2009, the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented revisions to the composition and quantities of WIC-provided Foods. New whole-grain products such as whole-wheat bread and allowable substitutes were added to encourage increased intake of whole grains and fiber among WIC participants. Purpose This paper assesses how the WIC revisions affected purchases of bread and rice among WIC-participating households in Connecticut and Massachusetts. Methods Scanner data from a regional supermarket chain were used to examine bread and rice purchases of 2137 WIC households. Purchased volume of bread and rice was compared before and after implementation of the WIC revisions (2009–2010) using generalized estimating equation models. Data were analyzed in 2013. Results Before the WIC revisions, when no bread or rice was provided through WIC, white bread dominated bread purchases among WIC households (78% of volume), and almost all rice purchased was white (94%). As a result of the WIC revisions, the share of 100% whole-grain bread in total bread purchases tripled (from 8% to 24%), replacing purchases of white bread; the share of brown rice rose to 30% of rice purchases. WIC households used WIC benefits to change some of their bread purchases, rather than to buy more bread overall, whereas total rice purchases increased. Conclusions The 2009 WIC revisions significantly increased purchases of whole-grain bread and rice among WIC-participating families. The likely increase in whole-grain and fiber intake among low-income communities could have important public health implications.
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grocery store beverage choices by participants in Federal Food assistance and nutrition programs
American Journal of Preventive Medicine, 2012Co-Authors: Tatiana Andreyeva, Joerg Luedicke, Kathryn E Henderson, Amanda S TrippAbstract:Background Sugar-sweetened beverages are a target for reduction in the 2010 Dietary Guidelines for Americans. Concerns have been raised about sugar-sweetened beverages purchased with Supplemental Nutrition Assistance Program (SNAP) benefits. Purpose This paper describes purchases of non-alcoholic refreshment beverages among participants in the U.S. Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and SNAP. Methods Grocery store scanner data from a regional supermarket chain were used to assess refreshment beverage purchases of 39,172 households in January–June 2011. The sample consisted of families with a history of WIC participation in 2009–2011; about half also participated in SNAP. Beverage spending and volume purchased were compared for WIC sampled households either using SNAP benefits (SNAP) or not (WIC-only). Analyses were completed in 2012. Results Refreshment beverages were a significant contributor to expenditure on groceries by SNAP and WIC households. Sugar-sweetened beverages accounted for 58% of refreshment beverage purchases made by SNAP households and 48% of purchases by WIC-only households. Soft drinks were purchased most by all households. Fruit-based beverages were mainly 100% juice for WIC-only households and sugary fruit drinks for SNAP households. SNAP benefits paid for 72% of the sugar-sweetened beverage purchases made by SNAP households. Nationwide, SNAP was estimated to pay at least $1.7 to $2.1 billion annually for sugar-sweetened beverages purchased in grocery stores. Conclusions Considerable amounts of sugar-sweetened beverages are purchased by households participating in WIC and SNAP. The SNAP program pays for most of the sugar-sweetened beverage purchases among SNAP households. The upcoming SNAP reauthorization could be a good time to reconsider the program priorities to align public funds with public health.
Walter C Willett - One of the best experts on this subject based on the ideXlab platform.
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improving the nutritional impact of the supplemental nutrition assistance program perspectives from the participants
American Journal of Preventive Medicine, 2017Co-Authors: Cindy W Leung, Aviva Musicus, Walter C Willett, Eric B RimmAbstract:Introduction The Supplemental Nutrition Assistance Program (SNAP) is the largest Federal Food assistance program designed to alleviate Food insecurity and improve dietary intake. This study assessed the opinions of SNAP participants and Food-insufficient nonparticipants on their perceptions of the program and strategies to improve its nutritional impact. Methods This study surveyed 387 individuals via Amazon Mechanical Turk, of whom 118 were SNAP participants and 269 were Food insufficient but not enrolled in SNAP (nonparticipants). Open-ended questions were coded and analyzed for thematic content. For closed-ended questions, response frequencies were compared using chi-square tests. Data were analyzed in 2016. Results SNAP participants reported that the program successfully served its primary purpose: to allow individuals to buy enough Food to make ends meet and reduce Food insecurity. Importance was placed on buying Food for their children/families and the ability to allocate money for other expenses. To improve the nutritional impact, SNAP participants suggested more nutrition education, increasing the benefit allotment, incentivizing healthful Foods, and excluding unhealthful Foods for purchase with SNAP. When participants and nonparticipants were asked to choose between SNAP and a nutritionally enhanced program combining healthy incentives with exclusions for sugary beverages (i.e., SNAP+), 68% of participants and 83% of nonparticipants chose SNAP+. Of those who initially chose SNAP, 68% of participants and 64% of nonparticipants chose SNAP+ if paired with a 50% increase in total benefits. Conclusions SNAP participants and Food-insufficient nonparticipants support policies that facilitate purchases of healthful Foods and limit purchases of unhealthful Foods, specifically sugary beverages.
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improving the nutritional impact of the supplemental nutrition assistance program perspectives from the participants
The FASEB Journal, 2016Co-Authors: Cindy W Leung, Aviva Musicus, Walter C Willett, Eric B RimmAbstract:The Supplemental Nutrition Assistance Program (SNAP) is the largest Federal Food assistance program in the United States designed to provide supplemental support to alleviate Food insecurity and im...
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household Food insecurity is positively associated with depression among low income supplemental nutrition assistance program participants and income eligible nonparticipants
Journal of Nutrition, 2015Co-Authors: Cindy W Leung, Walter C Willett, Eric B Rimm, Elissa S Epel, Barbara A LaraiaAbstract:Background: Food insecurity is associated with adverse mental health outcomes. Given that Federal Food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), aim to alleviate Food insecurity, there may be heterogeneity in the association between Food insecurity and depression by SNAP participation status. Objective: With the use of data from the 2005–2010 NHANES, we examined the associations between household Food security and depression and whether these differed by SNAP participation. Methods: The study population was restricted to 3518 adults with household incomes #130% of the Federal poverty level. Food insecurity was assessed with the 18-item US Household Food Security Survey Module; a score of $3 was considered Food insecure. Depression was assessed with the 9-item Patient Health Questionnaire and was defined as a score of $10. Multivariate logistic regression models examined the associations between Food insecurity and depression, adjusting for sociodemographic and health characteristics. Results:The overall prevalence of depression was 9.3%, ranging from 6.7% among SNAP nonparticipants to 12.8% among SNAP participants. For every depressive symptom, there was a dose-response relation, such that a higher prevalence was observed with worsening Food insecurity. After multivariate adjustment, Food insecurity was positively associated with depression (P-trend < 0.0001), but SNAP participation modified this relation (P-interaction = 0.03). Among low-income, eligible nonparticipants, very low Food security was significantly associated with higher odds of depression (OR: 5.10; 95% CI: 3.09, 8.41). Among SNAP participants, very low Food security was also associated with higher odds of depression but at a lower magnitude (OR: 2.21; 95% CI: 1.54, 3.17). Conclusion: The complex relation between Food insecurity and mental health may vary on the basis of SNAP participation status. Programmatic efforts to address the risk of depression among their beneficiaries may positively affect the mental health of low-income adults. J Nutr doi: 10.3945/jn.114.199414.
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a qualitative study of diverse experts views about barriers and strategies to improve the diets and health of supplemental nutrition assistance program snap beneficiaries
Journal of the Academy of Nutrition and Dietetics, 2013Co-Authors: Cindy W Leung, Elena Hoffnagle, Ana Cristina Lindsay, Hayley Lofink, Vanessa A Hoffman, Sophie Turrell, Walter C WillettAbstract:The Supplemental Nutrition Assistance Program (SNAP), the largest Federal Food assistance program, currently serves 44.7 million Americans with a budget of $75 billion in 2011. This study engaged leading experts for in-depth, semi-structured interviews to explore their opinions concerning the existing challenges and barriers to eating nutritiously in SNAP. Experts also proposed strategies for improving nutritional status among SNAP recipients. Twenty-seven individuals were interviewed from advocacy, government, industry, and research organizations. Interviews were recorded, transcribed, coded, and analyzed for thematic content. The high cost of nutrient-rich Foods, inadequate SNAP benefits, limited access to purchasing healthy Foods, and environmental factors associated with poverty were identified as barriers that influence nutrition among low-income households in the United States. Six themes emerged among respondents from diverse sectors about how to address these challenges, including providing SNAP participants with incentives to purchase nutrient-rich Food consistent with the 2010 Dietary Guidelines for Americans, restricting the purchase of nutrient-poor Foods and beverages with program benefits, modifying the frequency of SNAP benefit distribution, enhancing nutrition education, improving the SNAP retailer environment, and increasing state and Federal level coordination and consistency of program implementation. Given the recent dramatic increase in SNAP enrollment, policymakers must address existing barriers as well as consider new strategies to improve nutrition policies in SNAP so that the program can continue to address Food insecurity needs as well as provide a healthful diet for SNAP beneficiaries.
Cindy W Leung - One of the best experts on this subject based on the ideXlab platform.
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improving the nutritional impact of the supplemental nutrition assistance program perspectives from the participants
American Journal of Preventive Medicine, 2017Co-Authors: Cindy W Leung, Aviva Musicus, Walter C Willett, Eric B RimmAbstract:Introduction The Supplemental Nutrition Assistance Program (SNAP) is the largest Federal Food assistance program designed to alleviate Food insecurity and improve dietary intake. This study assessed the opinions of SNAP participants and Food-insufficient nonparticipants on their perceptions of the program and strategies to improve its nutritional impact. Methods This study surveyed 387 individuals via Amazon Mechanical Turk, of whom 118 were SNAP participants and 269 were Food insufficient but not enrolled in SNAP (nonparticipants). Open-ended questions were coded and analyzed for thematic content. For closed-ended questions, response frequencies were compared using chi-square tests. Data were analyzed in 2016. Results SNAP participants reported that the program successfully served its primary purpose: to allow individuals to buy enough Food to make ends meet and reduce Food insecurity. Importance was placed on buying Food for their children/families and the ability to allocate money for other expenses. To improve the nutritional impact, SNAP participants suggested more nutrition education, increasing the benefit allotment, incentivizing healthful Foods, and excluding unhealthful Foods for purchase with SNAP. When participants and nonparticipants were asked to choose between SNAP and a nutritionally enhanced program combining healthy incentives with exclusions for sugary beverages (i.e., SNAP+), 68% of participants and 83% of nonparticipants chose SNAP+. Of those who initially chose SNAP, 68% of participants and 64% of nonparticipants chose SNAP+ if paired with a 50% increase in total benefits. Conclusions SNAP participants and Food-insufficient nonparticipants support policies that facilitate purchases of healthful Foods and limit purchases of unhealthful Foods, specifically sugary beverages.
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improving the nutritional impact of the supplemental nutrition assistance program perspectives from the participants
The FASEB Journal, 2016Co-Authors: Cindy W Leung, Aviva Musicus, Walter C Willett, Eric B RimmAbstract:The Supplemental Nutrition Assistance Program (SNAP) is the largest Federal Food assistance program in the United States designed to provide supplemental support to alleviate Food insecurity and im...
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household Food insecurity is positively associated with depression among low income supplemental nutrition assistance program participants and income eligible nonparticipants
Journal of Nutrition, 2015Co-Authors: Cindy W Leung, Walter C Willett, Eric B Rimm, Elissa S Epel, Barbara A LaraiaAbstract:Background: Food insecurity is associated with adverse mental health outcomes. Given that Federal Food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), aim to alleviate Food insecurity, there may be heterogeneity in the association between Food insecurity and depression by SNAP participation status. Objective: With the use of data from the 2005–2010 NHANES, we examined the associations between household Food security and depression and whether these differed by SNAP participation. Methods: The study population was restricted to 3518 adults with household incomes #130% of the Federal poverty level. Food insecurity was assessed with the 18-item US Household Food Security Survey Module; a score of $3 was considered Food insecure. Depression was assessed with the 9-item Patient Health Questionnaire and was defined as a score of $10. Multivariate logistic regression models examined the associations between Food insecurity and depression, adjusting for sociodemographic and health characteristics. Results:The overall prevalence of depression was 9.3%, ranging from 6.7% among SNAP nonparticipants to 12.8% among SNAP participants. For every depressive symptom, there was a dose-response relation, such that a higher prevalence was observed with worsening Food insecurity. After multivariate adjustment, Food insecurity was positively associated with depression (P-trend < 0.0001), but SNAP participation modified this relation (P-interaction = 0.03). Among low-income, eligible nonparticipants, very low Food security was significantly associated with higher odds of depression (OR: 5.10; 95% CI: 3.09, 8.41). Among SNAP participants, very low Food security was also associated with higher odds of depression but at a lower magnitude (OR: 2.21; 95% CI: 1.54, 3.17). Conclusion: The complex relation between Food insecurity and mental health may vary on the basis of SNAP participation status. Programmatic efforts to address the risk of depression among their beneficiaries may positively affect the mental health of low-income adults. J Nutr doi: 10.3945/jn.114.199414.
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a qualitative study of diverse experts views about barriers and strategies to improve the diets and health of supplemental nutrition assistance program snap beneficiaries
Journal of the Academy of Nutrition and Dietetics, 2013Co-Authors: Cindy W Leung, Elena Hoffnagle, Ana Cristina Lindsay, Hayley Lofink, Vanessa A Hoffman, Sophie Turrell, Walter C WillettAbstract:The Supplemental Nutrition Assistance Program (SNAP), the largest Federal Food assistance program, currently serves 44.7 million Americans with a budget of $75 billion in 2011. This study engaged leading experts for in-depth, semi-structured interviews to explore their opinions concerning the existing challenges and barriers to eating nutritiously in SNAP. Experts also proposed strategies for improving nutritional status among SNAP recipients. Twenty-seven individuals were interviewed from advocacy, government, industry, and research organizations. Interviews were recorded, transcribed, coded, and analyzed for thematic content. The high cost of nutrient-rich Foods, inadequate SNAP benefits, limited access to purchasing healthy Foods, and environmental factors associated with poverty were identified as barriers that influence nutrition among low-income households in the United States. Six themes emerged among respondents from diverse sectors about how to address these challenges, including providing SNAP participants with incentives to purchase nutrient-rich Food consistent with the 2010 Dietary Guidelines for Americans, restricting the purchase of nutrient-poor Foods and beverages with program benefits, modifying the frequency of SNAP benefit distribution, enhancing nutrition education, improving the SNAP retailer environment, and increasing state and Federal level coordination and consistency of program implementation. Given the recent dramatic increase in SNAP enrollment, policymakers must address existing barriers as well as consider new strategies to improve nutrition policies in SNAP so that the program can continue to address Food insecurity needs as well as provide a healthful diet for SNAP beneficiaries.