SNAP, Food Stamps, Obesity, and Behavioral Economics

Often, when discussing the obesity crisis facing the United States, especially when I'm pointing out another failed effort to help people change their eating habits, it feels like there's nothing we can do. But sometimes it's actually more like there's nothing we will do. There's a difference.
That's especially true with The Supplemental Nutrition Assistance Program, or SNAP. That's the topic of this week's Healthcare Triage.

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

And the housekeeping:

[mikerr]

As a SNAP user, I thought this was a great video. Understanding that we don't want to restrict the few luxurys the poor may choose to indulge in while also understanding that we need to promote healthy eating, especially when it comes to what many children are ending up with at the end of the day, this video did a great job in expanding the conversation in a productive way.

[dcseain]

I once worked in a grocery store that did 98% of its sales in the first week of every month in food stamps. Our Spanish-speaking customers on the program bought mostly vegetables, fruit, dried beans, and rice with small amounts of meat and cheese. White English-siding customers on the program bought meat, pasta, and canned vegetables mostly. Black English-speaking customers on the program bought mostly boxes foods and soda. Education level and cultural heritage are huge in food cover fur program participants from what I saw.

[angimellin]

In Oregon there are bonus bucks for fruits and vegetables at the farmers market when purchased with SNAP or WIC.

[seanknabel]

I don't think it's the government's place to limit snap benefits like that. It's not like the $200 a month gets you very far...especially if you have any special dietary issues.
A person on SNAP has enough stress, embarrassment and judgement without having to memorize a list of approved and unapproved foods.

[GodsTeeth]

As a 9th or 10th grade student in the 90's this question was raised in Home/Economics: "How do we stop poor people from being so unhealthy?" This was addressed in a Midwestern state in a very Midwestern VILLAGE, IN THE 90's!!! My answer was 3 page paper was to make junk food (as it was called at the time) more expensive using food stamps. Alternatively using those same food stamps, but deem them more valuable for healthier alternatives, i.e. vegetables, fruits, eggs, fish, and human edible grains. Beef and pork were and still are, the cheapest meat product in central Ohio.

I realize there's a lot of talk about subsidies, but cant we promote healthy eating through a simple system of "If its good for you, it should cost less?" Its just a bit aggravating when a 9th grader in 1994 realizes the problems with agriculture policy and health problems still don't add up... It sucks.

I love unhealthy foods, but, being poor, that shouldn't have to be the only option.

[AlexiasShado]

Part of the problem is that lower income people hold multiple jobs and juggle child care, which means they do not have as much time as the rest to prepare food, nor as much money for ingredients. So this forces people to buy quick-to-prepare meals which are high in sodium, fat, starches, calories, and preservatives. Also, healthy food is insanely expensive! Consider the cost of buying a week's worth of groceries at Whole Foods vs. WalMart. Healthy food is financially unreachable and unsustainable.

[carolineleiden]

Supplying people with regular staple foods we all have in our pantries instead of money makes sure they don't eat junkfood. It also prevents fraud.

[willieclark]

I hear this all the time. As a farmer and nutrition lover, I can tell you that the poor eat badly due to EDUCATION not ease of access to nutrient dense food (although that IS becoming more and more an issue in our growing "food deserts")

[wren]

As a SNAP user i buy meat, dairy, produce, some fruit...I rarely buy anything in a box or bottle. And if coupons and store reductions give me a little bit more I will (after stocking up) buy a treat for myself once a month. Is this so bad?

[selfreference]

Keep in mind, it could be the case that a 30% rebate simply isn't enough to account for the difference in price. Spoilage is a real problem for healthy food, and it's already quite expensive compared to cheetos and ramen anyway.

[moredena]

the other problem that may be at hand is people who live in food deserts and also many poor people don't have time to work with fresh food before it goes bad when they're trying to juggle kids and 3 jobs. It's complicated.

[Thunderpupper]

When i was a kid my sister went on WIC after she got pregnant. I really liked how it only provided items that were necessary for assisting the child, to include some small stuff for mom.

I always thought food stamp-esque programs should operate in a similar manner. Junk food, such as chips, sodas, ice cream etc..., shouldn't be allowable.

I'm fine with SNAP being used for prepared items even in fast food places, because often the poorest have no means of preparing their own food let alone storing it. However even then many of the unhealthy items should be restricted.

I rather like the idea of the carrot & stick method. It is a two pronged approach which means it has the best chance of getting through to most of the people.

[maggienaas]

1. I can't get past the idea that often those calling for restrictions are the same people calling for severe cuts to all social programs. It seems dangerous to allow those people to start making cuts. I see a huge difference between restricting the purchase of soda and restricting the purchase of any item that might be classified as non-essential or luxury. Chicken breast can be fairly health, but also fairly expensive compared to other forms of protein. I wouldn't want to see a situation where SNAP participants can't buy the chicken because dried beans are cheaper. If we have to make the choice between leaving the soda or cutting the program to near nothing we should leave the soda on. 2. When looking at the correlation between obesity and poverty I think there are more factors at play than food. Poverty stands to restrict the ability to exercise- how much does a gym membership cost? Working hours? Physical work? Poverty can impact mental state. If you are worried about making rent and buying groceries do you really have the capacity to worry about planning an inexpensive healthy meal and free indoor work out. Poverty is an emotional strain. Surely that plays into eating behaviors. 3. I think we need to be careful to not allow restrictions to become too extreme. I would support restricting the purchase of soda on SNAP. I would not support restricting the purchase of sugar on SNAP. We need to keep a lax definition of healthy when making these restrictions. I'd support cutting the soda, but I want to leave things like sweetened yogurt and single serve oatmeal as part of the program.

[harmonicaveronica]

In college in MI the Farmer's market near me was set up so you could buy tokens to buy stuff from vendors with if you didn't have cash. If you had SNAP, you'd get tokens worth double what you'd charged to the card. I think it was a state wide program, but I'm not sure since I wasn't on assistance

[kgal]

I do get annoyed when I see Dominos accepting EBT cards for pizza, with that said having lived in poorer neighborhoods around LA I call BS on the access the poor have to snap benefits depending on location, but let's be honest city dwellers do have more poor people, back when I was broke I just shopped at the 99 Cent Store and they do have healthy options of food. Actually there are latin moms who would go in all the time and buy fresh produce and rice to make meals for their large families and they weren't on a benefit program, I know because I lived next to some who did this. I think it would be interesting to see what would happen if the restrictions and or benefits were applied. Like if you don't buy certain products for a certain amount of time maybe you can get a tax credit of some sort. It might be worth testing on a per state basis of course. Not everything works for the same people.

[SephonDK]

I'm loving your videos. Really enlightening.

[tophers]

Oh FFS. Screw prohibitions. If you're poor, splurging on some yummy calorie dense food might be some of the only luxuries you get to enjoy.

[ZombieX]

I love the "carrot and stick" analogy in general. The implication that we beat people so they do the right thing is just funny to me.

[kimisjustokay]

Justifying adding restrictions based on WIC having more restrictions neglects the fact that WIC has negative consequences related to those restrictions. Anecdotally, my husband and I both hold 4 year college degrees and have even worked in grocery/big box stores that sell groceries. When I was pregnant, we eventually found it was too stressful to try to find the right size package of the right variety of the right brand from the selection in our supermarket then go to check out with a line of people behind us only to find out that we would have an item like a loaf of bread that was the right variety of the right brand (and was the only size option) but was the wrong size or was described as being allowed (a frozen vegetable ✔️, a steam bag ✔️, an allowed variety ✔️) but rang up "non WIC" and either had to hold up the line by running around the store (either personally or sending an associate of the store who volunteered) or forfeiting that item and leaving without it. And that was without an infant who had been fed, burped, changed etc. spitting up and crying too hard to take a pacifier in the cart. The result was that we stopped using WIC for the duration of the pregnancy. The social worker who helped me apply for SNAP ( for the 3rd time, only to be foiled by paperwork and deadlines) after the birth shared a similar anecdote from her own experience, and encouraged me to apply for SNAP BECAUSE it didn't have such thorough restrictions. A few of you mentioned the time required to prepare healthy food: yes! Definitely a factor. ALSO Shopping for food on WIC takes a significant amount of time compared to simply buying ingredients for a healthy recipe based on budget and selection. One final anecdote: Right now, I spend discretionary grocery money on convenience foods like Chobani flips greek yogurt cups (because they're already put together and are enticing enough for me to grab and get some protein and calcium when I'm busy or out of ideas to make with canned beans or to replace an less healthy item like ice cream) This is the type of luxury food I would buy with SNAP. The money I saved could then go to something like the unpaid medical bills from my child's unexpected NICU stay.

[amseljack]

as someone who used wic, I can saw that my eating habits changed in a small way. but they did.

unfortunately I can say a lot of the food is wasted on some people. and the rules from state to state are confusing if you nove.