Family Health and Nutrition Policy

Thursday May 7, 2015Harrison Hall

John Hawkins, Lee Hollis, Jenni Martin, Paige Melton, Nomsa Mzozoyana, Anna Swanson

Agenda1. Identify and Define the Problem2. History of Problem and Policy3. Overview of Current Policies

a. SNAPb. WICc. School Lunch Program

4. Methodology5. Major Findings and Alternatives6. Our Recommendations

Hunger ParadoxNobel Prize winning economist Amartya Sen: "starvation is the characteristic of some people not having enough food to eat. It is not the characteristic of there being not enough food to eat. While the latter can be the cause of the former, it is but one of many possible causes” (p 1)

What is Food Security?

“Food security” and “food insecurity” focus on economic and other access-related issues and purchasing power.

Hunger physiological condition

Food security is built upon three principles:1. Food availability: sufficient and consistent food available2. Food access: having the resources to obtain food3. Food use: appropriate knowledge of basic nutrition

Varying Degrees of Food InsecurityHigh food security—Households had no problems, or anxiety about, consistently accessing adequate food.

Marginal food security—Households had problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of their food intake were not substantially reduced.

Low food security—Households reduced the quality, variety, and desirability of their diets, but the quantity of food intake and normal eating patterns were not substantially disrupted.

Very low food security—At times during the year, eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food.

Food Insecurity on the Rise

What is the problem?One in every seven Americans are food insecure

Why is this a public problem?● Market Imperfections

o Highly inefficient for a private company to step in and address the problem

o High transaction costso Lack of potential profits because most often serving lower

income families

● Externalities o Occur when either the costs or benefits that affect one

party who did not choose to acquire the cost or benefit, causing one party to be better or worse off

History of the Problem and PoliciesThe Food Stamp Program of 1939● Concern for the poor and growing food

surpluses● Orange and blue stamps

History of the Problem and Policies cont.Pilot Food Stamp Program of 1961● Executive Order 10914 - January 1961● “Call for expanded food distribution to needy

families”● Retained purchase requirement● Removed surplus focus

History of the Problem and Policies cont.Food Stamp Act of 1964● Permanent social program● Strengthen agricultural economy● Improve nutrition in low-income households● Congressional control

History of the Problem and Policies cont.National School Lunch Act and Child Nutrition Act of 1966● First with a focus on children

1972 WIC Pilot Program● Growing concern for pregnant women and

infants

History of the Problem and Policies cont.Public Law 94-105 (1975)● Made WIC a permanent program● Mentions breastfeeding● Extends the age to 5

History of the Problem and Policies cont.1971 Amendments to the Food Stamp Act● Work requirements● Household definitions● Disaster procedures● Eligibility tests● Able Bodied Adults Without Dependents (ABAWDs)

History of the Problem and Policies cont.Conservative Attacks● Ronald Reagan’s “young buck”● 1970’s committee members see “food as a spur

for people to work”

History of the Problem and Policies cont.

Personal Responsibility and Work Opportunity Reconciliation Act of 1996● Clinton● Increased use of EBT● Controversial● Most ABAWD and lawful immigrants lost benefits

History of the Problem and Policies cont.Food Conservation and Energy Act of 2008● Renamed to SNAP

History of the Problem and Policies cont.American Recovery and Reinvestment Act of 2009 (ARRA)● States suspend time limits for benefits placed on

ABAWD● Increased benefit levels

Current PoliciesSupplemental Nutrition Assistance Program (SNAP)

Special Nutrition Assistance Program for Women, Infants, and Children (WIC)

School Lunch Program

Who is in charge?US Department of Agriculture

Food and Nutrition Service (FNS) is umbrella organization

● Administers domestic food assistance programs authorized in the farm bill as well as WIC and Child Nutrition Programs

Secretary of Agriculture

Deputy Secretary

Under Secretary for Food Nutrition, & Consumer Service○ Food and

Nutrition Service○ Center for

Nutrition Policy and Promotion

Supplemental Nutrition Assistance Program (SNAP)The primary food assistance program of the Farm Bill; close to 79% of the 2014 Farm Bill spending was towards SNAP

National nutrition safety net

Provides benefits that supplement low-income recipients giving food purchasing power through Electronic Benefit Transfer (EBT) cards.

SNAP EBT Cards

● All 50 states in 2004

● Fraud prevention● Efficient

SNAP Funding

Funding● 100% federally funded● Administered by the states● State and federal governments share

administrative expenses● FY 2015 cost $73.7 billion

SNAP Description

SNAP participation adjusts to the economy● Grows when economy is weak● Lessens when economy is strong

Lifts millions out of poverty

Provides fiscal boost to local economies● $1 in benefits generates $1.80 in economic activity● $1 billion = 18,000 full-time jobs, 3,000 farm jobs

SNAP follows poverty and economic cycles

United States Department of Agriculture. (2012). Building A Health America: A Profile of the Supplemental Nutrition Assistance Program.

SNAP Eligibility

Eligibility: ● Gross income test ● Net income test ● (FY2015) liquid assets under $2,250 (assets

under $3,250 if elderly or disabled household members).

● Amount of Resources, deductions, employment requirements considered too.

SNAP Money Allotments

Demographics of SNAP Participants

United States Department of Agriculture. (2012). Building A Health America: A Profile of the Supplemental Nutrition Assistance Program.

48% of SNAP recipients are

children

SNAP ParticipationIn FY2014, SNAP had an average monthly participation of approximately 46.5 million individuals in 22.7 million households.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

● Provides grants to states for food and education for low-income mothers

● Pregnant women, breastfeeding women, postpartum women, infants, and children up to age 5

● Encourages healthy decisions and practices● FY 2015 cost $6,623,000 million

WIC Food PackageMust adhere to current food list:● Juice, milk, breakfast cereals,

cheese, eggs, fruits, vegetables, whole wheat bread, canned fish, canned and dried beans, and peanut butter

WIC DistributionSome states have transitioned to EBT cards, most still use paper vouchers● By 2020, all States are to distribute WIC

benefits via EBT cards

WIC Eligibility Pregnant, postpartum and breastfeeding women, infants, and children up to age five with a household income at or below 185% of federal poverty guidelines.

Applicants must be individually determined to be at “nutritional risk" by a health professional and must meet state residency requirements.

WIC Participation In FY2014, an average monthly total of approximately 8.3 million individuals (down from 8.7 million in FY2013) participated in WIC. This includes an average monthly total of 4.3 million (52%) children, 2.0 million (24%) infants, and 2.0 million (24%) women.

School Lunch ProgramsNational School Lunch Program (NSLP)● Established under the National School Lunch Act (NSLA)

signed by President Harry Truman in 1946● One of the larger U.S. food and nutrition assistance

program both in numbers of children served (30 million in 2006) and federal dollars spent (8 billion in 2006)

● Provides low-cost or free lunch meals to qualified students through providing subsidies to schools

MethodologyLegislation HistoryGovernment ReportsJournalsPeriodicalsInterest Groups

Major Findings

SNAP and WIC work well in alleviating food insecurity

Major Findings re: SNAP● SNAP participation reduces food

insecurity● 16.2% decrease in food insecurity

among needy households (Radcliffe, McKernan, & Zhang, 2011)

● Census Bureau: Lifted 3.9 million people out of povertyo Including 1.7 million children

Major Findings re: SNAP● SNAP is not contributing to the

nation’s long-term fiscal problems● SNAP eligibility changes have not

played a role in SNAP growth● Payment error rates at all-time lows

Major Findings re: WIC● WIC participation associated with improved

birth outcomes (Bitler and Currie, 2005)● Among mothers on Medicaid, each dollar spent

on WIC saved the state at least $1.77 to $3.13 in health care costs (1993)

Policy Alternatives: Shift the Focus

Policy focus should be on the quality of food not just quantity

Viable Policy Alternatives: Federal

Bi-Weekly SNAP Payments

Viable Policy Alternatives: City and State Initiative Examples

Reducing Transportation BarriersAustin, Texaso Austin Capital Metro Transit “grocery bus line”

Viable Policy Alternatives: City and State Initiative Examples

Ban Certain Foods and Beverages Outright● Former New York Mayor Michael Bloomberg's attempted ban on large-size sugary

beverages● Fat Tax

Viable Policy Alternatives: Non-governmental Examples

Farm-to-School Initiatives● Farmers and Schools work togetherCommunity Gardening● Vacant lots● positive spillover Farmers’ Markets● Huge influx and attitudinal shift.

o Increased dramatically; from 1,755 in 1990 to 7,175 since 2009

Recommendation 1:EBT at Farmers Markets

$9 million to equip all farmers markets with wireless EBT point-of-sale equipment● less than .0001% of

the 2014 SNAP budget

EBT at Farmers Markets cont.

Political Feasibility● Different stakeholders benefit● Viewed favorably by all● Economically feasible

Recommendation 2: Requiring SNAP and WIC Vendors to Carry Healthier FoodsThe healthier the environment, the easier the healthy choice.

USDA does not require qualifying WIC and SNAP vendors to carry items that meet standard nutrient criteria, or items specifically designated to be healthy within the staple categories.

Chocolate Milk Soy MilkWhite Bread Whole Wheat Bread

Current SNAP Vendor Eligibility

(A) Offer for sale, on a continuous basis, at least three varieties of

qualifying foods in each of the four staple food groups, with

perishable foods in at least two of the categories:

OR

(B) More than one-half (50%) of the total dollar amount of all retail

sales (food, nonfood, gas and services) sold in the store must be

from the sale of eligible staple foods.

Requiring SNAP and WIC Vendors to Carry Healthier Foods

Political Feasibility

Economic Feasibility

In closing…..“It is worth noting that the US has the most extensive anti-hunger and government supported nutrition and feeding programs in the world—which is certainly not a bad legacy for our country.”- Dan Glickman, Chairman of the Food Research and Action

Center

Family Health and Nutrition Policy

Questions?