Monday, January 16, 2017

A more constructive approach to SSB restrictions in SNAP

An old debate

First, let me review the harsh back and forth in a somewhat typical week of debate about sugar sweetened beverages (SSBs) in the Supplemental Nutrition Assistance Program (SNAP).

The New York Times this week published an article about "lots of soda" in the shopping carts of SNAP participants.

This drew fire from the magazine Jacobin ("Reason in Revolt"), where Joe Soss noted several problems with the NYT article. For example, the NYT listed "milk" first among beverage choices for nonparticipant households, but the original USDA study (.pdf) showed no significant difference in the ranking of food choices for participants and nonparticipants.

The NYT reporter, Anahad O'Connor, said "cities, states, and medical groups" have urged changes to SNAP, such as restricting soda purchases. Meanwhile, O'Connor said, industry organizations have spent millions opposing the changes, so USDA has refused to approve the proposals.

One would think from the NYT article that all the good folks favor the restrictions, and all the bad folks oppose. O'Connor didn't say that the list of supporters for such proposals also includes conservative critics of SNAP, who sometimes include such proposals in an agenda that also has budget cuts, nor that the list of opponents includes anti-hunger organizations, who are concerned that the proposals would increase program stigma and food insecurity by discouraging participation among eligible people.

In truth, people who care about poverty, hunger, and health are painfully divided about SNAP restrictions.

A more promising discussion

Second, let's consider a different approach to this policy discussion.

I have a wish that leading anti-hunger organizations would more sympathetically consider supporting a pilot project that includes SNAP restrictions.

Here is a draft set of principles, which, if met, might make such a proposal deserving of support by anti-hunger organizations, legislators who care about food security, and the USDA.
  1. the policy to be piloted places a high value on both nutrition and food security, combining a policy of interest for public health nutrition goals (the SSB restriction) with policies of interest for food security goals (such as enhanced benefits for some participants who currently receive too little);
  2. the pilot is a true pilot (pilot scale, with genuine empirical curiosity about the outcome, and no assumptions in advance that the outcome will be favorable);
  3. the outcomes for the study include reduced SSB consumption (intended outcome) and questions about perceived stigma and SNAP participation (possible unintended outcomes);
  4. the pilot policy does not have other food choice restrictions beyond the SSB restriction (no hints at more broadly paternalistic plans to convert SNAP into WIC); and
  5. the research protocol has a trigger, enforced by the Institutional Review Board (IRB), ending the pilot in the event of any evidence that the pilot proposal threatens household food security.
I wish such a pilot SSB restriction were not caught up in our poisoned partisan struggle over the safety net more broadly. This is merely a small reasonable revision of the definition of SNAP eligible foods to exclude soda. It is not about "banning" soda, just about altering what can be purchased with SNAP benefits. If the proposed policy turns out to threaten food security, almost everybody in the public health nutrition community would drop their interest in it. And, if the proposal turns out to be successful, and perhaps even popular with SNAP participants themselves -- who may appreciate the health halo associated with the revised program -- then it may merit support within the anti-hunger advocacy community.

Update (Jan 19): A clear and empathetic essay from Marlene Schwartz at the Rudd Center published yesterday in the American Journal of Preventive Medicine.

1 comment:

Anonymous said...

Your desire to limit SNAP restrictions to SSB is inappropriate.

If we are to mold SNAP into a meaningful program focused exclusively upon nutrition and food security, we must consider value and thrift as part of the program's purpose. In that vein, good to restrict SSB but also must restrict traditionally overpriced veblen goods, like organic. Likewise overpriced fad foods; 'grassfed', 'GMO-free', 'all natural', 'free range', those sorts of vacuous sales tactics that typically sport excessive pricing without commensurate nutritive value absolutely should be restricted from the SNAP food basket.

Best would be for SNAP purchases to be restricted to basic food necessities, and have individual product labels meet nutrition and value criteria in order to obtain a "SNAP-eligible" status. This would be no problem in today's world of electronic SKU scanners. That would assure the best and most cost-efficient use of SNAP dollars, really stretching the family's food budget as originally intended by the USDA and compassionate supporters. Program funding would be diverted toward a simple certification system for food marketers to access, and away from frivolous food purchases by SNAP recipients. May even be possible in this way to reduce the overall SNAP budget, something that absolutely needs to happen.