The Supplemental Nutrition Assistance Program (SNAP) provides access to healthy food for low-income individuals and households. Food security, however, does not necessarily achieve higher diet quality for beneficiaries. Diet quality is an important consideration for the development and management of chronic illness, a significant public health concern. In this study, we review incentives and disincentives implemented to improve the diet quality, the evidence on SNAP including benefits, challenges, and the politics of funding. New interventions and policies will be needed in order to improve the overall diet quality of SNAP households. SNAP should align with nutritional science to meet national public health goals. Nurses are trusted advocates for patients and the public and are uniquely positioned to aid in this effort. Informed by evidence, nurses willing to leverage their influence, can lead this needed change.
AlmadaL. N.TchernisR. (2018).
Measuring effects of SNAP on obesity at the intensive margin.Economics & Human Biology,
31, 150–163. https://doi.org/10.1016/j.ehb.2018.08.006
2.
AlmondD.HoynesH. W.SchanzenbachD. W. (2011).
Inside the war on poverty: The impact of food stamps on birth outcomes.TheReview of Economics and Statistics,
93(2), 387–403. https://doi.org/10.1162/REST_a_00089
3.
AndreyevaT.LuedickeJ.HendersonK. E.TrippA. S. (2012).
Grocery store beverage choices by participants in federal food assistance and nutrition programs.American Journal of Preventive Medicine,
43(4), 411–418. https://doi.org/10.1016/j.amepre.2012.06.015
4.
AndreyevaT.TrippA. S.SchwartzM. B. (2015).
Dietary quality of Americans by Supplemental Nutrition Assistance Program participation status: A systematic review.American Journal of Preventive Medicine,
49(4), 594–604. https://doi.org/10.1016/j.amepre.2015.04.035
5.
BarnhillA. (2018).
Do sugary drinks undermine the core purpose of SNAP?Public Health Ethics,
12(1), 82–88. https://doi.org/10.1093/phe/phy002
6.
BaronbergS.DunnL.NonasC.DanneferR.SacksR. (2013).
The impact of New York City’s Health Bucks Program on electronic benefit transfer spending at farmers markets, 2006–2009. Preventing Chronic Disease,
10, E163. https://doi.org/10.5888/pcd10.130113
7.
BartlettS., & Abt Associates. (2014). Evaluation of the Healthy Incentives Pilot (HIP), final report.
U.S. Department of Agriculture, Food and Nutrition Service.
8.
BasuS.SeligmanH.BhattacharyaJ. (2013).
Nutritional policy changes in the Supplemental Nutrition Assistance Program: A microsimulation and cost-effectiveness analysis.Medical Decision Making,
33(7), 937–948. https://doi.org/10.1177/0272989x13493971
9.
BauerU. E.BrissP. A.GoodmanR. A.BowmanB. A. (2014).
Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA. Lancet,
384(9937), 45–52. https://doi.org/10.1016/s0140-6736(14)60648-6
10.
BerkowitzS. A.SeligmanH. K.RigdonJ.MeigsJ. B.BasuS. (2017).
Supplemental Nutrition Assistance Program (SNAP) participation and health care expenditures among low-income adults. JAMA Internal Medicine,
177(11), 1642–1649. https://doi.org/10.1001/jamainternmed.2017.4841
11.
BitlerM. (2014). The health and nutrition effects of SNAP: Selection into the program and a review of the literature on its effects. University of Kentucky, Center for Poverty Research Discussion Paper Series, DP2014-02.
12.
BlumenthalS. J.HoffnagleE. E.LeungC. W.LofinkH.JensenH. H.FoersterS. B.CheungL. W.NestleM.WillettW. C. (2014).
Strategies to improve the dietary quality of Supplemental Nutrition Assistance Program (SNAP) beneficiaries: An assessment of stakeholder opinions.Public Health Nutrition,
17(12), 2824–2833. https://doi.org/10.1017/S1368980013002942
13.
ChoiS. E.SeligmanH.BasuS. (2017).
Cost effectiveness of subsidizing fruit and vegetable purchases through the Supplemental Nutrition Assistance Program.American Journal of Preventive Medicine,
52(5), e147–e155. https://doi.org/10.1016/j.amepre.2016.12.013
14.
ChristensenG.BronchettiE. (2017). Are SNAP benefits adequate for purchasing a healthy diet? Evidence on geographic variation in food prices and the purchasing power of SNAP.
15.
CohenA.RichardsonC.HeislerM.SenA.MurphyE.HestermanO.DavisM. M.ZickS. (2017).
Increasing use of a healthy food incentive: A waiting room intervention among low-income patients. American Journal of Preventive Medicine,
52(4), 554–554.
16.
CondonE.DrileaS.JowersK.LichtensteinC.MabliJ.MaddenE.NilandK. (2016). Diet quality of Americans by SNAP participation status: Data from the National Health and Nutrition Examination Survey, 2007–2010. U.S. Department of Agriculture.
17.
DeBonoN. L.RossN. A.Berrang-FordL. (2012).
Does the food stamp program cause obesity? A realist review and a call for place-based research.Health & Place,
18(4), 747–756. https://doi.org/10.1016/j.healthplace.2012.03.002
18.
FinkelsteinE. A.ZuckermanL. (2010). The fattening of America: How the economy makes us fat, if it matters, and what to do about it.
John Wiley & Sons.
GaraskyS.MbwanaK.RomualdoA.TenaglioA.RoyM. J. (2016, November). Foods typically purchased by Supplemental Nutrition Assistance Program (SNAP) households.
U.S. Department of Agriculture, Food and Nutrition Service.
HansonK. L.ConnorL. M. (2014).
Food insecurity and dietary quality in US adults and children: A systematic review.American Journal of Clinical Nutrition,
100(2), 684–692. https://doi.org/10.3945/ajcn.114.084525
25.
HarnackL.OakesJ. M.ElbelB.BeattyT.RydellS.FrenchS. (2016).
Effects of subsidies and prohibitions on nutrition in a food benefit program: A randomized clinical trial.JAMA Internal Medicine,
176(11), 1610–1618. https://doi.org/10.1001/jamainternmed.2016.5633
26.
HeflinC.OlsonK. (2017).
Unpacking an anomaly: Analyzing the 2005–2012 current population survey to understand why many emergency food assistance users report being food secure. Journal of Hunger & Environmental Nutrition,
12(1), 64–76. https://doi.org/10.1080/19320248.2016.1157548
27.
HernandezD. C.ReesorL. M.MurilloR. (2017).
Food insecurity and adult overweight/obesity: Gender and race/ethnic disparities.Appetite,
117, 373–378. https://doi.org/10.1016/j.appet.2017.07.010
28.
HizaH. A.CasavaleK. O.GuentherP. M.DavisC. A. (2013).
Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level.Journal of the Academy of Nutrition and Dietetics,
113(2), 297–306. https://doi.org/10.1016/j.jand.2012.08.011
29.
HoynesH.SchanzenbachD. W.AlmondD. (2016).
Long-run impacts of childhood access to the safety net. American Economic Review,
106(4), 903–934.
30.
JunS.ThuppalS. V.MauldingM. K.Eicher-MillerH. A.SavaianoD. A.BaileyR. L. (2018).
Poor dietary guidelines compliance among low-income women eligible for Supplemental Nutrition Assistance Program-Education (SNAP-Ed). Nutrients,
10(3), 327. https://doi.org/10.3390/nu10030327
31.
KaurJ.LambM. M.OgdenC. L. (2015).
The Association between food insecurity and obesity in children—The National Health and Nutrition Examination Survey.Journal of the Academy of Nutrition and Dietetics,
115(5), 751–758. https://doi.org/10.1016/j.jand.2015.01.003
LeungC. W.MusicusA. A.WillettW. C.RimmE. B. (2017).
Improving the nutritional impact of the Supplemental Nutrition Assistance Program: Perspectives from the participants.American Journal of Preventive Medicine,
52(2), S193–S198. https://doi.org/10.1016/j.amepre.2016.07.024
35.
LeungC. W.VillamorE. (2011).
Is participation in food and income assistance programmes associated with obesity in California adults? Results from a state-wide survey. Public Health Nutrition,
14(4), 645–652.
36.
LongM. W.LeungC. W.CheungL. W.BlumenthalS. J.WillettW. C. (2014).
Public support for policies to improve the nutritional impact of the Supplemental Nutrition Assistance Program (SNAP).Public Health Nutrition,
17(1), 219–224. https://doi.org/10.1017/s136898001200506x
37.
LongV. (2013). Supplemental Nutrition Assistance Program Education and Evaluation Study (Wave II): Michigan State University Extension’s Eat Smart, Live Strong program [Report]. U.S. Department of Agriculture, Food and Nutrition Service.
MabliJ.OhlsJ.DragosetL.CastnerL.SantosB. (2013). Measuring the effect of SNAP participation on food security.
U.S. Department of Agriculture.
40.
MalikV. S.PopkinB. M.BrayG. A.DespresJ. P.HuF. B. (2010).
Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk.Circulation,
121(11), 1356–1364. https://doi.org/10.1161/circulationaha.109.876185
41.
Mathematica. Impact of proposed policy changes to SNAP categorical eligibility by state. (2019). www.mathematica-mpr.com
42.
MeyerhoeferC. D.PylypchukY. (2008).
Does Participation in the food stamp program Increase the Prevalence of Obesity and Health Care Spending?American Journal of Agricultural Economics,
90(2), 287–305. https://doi.org/10.1111/j.1467-8276.2007.01125.x
43.
NguyenB. T.ShuvalK.NjikeV. Y.KatzD. L. (2014). The Supplemental Nutrition Assistance Program and dietary quality among US adults: Findings from a nationally representative survey [Paper presentation]. Mayo Clinic Proceedings.
44.
OlshoL. E. W.KlermanJ. A.BartlettS. H.LoganC. W. (2017).
Rebates to incentivize healthy nutrition choices in the Supplemental Nutrition Assistance Program.American Journal of Preventive Medicine,
52(2), S161–S170. https://doi.org/10.1016/j.amepre.2016.08.023
45.
ParksC. A.SternK. L.FrickeH. E.ClausenW.FoxT. A.YarochA. L. (2019).
Food insecurity nutrition incentive grant program: Implications for the 2018 Farm Bill and future directions. Journal of the Academy of Nutrition and Dietetics,
119, 395–399. https://doi.org/10.1016/j.jand.2018.12.005
46.
PomeranzJ. L.ChriquiJ. F. (2015).
The Supplemental Nutrition Assistance Program: Analysis of program administration and food law definitions.American Journal of Preventive Medicine,
49(3), 428–436. https://doi.org/10.1016/j.amepre.2015.02.027
47.
PruittZ.EmechebeN.QuastT.TaylorP.BryantK. (2018).
Expenditure reductions associated with a social service referral program.Population Health Management,
21(6), 469–476. https://doi.org/10.1089/pop.2017.0199
48.
RaoM.AfshinA.SinghG.MozaffarianD. (2013).
Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis. BMJ Open,
3(12), e004277.
49.
RigdonJ.BerkowitzS. A.SeligmanH. K.BasuS. (2017).
Re-evaluating associations between the Supplemental Nutrition Assistance Program participation and body mass index in the context of unmeasured confounders.Social Science & Medicine (1982),
192, 112–124. https://doi.org/10.1016/j.socscimed.2017.09.020
WebbA. L.SchiffA.CurrivanD.VillamorE. (2008).
Food stamp program participation but not food insecurity is associated with higher adult BMI in Massachusetts residents living in low-income neighbourhoods. Public Health Nutrition,
11(12), 1248–1255.
56.
World Health Organization. (2003). Diet, nutrition, and the prevention of chronic diseases: Report of a joint WHO/FAO expert consultation (Vol. 916).
57.
ZagorskyJ. L.SmithP. K. (2009).
Does the US food stamp program contribute to adult weight gain?Economics & Human Biology,
7(2), 246–258.
58.
ZhangF. F.LiuJ.RehmC. D.WildeP.MandeJ. R.MozaffarianD. (2018).
Trends and disparities in diet quality among US adults by Supplemental Nutrition Assistance Program participation status. JAMA Network Open,
1(2), e180237–e180237. https://doi.org/10.1001/jamanetworkopen.2018.0237%J JAMA Network Open
