From paper to plastic: Understanding the impact of eWIC on WIC recipient behavior

Evidence shows that the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is underutilized. WIC enrolls 52.7% of eligible persons and participants claim a fraction of available benefits. Researchers suggest that people underutilize WIC because of the time needed to enroll in and use WIC and because participants may believe that, if others notice them participating in WIC, community members will stigmatize them. Recently enacted policies may reduce both time costs and potential for stigma associated with WIC. Congress mandated that, by 2020, all states disburse WIC benefits through an Electronic Benefits Transfer (eWIC) system. Given that eWIC reduces the time required for each transaction and and makes it more difficult to identify beneficiaries, we expect WIC redemptions to increase. In addition, eWIC might also increase the chance WIC recipients choose non-WIC foods for redemption increasing non-WIC expenditures. To measure the impact of eWIC on WIC redemptions and non-WIC food expenditures we analyze data on grocery expenditures of 11,887 WIC-participating households in one state over the period it implemented eWIC. We find that, after beneficiaries began redeeming WIC benefits through eWIC, spending on non-WIC eligible foods did not change but redemptions of WIC benefits increased.     

Food environment in the United States as a complex economic system

The food environment in the United States is complex. Sixteen socio-economic-demographic variables from various public data sources are studied with a machine learning algorithm to ascertain the causality structure associated with the food environment in the United States. High levels of unemployment and poverty are direct causes of high levels of food insecurity, while low income causes high levels of food insecurity via increased levels of poverty. Unemployment is a common cause for both increased levels of food insecurity and poverty. We find that food insecurity and participation in Supplemental Nutrition Assistance Program (SNAP) are related, yet no direct causality is observed. Contrary to past studies which find that SNAP participation decreased the occurrences of poverty, in contemporaneous time, we find that poverty and SNAP participation are related through several back-door paths, via food insecurity, unemployment, race and food taxes. Obesity and SNAP participation are indirectly related via several back-door paths, namely, race income, poverty and food insecurity and unemployment. Also, food insecurity and obesity are related by several back-door paths. Low income, high food taxes, and race (being Black and non-Hispanic) are direct causes of obesity. The complex causality structure in the US food environment reveals that policy variables cannot be treated independently of their rich causal structure. Government agencies responsible for designing policies for food assistance, poverty alleviation, combating food insecurity and obesity need to consider the interrelationships among these variables.     

Buyer Alliances as Countervailing Power in WIC Infant-Formula Auctions

State agencies in infant-formula procurement auctions receive lower bids when they are in buyer alliances than when they are unallied. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) uses an auction to procure infant formula. Manufacturers bid on the right to be an agency’s sole supplier by offering a rebate on formula sold through WIC. Agencies frequently join together in buyer alliances. An empirical estimation shows that bids are lower to alliances and that lower prices result because alliances are heterogeneous. Results suggest that when heterogeneity is not controlled, bids decline with alliance size, which has policy implications because Congress recently limited alliance size.     

Local food prices and the purchasing power of SNAP benefits

While the nominal value of Supplemental Nutrition Assistance Program (SNAP) benefits is fixed across states (except for Hawaii and Alaska), variation in food prices across the U.S. is dramatic. We provide new evidence describing geographic variation in the purchasing power of SNAP benefits, measured by the extent to which SNAP-recipient households are able to afford the Thrifty Food Plan (TFP), the U.S. Department of Agriculture (USDA) food plan on which legislated SNAP benefit levels are based. For more than one-quarter of SNAP households, SNAP benefits are too low to cover the cost of the TFP at the primary stores where they report shopping. SNAP purchasing power increases somewhat as we assume households can travel farther to shop and increases much more with the assumed ability to identify and travel to the lowest-cost store in a given area. It is unlikely, however, that SNAP households are sufficiently informed and mobile to shop at the lowest-cost store in a large (e.g., 10 to 20-mile) geographic area. We demonstrate that aggregate dollar shortfalls for SNAP households who cannot afford the TFP could be completely eliminated by redistributing from households in low-cost areas to those in high-cost areas, e.g., by indexing SNAP benefits to local food prices.     

The Effects of Minimum Wages on Food Stamp Enrollment and Expenditures

We provide the first causal analysis of how minimum wages affects enrollments and expenditures in the Supplemental Nutrition Assistance Program (SNAP). Exploiting state‐ and federal‐level variation in minimum‐wage policy between 1990 and 2012, and incorporating local controls in our specifications, we find that a 10 percent minimum wage increase reduces SNAP enrollment between 2.4 and 3.2 percent, and reduces program expenditures an estimated 1.9 percent. If the federal minimum wage were increased from $7.25 to $10.10, enrollment would fall between 7.5 and 8.7 percent (3.1 to 3.6 million persons) relative to 2012 levels, and annual expenditures would decrease 6 percent ($4.6 billion).     

Does food retail access moderate the impact of fruit and vegetable incentives for SNAP participants? Evidence from western Massachusetts

ObjectivesThis study investigates whether the response of Supplemental Nutrition Assistance Program (SNAP) participants to a 30% incentive on fruit and vegetable spending varies with their access to food retailers.MethodsThe analysis exploits the random assignment of SNAP households in Hampden County, MA, to an intervention group that earned the incentive. Regression models for the impact of the incentive are augmented with measures of food retail access and interactions of random assignment status with food retail access. The main outcome—use of the SNAP benefit—is based on Electronic Benefit Transfer (EBT) card transaction records.ResultsAlthough households that lived within a mile of a participating supermarket spent approximately $2.13 or 19% more per month on targeted fruits and vegetables at participating supermarkets than households that did not live within a mile of a participating supermarket, we found no evidence that the impact of the incentive on SNAP fruit and vegetable spending varies with distance to retailers.ConclusionsThese findings imply that incentives to purchase fruits and vegetables were equally efficacious for SNAP households with high and low access to food retailers.     

Are SNAP benefits adequate? A geographical and food expenditure decomposition

The Supplemental Nutrition Assistance Program (SNAP) provides resources to supplement household food expenditures in order to achieve a nutritious diet. Determining the amount of support required - or extent of food expenditure poverty -- entails comparing available resources for food to a nutrition-determined threshold. Clearly the value of the threshold will affect the degree of food expenditure poverty. If the threshold value is inaccurate, the calculated degree of poverty will be inaccurate. USDA uses a threshold for setting SNAP benefits that does not vary geographically or temporally, so consequently (food expenditure) poverty may be understated or overstated in different regions and time periods. This article compares food expenditure poverty estimates for SNAP participants when geographical differences in the threshold are ignored versus not ignored. In addition, the article decomposes household food expenditures into Food-Away-From-Home (FAFH), Food-at-Home (FAH), personal funded FAH, and SNAP funded FAH in order to assess the degree to which each of these contribute to reducing food expenditure poverty. The general findings are that all food expenditure poverty measures are worse when geographical differences are taken into account. In addition, the analysis shows that FAH expenditures, and in particular SNAP FAH expenditures, contribute the most to reducing food expenditure poverty in SNAP households. The policy implications are that food expenditure poverty is currently underestimated in the US by ignoring geographical differences in thresholds, but the food expenditure poverty would be even worse without SNAP benefits. Geographical adjustments to the national threshold could help reduce food expenditure poverty across regions.     

Breakfast,lunch, and dinner expenditures away from home in the United States

This study investigates the differentiated effects of economic and socio-demographic variables on food away from home (FAFH) expenditures by type of meal among different types of households in the United States. Using data from the 2008 and 2009 Consumer Expenditure Surveys, the systems of expenditures on breakfast, lunch, and dinner are estimated with a multivariate sample selection procedure. Statistical significance of error correlations among equations justifies estimation of the sample selection systems. Income, work hours, race, education, geographic region, and household composition are important determinants of FAFH expenditures. Income contributes to FAFH expenditures of all meal types implying that the future of FAFH industry is tied to macroeconomic conditions. More education is associated with increased expenditures for FAFH lunch and dinner. Effects of the Supplemental Nutrition Assistance Program (SNAP) are negligible.     

WIC Contract Spillover Effects

Under the U.S. Special Nutrition Program for Women, Infants, and Children (WIC) program, the three major infant formula manufacturers compete for WIC supply contracts, state by state. Policy makers have been puzzled by the question of why the contracted WIC price is substantially lower than the retail (non-WIC) price. Our explanation is that winning the WIC contract is extremely valuable to a manufacturer because of a spillover effect: The increased retail shelf-space that is dedicated to the WIC brand and the WIC logo increases non-WIC sales. We identify this effect by showing the variations in market shares of winning and losing firms that follow WIC contract changes. Immediately after the contract change, there is an immediate increase in the market share of the WIC contract winner and an equal drop in the loser’s share because of new WIC purchases. Then, over an extended period, the spillover effect increases the winner’s share and decreases the loser’s share as retailers shift shelf space from the loser to the winner.     

Changes in the propensity of overweight US women to under-assess their body weight status

National data indicate that there was almost no change in the accuracy of body weight assessments of overweight women over the past 20 years. The accuracy in weight assessment is influenced by a number of social-demographic and economic factors; many of them have opposite effects and cancel out each other. This paper examines changes in misperception of body weight among overweight women in the United States, using data from the 1988–1994 and 1999–2004 National Health and Nutrition Examination Survey. Changes in characteristics of the population, such as the increased share of Hispanics in the US population, between these two time periods explain only a small portion of the changes in the accuracy of body weight assessment. Most of the differences come from changes in the association between population characteristics and the likelihood an overweight woman underestimates her weight status. Results also indicate that overweight women who receive benefits from the Supplemental Nutrition Assistance Program (formerly Food Stamp Program) are consistently more likely to misperceive themselves as healthy weight or underweight than higher income overweight women.     

Household history,SNAP participation,and food insecurity

Food security in an important public policy issue. In 2015, approximately 1 in 8 U.S. households experienced food insecurity at some point in the year. Low-income families are at higher risk for food insecurity than other families, and these families may also face higher levels of disruption (e.g., moves, loss of income, or individuals entering or leaving the household) than other families. I use data from the Survey of Income and Program Participation to explore the relationship between food insecurity, the household’s history during the previous year, and SNAP participation. The results indicate that a number of aspects of the household’s recent experience including negative income shocks, moves, and both increases and decreases in household size increase the probability of being food insecure while SNAP participation is estimated to reduce the probability of being food insecure.     

Does SNAP improve your health?

In this study, we examine the effect of SNAP on health quite generally, examining self-assessed health (SAH), healthy time, and basic health utilization measures as outcomes. Our approach is to model outcomes and participation simultaneously, using exogenous variation in state eligibility to identify SNAP participation. We use this approach for both ordered choices (health) and count outcomes (sickdays, office-based visits, outpatient visits), where the former uses maximum likelihood and the latter maximum simulated likelihood. In addition, we control for state-level unobservables that are correlated with both participation and health, which previous studies of this question have neglected. Our results indicate that SNAP has an consistently positive effect on SAH; it significantly increases the probability of reporting excellent or very good health. We also find that SNAP participants spend about 3 fewer days in bed due to illness each year, and report between 1 and 2 fewer office-based doctor visits and a fraction fewer outpatient visits. Supplementary specifications indicate that, although SNAP participants consume fewer office visits overall, they have more checkups than comparable non-participants.     

First of the month effect: Does it apply across food retail channels?

In this study we use detailed daily scanner data on household food purchases to examine monthly food expenditure patterns across food retail channels. We compare food expenditure patterns in high and low-income households comparing those where Supplementary Nutrition Assistance (SNAP) is received in the first 10 days of the month versus households which receive SNAP over the first 15 days of the month. We find that food expenditure patterns vary systematically across the month within different retail channels by income and SNAP payment schedules. Low-income households in early SNAP distribution areas decrease their grocery and mass/club/superstore expenditures at the end of the calendar month and supplement this decrease with increased food expenditures in convenience stores and food away from home. Households in staggered SNAP payment areas show far fewer systematic patterns given the more distributed payment system.     

Capacity development in food and nutrition in central and Eastern Europe: A decade of achievements

This article summarizes the activities performed by the Network for Capacity Development in Nutrition in Central and Eastern Europe and Balkan countries (NCDNCEE) in the past decade. The article gives a retrospective of the achievements and challenges in building capacity in nutrition research.Recognizing the lack of capacity and incoherent nutritional situation in CEE/BC, the United Nations University (UNU), Food & Nutrition Programme and the UN Standing Committee on Nutrition (SCN) encouraged the formation of NCDNCEE in 2005, which became CAPNUTRA in 2012.The network’s aim was to initiate and support tailor-made activities for capacity development in food & nutrition in research and training in CEE/BC. To identify the challenges and needs of nutrition research in the region, the network performed inventories on existence of food composition databases, food systems elements, dietary surveys, micronutrient recommendations, application of dietary assessment methods and grey literature. Further on, the network focused on the development of food composition databases and concomitant data management software, the Diet Assess & Plan platform for food consumption collection, dietary intake assessment and nutrition planning. These and other elements form the Balkan Food Platform, which underpins harmonized nutrition research in CEE/BC. Among key actions promoted by the platform are EFSA-supported dietary surveys conducted in four Balkan countries, on children and adults, in which food consumption data are collected and analysed in a harmonized way. Cooperation with FAO and active participation in international research projects enhanced the exchange of information and knowledge and brought international recognition to the CAPNUTRA network.     

The challenge of program evaluation: When increasing program participation decreases the relative well-being of participants

Two goals of food assistance programs are to improve well-being and to increase participation among those in need. Progress in meeting the first goal can be measured by the difference in well-being between participants and eligible non-participants. This gap in well-being though can be affected by progress made toward the second goal of increasing participation rates. In particular, if those with the lowest levels of well-being disproportionately enter the program, the gap can increase. To examine whether this tension between goals exists empirically, we consider the case of the Food Stamp Program and its effect on food insecurity in the United States, using data from the Survey of Income and Program Participation (SIPP). In particular, we use variation in State policies (the change in administrative error rates and the combined value of Temporary Assistance for Needy Families (TANF) and food stamp benefits) to analyze whether increasing participation rates leads to increases in the difference in food insecurity rates. Controlling for other factors, we find evidence of the tension between these two program goals insofar as States with policies which encourage participation have higher differences in the food insecurity rates of participants and non-participants.     

The heterogenous relationship of food stamp participation with body mass: Quantile regression model

This study explores the heterogenous relationship between Food Stamp Program (FSP) participation and body mass index (BMI) for low income individuals whose per capita family income falls in the bottom two quintiles. We estimate changes in the dispersion of the entire distribution of BMI following FSP participation using a quantile regression model in both cross-sectional and longitudinal analyses. For women, we find that the mean OLS estimate of FSP participation underestimates the extent of the positive association with BMI at the top quantiles in both cross-sectional and longitudinal individual fixed effects models. Controlling for individual fixed effects in the quantile regression model reduces the estimated magnitude of the association by a factor of three to four, although the estimates remain statistically significant for women. For men, a marginally statistically significant positive association of FSP participation with BMI is found at the top quantiles compared to no statistically significant mean estimate although the association is no longer statistically significant when time-constant individual heterogeneity is adjusted for in the individual fixed effect models.     

Food self-sufficiency in Micronesia: Effects of a nutrition assistance programme on food consumption

Food assistance programmes in Micronesia have been blamed for creating disincentives to agriculture and nutritionally adverse dietary habits. In 1982 a USDA commodity programme in the Northern Mariana Islands was replaced by the Nutrition Assistance Program (NAP), which required that at least 25% of food coupons be used for the purchase of local foods. Consumption of local fish and bread increased, but consumption of local fruits and vegetables declined among NAP participants. Although targeted coupons did not reverse the trend towards imported foods, the bakery and fishery endeavours indicate that improved marketing can be coupled with food stamps to increase local food production and consumption.     

Hazard materials testing at the U.S. department of energy's liquefied gaseous fuels spill test facility

The U.S. Department of Energy (DOE) constructed the Liquefied Gaseous Fuels Spill Test Facility (LGFSTF) to provide a facility on a user-free basis to private and public sector test sponsors who are concerned with the safety of hazardous liquids and gases. The LGFSTF provides a facility for testing under controlled conditions to determine: patterns of dispersion, mitigation techniques, combustion characteristics, cleanup techniques, environmental impacts, and emergency planning guidelines. A further goal of the LGFSTF Program is to provide a framework for establishing relationships for joint government-industry participation.     

Peer Interactions in Shared Technological Activity: A Study of Participation

This study assumes a sociocultural perspective which draws on the work of Vygotsky (1986) and his focus on the cognitive development of children as it emerges through social interaction, mediated by language. The data in this report are derived from transcribed video tape of one pair of Grade 6 students working on an assigned task of building a robot with eyes which light up. In an analysis of the shared interactions, the nature of the participation through the talk and action constituting the design and make task is examined. This is portrayed as enactment of complementary roles, participatory contributions, and the use of tools. The study raises questions about the nature of participation in shared technological activity.     

Towards better nutrition in Europe: Evaluating progress and defining future directions

This paper provides a snapshot of the implementation of the WHO European Food and Nutrition Action Plan 2015–2020 among Member States in the WHO European Region. The focus is on the level and degree of implementation of selected policies recommended in this regional framework to promote healthy nutrition and prevent diet related noncommunicable diseases including obesity. Data was gathered through online and off-line versions of the Global Nutrition Policy Review questionnaire in 2017, through appointed focal points from the ministries of health. Almost all (94%) countries in the European region responded to the questionnaire, although not all responses were equally detailed. Significant progress has been made in some areas of public health nutrition, such as within school food policies, product reformulation, and implementation of trans fat regulations. However, if countries are to achieve global NCD targets, more ambitious policies with appropriate breadth and depth are needed. This is mainly the case for consumer-friendly front-of-package labelling, restrictions on marketing of foods to children as well as policies to protect, promote and support exclusive breastfeeding and appropriate complementary feeding practices. Lastly, it is crucial to prioritize robust monitoring, surveillance and evaluation systems in order to understand the effect of these actions and to guide timely and appropriate adjustment of policies.