30% price incentive has positive impact on fruit and vegetable intake for SNAP participants

USDA's Food and Nutrition Service today released the Interim Report from the Healthy Incentives Pilot (HIP), a major study of price incentives for fruit and vegetable intake for Supplemental Nutrition Assistance Program (SNAP) participants.

This study may help to inform the national discussion about the economic environment and its influence on food choices.  Agriculture Secretary Tom Vilsack today said, "The results of the Healthy Incentives Pilot demonstrate the clear impact that promoting nutritious food choices can have on improving the healthfulness of SNAP purchases."

Here is the punchline:

Our interim results indicate that HIP participants (adults aged 16 and older) consumed one-fifth of a cup-equivalent more fruits and vegetables per day than did non-participants (ES.1). This represents a difference of 25 percent in consumption over control group members. Approximately 60 percent of the observed difference was due to a difference in consumption of vegetables and 40 percent due to a difference in consumption of fruit.

These impact estimates are statistically significant, and they are big in percentage terms, but the baseline intake for the control group is quite low, so the impact seems fairly small in terms of cup-equivalents.  There is evidence that some retailers and participants in the pilot were still in the process of learning how the incentive worked.

The pilot was implemented in Hampden County, MA.  The study used a random assignment research design.  The Interim Report is based on a pre-implementation survey and an early post-implementation survey.  A Final Report in several months will use an additional later second post-implementation survey.

The authors of the Interim Report are Susan Bartlett, Jacob Klerman, Parke Wilde, Lauren Olsho, Michelle Blocklin, Christopher Logan, and Ayesha Enver.  As one of the co-authors, I worked on this study as part of a team led by Abt Associates, with funding from USDA's Food and Nutrition Service.  I will be presenting some results from this report on August 5 in Washington, DC, at the annual meeting of the Agricultural and Applied Economics Association (AAEA).  For me, personally, the project is the most terrifically ambitious research effort to which I have ever contributed.

This pilot initiative is related to other efforts to enhance incentives for purchasing fruits and vegetables, in farmers' markets and other outlets.  Some municipalities, including Boston, have Bounty Bucks programs, and Wholesome Wave has a series of related efforts.  One cool thing about the HIP study is that it worked through the SNAP participants' Electronic Benefit Transfer (EBT) card in all sorts of participating retailers.

With declines in Ogallala Aquifer, a reflection on the politics of agricultural environmentalism

Here is an excellent, sober, persuasive, and worrisome report at Science 360 about the accelerated decline of the Ogallala Aquifer from 2011 to 2013, because of drought on the Great Plains.

 

In the summer of 2010, I drove across the country visiting farms, markets, agricultural research stations, and other food policy sites.  One of the most interesting stops was a visit with a large-scale corn farmer in southern Nebraska, who showed me the modern irrigation equipment and careful monitoring system he used in an effort to waste as little water as possible from the Ogallala Aquifer.  He argued that aquifer declines were really only a problem further south, in Kansas and Oklahoma, not in his part of Nebraska.  He said farmers have a strong economic incentive to conserve water, because of the electricity costs and other variable costs from pumping water.  I think many farmers in his situation don't want government regulation or too much attention from worried environmentalists.

At the time, I wondered if these internalized costs really provided a strong enough incentive.  The big cost of irrigation is the value of the aquifer water itself.  Without coordination among farmers, each farmer has an incentive to use too much water.  I thought at the time that environmentally aware corn farmers in Kansas and Nebraska should go a little softer in their ferocious criticism of government environmental regulations, because without these regulations their own livelihoods are in jeopardy.

Climate science includes big uncertainties, but it seems likely that global climate change is causing more frequent droughts in the Great Plains.  I hope scientifically savvy and pragmatic corn farmers who rely on the Ogallala Aquifer have the political courage to resist the temptation to ally with anti-government conservatives who flirt with climate denialism.  Even though it takes some work and some compromise, and even some tolerance for cultural differences between heartland folks and city dwellers, I think farmers have a more promising long-term future allied with the pragmatic wing of the environmental movement.

Minnesota Public Radio discusses the politics of food assistance

Julie Siple at Minnesota Public Radio last week described some of the political history of the Supplemental Nutrition Assistance Program (SNAP), including the early bi-partisan support in the days of McGovern and Dole, the 1990s era of welfare reform, the caseload increases of the Great Recession, and the peculiar acrimony of recent food stamp debates in the House of Representatives.

Mark Winne discusses SNAP reform

Long-time anti-hunger and community food security activist Mark Winne has a new essay on the Supplemental Nutrition Assistance Program (SNAP).  Winne is passionate about protecting the program from the deep cuts proposed in the House of Representatives and eloquent about the hardship SNAP participants face in these hard economic times.

And yet, Winne includes the following strident call for reform and improvement of SNAP:

Whether we have more food stamp spending or less begs the question of why such a major act of social policy that nobody, including the recipients, seems to like, continues unreformed and unevaluated. With a national poverty rate locked at 15 percent and a near-poverty rate bringing the combined numbers to well over 30 percent, food stamps provide some relief but no solutions. With overweight and obesity affecting 65 percent of the population and eclipsing hunger as America’s number one diet-related health problem, food stamps do little to encourage healthy eating and less to discourage unhealthy eating. And with high unemployment, low wage jobs, and few prospects for growth – other than big box stores and casinos – leaving the economy stuck in neutral, food stamps $70 billion in federally generated buying power helps Kraft Foods (food stamps are 1/6 of its sales), but nearly nothing to infuse local economies with new energy.

But the anti-hunger orthodoxy that SNAP is a vital part of the nation’s safety net and must never be altered goes unchallenged. Whenever an innovation is proposed, e.g. Mayor Bloomberg’s request to prohibit the use of food stamps to purchase sugary soft drinks, the program’s pit bull defenders bare their teeth threatening to rip the limbs off heretics who might modify even one of SNAP’s holy sacraments. It may be that they are in bed with Wal-Mart and others who have tragically dumbed-down American wages and whose workers are subsidized by the food stamp program, or it may be that they are riveted to the notion that they are all that stand between a modicum of food sufficiency and mass starvation. Either way, the tenaciousness of their enterprise, which opposes food stamp change at any cost, is only matched by an equally fervent brand of conservatism embodied by the Tea Party. The result: A program now more than 50 years old remains largely unchanged even though the nation that it helps feed has changed in myriad ways.

Imagine a corporation or major private institution that did not conduct research and development, kept the same product line for generations, and never engaged in strategic thinking. That enterprise would be out of business (or subsidized by the federal government).

It's something to think about.

Like Winne, I think it would be fine for USDA to use its existing authority to permit pilot innovations that would change the definition of "food" under SNAP to exclude sugar sweetened beverages such as soda. The New York City proposal was designed to appeal only to public health nutrition advocates and did not do well at building bridges with anti-hunger advocates.  Yet, I think both public interest traditions should support such a pilot.  The anti-hunger advocates say the proposal is stigmatizing, but I see no evidence that SNAP participants actually would mind.  Remember, low-income parents, just like all parents, work hard to choose healthy foods in a rough marketing environment, and they may find the restriction helpful as they discuss food and beverage choices with their children in the aisle of the grocery store.  Congress has to draw the line between "food" and "non-food" somewhere, and it makes sense for USDA to use pilot studies to help Congress figure out the best way to do so.  If the pilot finds that the proposed reform increases stigma, reduces program participation, or damages food security, the proposal should be dropped.  But, quite possibly, the opposite will happen.  Anti-hunger advocates may be stuck in the way things have always been, overlooking an opportunity that could be appealing to program participants and politically popular with the public at large.

I once interviewed Winne for this blog, shortly after he wrote his book, Closing the Food Gap.  Winne's new book is Food Rebels, Guerrilla Gardeners, and Smart Cookin’ Mamas.

High ethical standards in the supplement industry

Talking Points Memo and other media have been covering the many thousands of dollars in allegedly unreported gifts from dietary supplement industry executive Jonnie Williams to Virginia Governor Bob McDonnell and 2005 Republican gubernatorial candidate Jerry Kilgore.  Star Scientific, Williams' company, markets a product called "Anatabloc" for its supposed anti-inflammatory benefits.

Records maintained by The Virginia Public Access Project show that Star Scientific gave over $250,000 in campaign contributions in Virginia between 1999 and 2011. Much of that money went to McDonnell’s gubernatorial campaign and leadership PAC between 2009 and 2011. But the top recipient of Star Scientific donations during the 12 year period was actually Kilgore’s 2005 gubernatorial campaign. Star Scientific contributed $101,462 to the Kilgore campaign between 2002 and 2005. And Williams personally chipped in another $27,323. 

The FBI is investigating gifts from Jonnie Williams to McDonnell and members of his family in the growing scandal.

The Star Scientific website includes the usual supplement industry misdirection, hinting at medicinal effects while taking care not to state these claims in plain language.  For example, a news release hints at what disease Anatabloc's supposed anti-inflammatory properties could treat: "The company also reported positive results from a study conducted by researchers at the University of Virginia Medical School investigating the effects of anatabine in an animal model of idiopathic inflammatory bowel disease, ulcerative colitis."  If the company actually claimed to treat a medical condition or disease, FDA would require the company to prove safety and efficacy in human trials.  With mere hints, the company is not obliged to prove anything in human trials.  All of this is typical for supplement company websites.

The real gem of the Star Scientific website is the lovely "Code of Ethics."  It has delightfully specific warnings against seeking to influence government officials through gifts.

When working with government agencies and officials, we must know the regulations and policies governing our conduct. What is acceptable practice in the commercial market may violate strict rules and regulations in government interactions. In all our dealings with governments, our actions must comply with applicable laws and regulations. Do not offer or provide gifts, gratuities or political contributions or discuss employment opportunities with a government official. Even paying for a business meal is prohibited by some government policies. To prevent legal problems for ourselves or the Company, and because laws differ throughout the country, you should work closely with Star's General Counsel when dealing with the government.

Perhaps Jonnie Williams and other Star Scientific executives will pull this dusty old document out of the company files and give it a second read.

Recent activities of Dietitians for Professional Integrity

Andy Bellatti last month summarized in a column for Civil Eats the recent activities of Dietitians for Professional Integrity, an initiative to encourage the leading dietetics professional association, the Academy of Nutrition and Dietetics, to distance itself more clearly from its food and beverage industry sponsors.

For years, many of my colleagues and I have voiced our discontent that the professional organization that represents us takes money from and partners with the likes of Coca-Cola, PepsiCo, McDonald’s, and Hershey’s, supposedly to foster dialogue with the industry and help Americans get healthier. In reality, Big Food gets free press for feigning concern, while going about its usual business, and the registered dietitian credential gets dragged through the mud.

“Too often I’ve lost the trust of potential clients because, despite my rigorous education in nutrition, they only see the dietetics field as corrupted by big businesses,” says Matt Ruscigno, MPH, RD, one of Dietitians for Professional Integrity’s co-founders.

Over the past four months, Dietitians for Professional Integrity has shared many statements of concern from registered dietitians on its Facebook page, and helped raise awareness of Big Food’s influence on the Academy (from the world’s largest aspartame producer helping to fund the organization’s evidence analysis team on the artificial sweetener to Coca-Cola’s Academy-approved continuing education webinars which  teach dietitians that soda is unfairly vilified).

A key point is that Dietitians for Professional Integrity is not a "nanny state" initiative.  There are good reasons why it is sometimes difficult for government agencies to take strong public interest positions on key challenges to the healthfulness of the food and beverage industry.  Government institutions in a democracy frequently must represent the mainstream of public opinion.  They explicitly must be concerned both with public health and with encouraging a thriving economy.  When government agencies push too hard or are insufficiently deferential to individual preferences in guiding people toward healthy nutritional choices, the public worries about government overreach.

Because of these constraints on government activism, it is especially important that non-profit public interest organizations such as the Academy of Nutrition and Dietetics speak clearly, boldly, and without bias on the nutrition issues of the day.  I think Bellatti and Dietitians for Professional Integrity have a good point in encouraging this private-sector nutrition organization to be more independent from its corporate sponsors.  Sometimes, the Academy should have more courage to criticize food and beverage industry products and marketing practices that really do contribute to an unhealthy nutrition environment.

City Blossoms: urban gardens make people smile

My parents and I were inspired by our recent visit to City Blossoms near our old neighborhood in Washington, DC.  This series of urban gardens, including gardening programs for children and youth, was founded by Lola Bloom and our long-time family friend Rebecca Lemos-Otero when they were still in high school and college.

I see on the City Blossoms events page that they will host an upcoming dinner night on July 26, in partnership with Brainfood: A Recipe for Youth Development.  Brainfood is a DC food non-profit organization housed at my old childhood church, St. Stephen and the Incarnation, a pillar of community activism in the 16th Street corridor since the 1960s.

Photo: Margaret Wilde.  From l to r: Parke Wilde, Rebecca Lemos-Otero, Fernando Lemos.

An introduction to Food Policy in the United States

A second excerpt from the first chapter of Food Policy in the United States: An Introduction (Routledge/Earthscan), which was published in April.

This book offers an introduction to food policy in the United States. Food policy encompasses laws, regulations, decisions and actions by governments and other institutions that influence food production, distribution and consumption. While food policy is defined broadly, a food program is a more specific institution that provides or distributes food.

Food policy is intertwined with many of the fundamental economic and social decisions of the day. Will traditional farming in the United States disappear as an economically viable way of life? Can U.S. agriculture contribute to nourishing a growing world population without destroying the environment? What labor rights do farm workers have? Does globalization help or harm U.S. farmers and food consumers?  How can the safety of food be protected without imposing unnecessarily burdensome rules and regulations? What can be done about the epidemic of obesity and chronic disease? How can school lunches be improved? Why do some families go hungry in such a rich country?

U.S. food policy is an important topic for readers in the United States and also in other countries. The United States is the world’s largest exporter for some crops and a leading importer for others. The U.S. government position carries considerable weight in multinational policy decisions about globalization and international trade. Consumers around the world aspire to emulate some aspects of U.S. consumer culture, even as doubts arise about the nutritional merit and environmental sustainability of U.S. food consumption patterns. Some environmental constraints on U.S. agricultural production are local, but others are global. In these respects, the implications of U.S. food policy extend beyond national borders.

This book focuses on national-level food policy in the United States, but there are similarities with policy-making at other levels of government and in other institutions. Federalism refers to the division of authority between the national government and state and local governments. Policy innovations may be first attempted at the state and local level and later adopted at the federal level.

U.S. food policy is absorbing in part because it is dysfunctional. Just as other areas of politics in the United States suffer from partisanship and deep regional and cultural divisions, food policy can become mired down in bitter struggles across stagnant political lines in the sand. On topics ranging from genetically modified organisms (GMOs) to advertising that targets children, it can seem as if no policy actors have either changed their mind or persuaded an opponent in the past generation.

Faced with such challenges, it may be worthwhile to climb down from the ramparts and devote some time to reflection and study. To some extent, this book is a descendant of hefty agricultural policy textbooks such as traditionally were used in departments of agricultural economics in U.S. land-grant universities, but there are important differences. This book tackles both normative questions (about how decisions should be made) and positive questions (about how decisions actually are made) in U.S. food policy. Throughout the book, real-world policy struggles provide the contemporary hook to motivate the reader’s attention to the more specialized details of economic principles, policy analysis, institutional structures and data sources. The study of these more academic topics may pay off even for readers whose primary interest is the policy arena. The hope for this book is that these principles and data sources hold some promise for knocking loose the logjam in policy-making.

Why would anybody want to split the Farm Bill?

The Farm Bill traditionally is "omnibus" legislation, including an array of farm programs and nutrition assistance programs.  The largest Farm Bill program -- and the largest USDA program -- is the Supplemental Nutrition Assistance Program (SNAP), also known as food stamps.

The House of Representatives yesterday voted for a stand-alone Farm Bill with no food stamps.  Why on earth would they want to do that?

To make sense of this, one needs to look beyond traditional Democratic/Republican partisan politics and instead think about a four-way political cross-tabulation.