Wednesday, July 24, 2013

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.


Stacia C said...

This is an exciting outcome! Health Care Without Harm has been working with hospitals to implement healthy food and beverage pricing incentives internally in their retail environments as well as through employee wellness programs subsidizing CSA shares and farmers market purchases. This study will be key in showcasing the potential impact on food choices. Great work!

Anonymous said...

This is fantastic news. The implications are endless. The Health Bucks program, for example, has already rolled out in a few U.S. cities, especially New York City. The news will especially give insurance companies more reason to roll out health incentive programs; I understand Humana and Discovery South Africa have already studied such possibilities in South Africa.

Also - I've only recently discovered your blog and I'm hoping to stop by your page more often. I'm very impressed by the topics you choose! Thank you for sharing! said...

Hi Parke,

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Anonymous said...

Question: Is it known whether increasing the maximum SNAP benefit would affect fruit and vegetable purchase/consumption among SNAP recipients? It would be interesting to compare within the context of this study, whether doing so would have the same effect independent of an incentive-based system. Essentially participants in the HIP program have the opportunity to increase their benefits by $260 if they take full advantage of it (is that accurate?). That seems like a potentially expensive policy if implemented at full scale. Although probably politically less popular/feasible, would simply allotting participants more money (or even additional money earmarked for fruits and veggies) have the same effect at a potentially lower cost? Or is the incentive element seen as necessary from a behavioral economic perspective? said...

Hi Parke,

Healthline has just released their list of Best Weight Loss Apps for this year: Much like your blog, these apps were thoughtfully chosen by our editorial team. They were also medically reviewed by our in-house team. As a winner of our Best Blogs this year, we thought that you might be interested in sharing this list with your audience in hopes that they will find some of these apps useful. Thanks again for creating a wonderful resource for the Obesity community!


Alex Sten
Healthline Team