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The Boston Globe-Food stamp discount for buying produce
August 19, 2010
By Patrick G Lee
More than two dozen cities and towns in Western Massachusetts will be the focus of a major federal initiative being announced today to increase low-income families’ consumption of fruits and vegetables, as part of the nation’s efforts to combat obesity.
The Agriculture Department awarded $20 million to Massachusetts and a Cambridge-based research firm to test whether providing subsidies for buying produce will encourage food stamp recipients in Hampden County communities — including Springfield, Chicopee, and Holyoke — to eat more nutritious meals.
Of the 50,000 households in Hampden County that rely on food stamps, several thousand will be offered a 30-cent discount for every dollar spent on fresh fruits and vegetables, while other families will continue to pay full price. Households will be tracked for 15 months to see whether their eating habits change and health outcomes, including obesity rates, improve. State officials hope to begin the program in fall 2011.
The experiment, authorized by the 2008 Farm Bill, will guide policy makers in Washington as they consider how to revamp food stamps, now known as the Supplemental Nutrition Assistance Program, to promote better dietary habits among Americans.
“It’s one of the largest in the history of the Food and Nutrition Service, not only in terms of the size of the pilot, but the rigor associated with the evaluation,’’ Kevin Concannon, the Agriculture Department’s undersecretary for food, nutrition, and consumer services, said in an interview yesterday. “We have a lot of information on nutrition, we have a lot of information on health, but we have a lot less information on what influences behavior.’’
The grant announcement follows a flurry of more limited local and state programs to ramp up fruit and vegetable purchases among low-income residents. These include Boston Bounty Bucks, which offers discounts for residents who buy produce at farmers’ markets with food stamps, and doctor-provided “prescriptions,’’ which are actually coupons that can be redeemed at farmers’ markets for fruits and vegetables.
The new initiative is more sweeping, involving far more people and a rigorous methodology for measuring the impact of financial incentives on food consumption.
By drawing on a large, randomly selected sample in Hampden County, researchers will be able to control for variations in income, race, and age so as to isolate the influence of the 30-cent subsidy on families’ food choices, said Steve Carlson, a program specialist with the Agriculture Department.
Financial incentives are important for bringing about lasting changes in behavior, but the key to their success will be whether the discount is large enough to make healthy food as affordable as junk food, said Dr. David Ludwig, director of the Optimal Weight for Life program at Children’s Hospital Boston.
The pilot program will help “remove the paradox that low-income people who suffer most from obesity and related illnesses are least able to afford the cure, which is nutritious food,’’ he said. “If low-income populations simply can’t afford nutritious foods, then behavior modification will not solve the problem.’’
The state and federal governments have focused on making the purchase of subsidized produce through the program as seamless as possible: The regular prices will show up on the cash register receipt, but the discount will be immediately credited back to the customer’s food stamp debit card.
This might not be ideal, said Dr. Kevin Volpp, director of the Center for Health Incentives at the University of Pennsylvania. Incentives work best when they are immediate and “as visible as possible,’’ he said. “That’s probably the part I worry about most. Instead of taking $20 off my card, now I’m taking $14 — is that going to be noticeable?’’
Volpp suggests that the distribution of a discount coupon for future fruit and vegetable purchases might be a more effective way to influence behavior and increase consumption of healthy foods.
And even if the 30-cent discount does succeed in increasing produce consumption relative to those who pay normal prices, the government will need to fund future studies to see whether other types of financial incentives change behavior more efficiently, Volpp said.
Even so, state officials said they are astounded and honored to have received the multimillion dollar grant authorized by Congress two years ago.
“Even when low-income people receive assistance for food, processed foods are less expensive,’’ said Julia Kehoe, state commissioner of the Department of Transitional Assistance, which administers the SNAP program. “What this is doing is leveling the playing field for low-income folks, so that a healthier diet is within their reach.’’
About half the grant will go to Abt Associates Inc., a consulting company that will conduct three surveys during the research period to determine whether the produce consumption of those receiving the subsidy is markedly different from that of other families.
Up to $4 million could go toward the subsidies and about $6 million will go toward equipment and administrative costs.
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