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To determine public attitudes towards federal spending on nutrition assistance programs and support for policies to improve nutritional impact of the Supplemental Nutrition Assistance Program (SNAP).
Participants answered survey questions by telephone assessing support for SNAP spending and proposed program policy changes.
Survey of 3,024 adults selected by random digit dialing conducted in April 2012, including 418 SNAP participants.
A majority (77%; 95% CI: 75, 79) of all respondents supported maintaining or increasing SNAP benefits, with higher support among Democrats (88%; 95% CI: 86, 90) than Republicans (61%; 95% CI: 58, 65). The public supported policies to improve the nutritional impact of SNAP. 82% (95% CI: 80, 84) of respondents supported providing additional benefits to program participants that can only be used on healthful foods. 69% (95% CI: 67, 71) of respondents supported removing SNAP benefits for sugary drinks. A majority of SNAP participants (54%; 95% CI: 48, 60) supported removing SNAP benefits for sugary drinks. Of the 46% (95% CI: 40, 52) of SNAP participants who initially opposed removing sugary drinks, 45% (95% CI: 36, 54) supported removing SNAP benefits for sugary drinks if the policy also included additional benefits to purchase healthful foods.
The U.S. public broadly supports increasing or maintaining spending on SNAP. The majority of respondents, including SNAP participants, supported policies to improve the nutritional impact of SNAP by restricting the purchase of sugary drinks and incentivizing purchase of healthful foods with SNAP benefits.
Facing ongoing national fiscal budgetary challenges, policymakers in the U.S. are debating whether to cut spending on federal nutrition assistance programs, including the Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp Program.(1, 2) Simultaneously, the public health community is urgently seeking policy solutions to the obesity epidemic with the potential to both improve population health and reduce future obesity-related medical expenditures.(3)
In December 2011, a record 46.5 million people, or approximately 1 in 7 Americans, participated in SNAP.(4) With a budget of $75 billion in 2011, SNAP is the largest of the 15 federal nutrition assistance programs. SNAP aims to alleviate hunger and improve the health of low-income individuals by providing resources to purchase food.(5) As one of the major federal anti-poverty programs, SNAP has provided a critical buffer against poverty for millions of adults and children.(6) Despite the program’s success at reducing hunger and poverty, few efforts have been undertaken to leverage spending on SNAP to improve the health of program participants. Recent evidence-based nutrition updates to the National School Lunch Program and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) demonstrate the potential for aligning SNAP benefits with the Dietary Guidelines for Americans.(3, 7, 8)
A range of policies aimed at improving the nutritional impact of SNAP have been proposed or piloted, including incentivizing SNAP participants to purchase healthful foods such as fruits and vegetables, increasing the amount of SNAP benefits per household, limiting the use of SNAP benefits for unhealthful foods such as sugar-sweetened beverages (SSBs) or sugary drinks, and increasing nutrition education efforts targeting SNAP participants.(3, 8–10) In 2011, the USDA rejected a request from New York City (NYC) to pilot test removing sugar-sweetened beverages from the products SNAP participants could purchase using benefit dollars.(11) The USDA noted potential stigmatization of SNAP participants as one of the reasons why it rejected the proposal. However, support for the proposal among SNAP participants was not assessed as part of the agency’s review process in making the decision.
To inform the ongoing SNAP policy debate, we assessed the opinion of a representative sample of U.S. adults, including SNAP participants, regarding federal spending on SNAP and on policy proposals to improve the nutritional impact of SNAP.
Data are from a four-question survey added to an ongoing weekly Harris Interactive poll by researchers at the [name of institution removed for blinding] assessing attitudes regarding support for federal spending on nutrition assistance and farming programs as well as support for policies to improve the nutritional impact of SNAP (Appendix). Harris Interactive conducted the random digit dialed telephone survey as part of the weekly Harris Poll National Quorum omnibus survey within the United States between April 12 and 22, 2012, among 3,024 adults (aged 18 and over), including 418 adults who reported that their household had received SNAP benefits in the previous 12 months. This survey was conducted over three waves with ~1,000 respondents each wave on April 12–15, April 13–16, and April 19–22. Cooperation and response rates in the Harris Poll National Quorum are not reported for every wave fielded, but the poll had an average cooperation rate of 36% and an average response rate of 5% during this period computed according to the American Association for Public Opinion Research (AAPOR) standard definitions for cooperation (COOP3) and response (RR3) rates, assuming 31% of telephone numbers with unknown eligibility would be eligible based on recent research.(12, 13) According to AAPOR, the cooperation rate is the number of complete interviews divided by all eligible households contacted, whereas the response rate is the number of complete interviews divided by all eligible households in the sample.
Survey responses were weighted for age, sex, race/ethnicity, education, region, number of adults in the household, number of phone lines in the household where necessary to bring them into line with their actual proportions in the population. Although response rates to telephone surveys have declined in recent years, independent studies have found that weighted results from shorter duration telephone surveys are similar to results from surveys with longer duration and higher response rates.(13–15) In addition to possible non-response bias and sampling error, variation in responses may occur due to question wording or order when compared to other surveys.
Demographic variation in support for SNAP spending and support for SNAP nutrition policy proposals is presented based on weighted and un-weighted responses with 95% confidence intervals (CI) based on weighted data. There were no qualitative differences between weighted and un-weighted results. Differences in the proportion of respondents supporting SNAP spending and nutrition policy proposals by demographics were tested for significance adjusting for survey weighting using the Rao-Scott Chi-Square test. Data were analyzed using the PROC SURVEYFREQ statement in the SAS® statistical software package version 9.3 (SAS Institute Inc., Cary, NC, USA).
Seventy-seven percent of the public believed that federal spending on SNAP should be increased (48%) or maintained (29%) (Table 1). Only 21% of the public believed that federal spending on SNAP should be decreased. Among other factors, support varied significantly by political party identification (p < 0.001); 88% of Democrats believed that federal spending should be increased or maintained compared to 81% of Independents and 61% of Republicans. The majority of respondents supported increasing or maintaining spending on SNAP across all sociodemographic subgroups measured.
Support for proposed policies to improve the nutritional impact of SNAP was also high across political party identification and SNAP participation status (Table 2). Of the four policies proposed, respondents were most supportive of a proposal to provide “… additional money to SNAP (Food Stamp) participants that can only be used on fruits, vegetables, or other healthful foods.” Eighty-two percent of all respondents supported this proposal, including 87% of Democrats and 76% of Republicans. SNAP participants also supported this proposal (86%) more than any of the other four policies proposed. While still supported by the majority of respondents, support was lowest (65%) for a proposal to provide SNAP participants “… more food stamp dollars to guarantee that they can afford a healthy diet.” This proposal to increase SNAP benefit levels had the largest gap in support across political party identification, with only 49% of Republicans who supported the proposal compared to 77% of Democrats.
The proposal to remove “sugary drinks (such as soda) from the list of products that can be purchased using SNAP (or Food Stamp) benefits,” was supported by 69% of all respondents with no gap in support between Republicans (70%) and Democrats (69%). A majority of SNAP participants (54%) supported removing sugary drinks from SNAP benefits. Respondents who did not support removing sugary drinks from SNAP benefits were asked whether they would support removing sugary drinks if the proposal was combined with a policy that would provide additional money to purchase fruits, vegetables and other healthy foods. Of the 46% of SNAP participants who initially did not support removing sugary drinks (n = 181), 45% (95% CI: 36, 54) supported removing sugary drinks if the policy also included additional benefits to purchase healthful foods (data not shown in table).
As Congress debates changes to SNAP and other components of U.S. farm and nutrition policy, this nationally-representative survey found widespread public support for increased or maintained federal spending on SNAP. These results are very consistent with a survey conducted for the Food Research and Action Center in January 2012, which similarly found that 77% percent of U.S. adults did not support cutting federal spending on SNAP as a way to reduce government spending.(16) A June 2012 survey conducted for the National Journal also found that a majority (62%) of respondents supported increasing or keeping SNAP spending the same.(17) As research from the USDA has recently shown, SNAP provides a critical buffer against the experience of severe poverty, particularly for children.(6)
In addition to confirming public support for maintaining SNAP benefits identified in previous surveys, the broad public support for removing sugary drinks from SNAP benefits identified in this study highlights the need for a more comprehensive debate about the current ability of SNAP to fulfill its mandate to, “provide for improved levels of nutrition among low-income households.”(18) Although a recent Institute of Medicine (IOM) report emphasized that improving the nutritional impact of SNAP is an essential component of a national strategy addressing the obesity epidemic due to the program’s scale, reach, and level of federal investment in the program, the IOM committee concluded that in addition to practical considerations, “… limiting food choices for SNAP recipients may be viewed as patronizing and discriminatory to low-income consumers.”(3) Similar concerns regarding potential stigmatization of SNAP participants were raised in the USDA’s rejection of the request from New York City to pilot test removing sugary drinks from SNAP benefits.(11) However, a 2011 in-person survey of 498 SNAP participants and applicants in New York City found that 49% supported New York City’s proposal to remove SNAP benefits for purchasing sugary drinks, compared to 16% who did not care and 35% who did not support the proposal.(19) The current study is the first national survey of whether SNAP participants would support removing SNAP benefits for the purchase of sugary drinks. In contrast to concerns over patronizing SNAP participants and in line with findings from New York City, over half of SNAP participants surveyed in this study supported the proposal. The percent rises to three-quarters of SNAP participants supporting removing sugary drinks from benefits if the policy also included incentives to purchase healthful foods.
While the USDA rejected NYC’s request to evaluate the impact of removing sugary drinks from SNAP benefits, it is currently running a small $20 million pilot program testing the impact of incentivizing the purchase of fruits and vegetables in SNAP.(10) Consistent public approval for incentivizing SNAP fruit and vegetable purchases across political parties and SNAP participation status supports increased investment in evaluation of this strategy. Additionally, given the demonstrated negative health impact of sugary drinks(20) and public support identified in this study, policymakers should consider a pilot program that both incentivizes healthful SNAP purchases such as fruits and vegetables and removes sugary drinks from the list of products that can be purchased with SNAP benefits.
This study provides decision-makers with a clear statement of public support for continued federal investment in preventing hunger and severe poverty through the SNAP program. As decision-makers seek to improve the effectiveness and impact of federal spending, the findings from this study also document widespread support for policy proposals to align investments in SNAP with the broader goal of improving the health of Americans.
This study received funding from the Harvard School of Public Health Department of Nutrition and from a gift from the Cabot Foundation. M.W.L. was supported by the Barry R. and Irene Telenius Bloom Fellowship and the Bernard and Gloria Salick Fellowship. C.W.L. was supported by a National Institutes of Health training grant (5 T32 CA009001–35). The study protocol was reviewed and determined to be Not Human Subjects Research by the Harvard School of Public Health Institutional Review Board. The authors report no conflicts of interest. The authors would like to thank the reviewers for their comments as well as Robert Blendon and Gillian SteelFisher for their advice throughout the project.
Survey developed by the [name of institution removed for blinding]. Random digit dialed landline-only telephone survey of 3,024 adults aged 18 years or older conducted by Harris Interactive in three waves fielded April 12–15, April 13–16, and April 19–22.
Q1 Congress is currently debating support for farming and nutrition assistance programs included in the federal budget. I’m going to read some nutrition and farm assistance programs and for each one, I’d like you to tell me whether you think spending on that program should be increased a lot, increased a little, kept the same, decreased a little or decreased a lot. [READ EACH ITEM – should spending on this program be increased a lot, increased a little, kept the same, decreased a little or decreased a lot?]
(1–6 below read in random order)
Q2 How much do you agree or disagree that participants in the SNAP or Food Stamp program use their SNAP benefits to purchase healthy foods? Do you strongly agree, somewhat agree, somewhat disagree or strongly disagree?
Q3 Please tell me how much you would support or oppose the following SNAP (or Food Stamp) program policies to improve participants’ diets. [READ EACH ITEM – do you strongly support, somewhat support, somewhat oppose or strongly oppose this policy?]
(1–4 Below read in random order)
Q4 During the past twelve months, have you or a member of your immediate family received benefits from the SNAP (or Food Stamp) program?