Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What if people were only allowed to use food assistance dollars to buy healthy food?

Peter Ubel, MD
Policy
December 15, 2019
Share
Tweet
Share

One of my elderly relatives was in line at the grocery store one day and saw the person ahead of him, charging what looked like a cart full of junk food to her food assistance card. My relative was incensed: Why, should his hard-earned tax dollars be used to pay for someone’s Cheetos?

Currently, one in seven Americans receives some kind of government assistance to pay for food. The largest such program – called SNAP for “supplemental nutrition assistance program” – subsidizes a wide range of food purchases. No alcohol or tobacco, mind you, but as many Cheetos, Pepsi-colas, and hot dogs as a person can fit within their budget. Subsidizing such unhealthy foods is politically controversial, raising the question: What would happen if people were only allowed to use SNAP dollars to buy healthy food?

An important study out of Stanford and the University of California, San Francisco, set out to answer this question. The study tested two programmatic changes to food assistance.

1. For half the people in the study, their food assistance dollars could only be used to buy fruits and vegetables.

2. For half the people, the assistance money became available in full every month, whereas the other half, a quarter of their money became available every week.

The idea behind monthly versus weekly allotments of money comes out of behavioral economics. People getting a monthly lump sum may spend all that money quickly, forcing themselves to have limited money remaining at the end of the month. This kind of feast and famine cycle is bad for people’s health. It also encourages people to splurge on calorie-dense and unhealthy foods when they finally get their monthly funds, to make up for all the calories they’ve gone without at the end of the previous month. Weekly (versus monthly) funds may also promote fruit and vegetable purchases, because those products often have a short shelf life.

The researchers thought was that weekly funds would increase the number of fruits and vegetables that people bought.

The reality was that nothing changed. Zilch. Nada. Six months into the intervention, fruit and vegetable purchasing was unchanged.

Moreover, the group that was only allowed to buy healthy foods with their assistance dollars didn’t buy any more healthy foods than anyone else. They just used their own money to buy unhealthy foods and subsidy money to buy healthy ones. Those given more freedom to use the assistance dollars any way they wanted bought just as many healthy and unhealthy foods. Money is fungible, after all. And no one can stop people from buying unhealthy food with their own money.

I don’t want to say that food assistance didn’t do any good. It dramatically reduces people’s food insecurity. Receiving monthly or weekly food assistance is enormously helpful to people. Being able to buy health or unhealthy food with such money is beneficial.

Nevertheless, these programmatic changes failed to encourage people to buy healthier food. Why did it fail? I have a few ideas.

1. Habits are hard to change. I have a handful of “go-to meals” I can cook without effort or without making a separate trip to the grocery store. People in the study probably stuck with their go-tos, too.

2. Money is fungible. People who receive food assistance typically spend some of their own money on food, too. Only allow people to spend assistance dollars on fruits and vegetables, and they’ll simply shift which items they purchase with their own money.

ADVERTISEMENT

3. We might be a bit obsessed with fruits and vegetables. Maybe reducing food insecurity is enough of an accomplishment. No one should worry whether they have enough money to pay for their next meal.

Peter Ubel is a physician and behavioral scientist who blogs at his self-titled site, Peter Ubel and can be reached on Twitter @PeterUbel. He is the author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together. This article originally appeared in Forbes.

Image credit: Shutterstock.com

Prev

Stop FGM: female genital massacre

December 15, 2019 Kevin 2
…
Next

We need physicians who advocate for patients' best interests

December 16, 2019 Kevin 2
…

Tagged as: Nutrition, Primary Care

Post navigation

< Previous Post
Stop FGM: female genital massacre
Next Post >
We need physicians who advocate for patients' best interests

ADVERTISEMENT

More by Peter Ubel, MD

  • Clinicians shouldn’t be punished for taking care of needy populations

    Peter Ubel, MD
  • Patients alone cannot combat high health care prices

    Peter Ubel, MD
  • Is the FDA too slow to handle the pandemic?

    Peter Ubel, MD

Related Posts

  • When celebrities attack children with food allergies

    Lianne Mandelbaum, PT
  • Beware of food sensitivity tests on Facebook

    Roy Benaroch, MD
  • Advocating for people with disabilities: People First Language

    Leonard Wang
  • Food allergies are frightening, not funny

    Lianne Mandelbaum, PT
  • How a food blog paid for medical school tuition

    Monica Bravo
  • The Buffalo mass shooting and food deserts

    Divya Srinivasan and Tejas Sekhar

More in Policy

  • How the One Big Beautiful Bill could reshape your medical career

    Kara Pepper, MD
  • Why the U.S. Preventive Services Task Force is essential to saving lives

    J. Leonard Lichtenfeld, MD
  • Brooklyn hepatitis C cluster reveals hidden dangers in outpatient clinics

    Don Weiss, MD, MPH
  • Why nearly 800 U.S. hospitals are at risk of shutting down

    Harry Severance, MD
  • Innovation is moving too fast for health care workers to catch up

    Tiffiny Black, DM, MPA, MBA
  • How pediatricians can address the health problems raised in the MAHA child health report

    Joseph Barrocas, MD
  • Most Popular

  • Past Week

    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Focusing on well-being versus wellness: What it means for physicians (and their patients)

      Kim Downey, PT & Nikolai Blinow & Tonya Caylor, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • How to balance clinical duties with building a startup

      Arlen Meyers, MD, MBA | Physician
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Could ECMO change where we die and how our organs are donated?

      Deepak Gupta, MD | Conditions
    • Every medication error is a system failure, not a personal flaw

      Muhammad Abdullah Khan | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 31 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • Why medical notes have become billing scripts instead of patient stories

      Sriman Swarup, MD, MBA | Tech
    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Focusing on well-being versus wellness: What it means for physicians (and their patients)

      Kim Downey, PT & Nikolai Blinow & Tonya Caylor, MD | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • New student loan caps could shut low-income students out of medicine

      Tom Phan, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • Doctors reclaiming their humanity in a broken system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Guilty until proven innocent? My experience with a state medical board.

      Jeffrey Hatef, Jr., MD | Physician
    • How to balance clinical duties with building a startup

      Arlen Meyers, MD, MBA | Physician
    • When life makes you depend on Depends

      Francisco M. Torres, MD | Physician
    • Could ECMO change where we die and how our organs are donated?

      Deepak Gupta, MD | Conditions
    • Every medication error is a system failure, not a personal flaw

      Muhammad Abdullah Khan | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What if people were only allowed to use food assistance dollars to buy healthy food?
31 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...