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

  • Why medical organizations must end their silence

    Marilyn Uzdavines, JD & Vijay Rajput, MD
  • The flaw in the ACA’s physician ownership ban

    Luis Tumialán, MD
  • The paradox of primary care and value-based reform

    Troyen A. Brennan, MD, MPH
  • a desk with keyboard and ipad with the kevinmd logo

    Deaths in custody highlight crisis in Philly prisons

    Kendall Major, MD, Tommy Gautier, MD, Alyssa Lambrecht, DO, and Elle Saine, MD
  • South Carolina’s CON repeal: an opportunity for doctors

    Marcelo Hochman, MD
  • Why ACA subsidies aren’t the main issue

    Andrew Murphy, MD
  • Most Popular

  • Past Week

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • The paradox of primary care and value-based reform

      Troyen A. Brennan, MD, MPH | Policy
    • Why CPT coding ambiguity harms doctors

      Muhamad Aly Rifai, MD | Physician
    • Escaping the trap of false urgency [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • A neurosurgeon’s fight with the state medical board [PODCAST]

      The Podcast by KevinMD | Podcast
  • Recent Posts

    • Why do doctors lose their why?

      Tomi Mitchell, MD | Physician
    • Bureaucratic evil in modern health care

      Dr. Bryan Theunissen | Patient
    • Protecting elder clinicians from violence

      Gerald Kuo | Conditions
    • Why does lipoprotein(a) exist?

      Larry Kaskel, MD | Conditions
    • The myth of endless availability in medicine

      Emmanuel Chilengwe | Conditions
    • China’s health care model of scale and speed

      Myriam Diabangouaya, MD & Vikram Madireddy, MD | Physician

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

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • The paradox of primary care and value-based reform

      Troyen A. Brennan, MD, MPH | Policy
    • Why CPT coding ambiguity harms doctors

      Muhamad Aly Rifai, MD | Physician
    • Escaping the trap of false urgency [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The dangerous racial bias in dermatology AI

      Alex Siauw | Tech
    • When language barriers become a medical emergency

      Monzur Morshed, MD and Kaysan Morshed | Physician
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • A neurosurgeon’s fight with the state medical board [PODCAST]

      The Podcast by KevinMD | Podcast
  • Recent Posts

    • Why do doctors lose their why?

      Tomi Mitchell, MD | Physician
    • Bureaucratic evil in modern health care

      Dr. Bryan Theunissen | Patient
    • Protecting elder clinicians from violence

      Gerald Kuo | Conditions
    • Why does lipoprotein(a) exist?

      Larry Kaskel, MD | Conditions
    • The myth of endless availability in medicine

      Emmanuel Chilengwe | Conditions
    • China’s health care model of scale and speed

      Myriam Diabangouaya, MD & Vikram Madireddy, MD | Physician

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...