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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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SUPPLEMENTAL
NUTRITION
ASSISTANCE
PROGRAM

Examining the Evidence to Define Benefit Adequacy

Committee on Examination of the Adequacy of Food Resources and
SNAP Allotments

Food and Nutrition Board
Committee on National Statistics

Julie A. Caswell and Ann L. Yaktine, Editors

INSTITUTE OF MEDICINE And
NATIONAL RESEARCH COUNCIL
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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THE NATIONAL ACADEMIES PRESS    500 Fifth Street, NW    Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by Contract No. USDA-AG-3198-G-11-0011, between the National Academy of Sciences and the U.S. Department of Agriculture, Food and Nutrition Service. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-26294-1
International Standard Book Number-10: 0-309-26294-1

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Copyright 2013 by the National Academy of Sciences. All rights reserved.

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Suggested citation: IOM (Institute of Medicine) and NRC (National Research Council). 2013. Supplemental Nutrition Assistance Program: Examining the evidence to define benefit adequacy. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

 

COMMITTEE ON EXAMINATION OF THE ADEQUACY
OF FOOD RESOURCES AND SNAP ALLOTMENTS

JULIE A. CASWELL (Chair), Professor, Department of Resource Economics, University of Massachusetts Amherst

SARA N. BLEICH, Assistant Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

NOEL CHAVEZ, Associate Professor, School of Public Health, University of Illinois at Chicago

JAMIE DOLLAHITE, Associate Professor, Division of Nutritional Sciences, Cornell University, Ithaca, New York

PHILIP GLEASON, Senior Fellow, Mathematica Policy Research, Geneva, New York

BARBARA A. LARAIA, Associate Professor, School of Public Health, University of California, Berkeley

SHEILA MAMMEN, Professor, Department of Resource Economics, University of Massachusetts Amherst

MARY K. MUTH, Director, Food and Nutrition Policy Research Program, RTI International, Research Triangle Park, North Carolina

BONNY O’NEIL, Retired, USDA Food and Nutrition Service, Alexandria, Virginia

DIANE W. SCHANZENBACH, Associate Professor, School of Education and Social Policy, Northwestern University, Evanston, Illinois

JAMES P. ZILIAK, Professor and Carol Martin Gatton Endowed Chair in Microeconomics, Department of Economics, University of Kentucky

IOM Staff

ANN L. YAKTINE, Study Director

JULIA HOGLUND, Research Associate

ANTON BANDY, Financial Officer

GERALDINE KENNEDO, Administrative Assistant

LINDA D. MEYERS, Director, Food and Nutrition Board

GOOLOO S. WUNDERLICH, Senior Program Officer (Committee on National Statistics)

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

 

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

MARIANNE P. BITLER, University of California, Irvine

GEORGE BRALEY, Retired, U.S. Department of Agriculture, Oakton, Virginia

GEORGE DAVIS, Virginia Polytechnic Institute and State University, Blacksburg

EDWARD FRONGILLO, University of South Carolina, Columbia

HILARY HOYNES, University of California, Davis

HELEN H. JENSEN, Iowa State University, Ames

JACOB KLERMAN, Abt Associates, Inc., Cambridge, Massachusetts

DARREN LUBOTSKY, University of Illinois at Urbana-Champaign

SUZANNE P. MURPHY, University of Hawaii at Manoa

HILARY K. SELIGMAN, University of California, San Francisco

VALERIE TARASUK, University of Toronto, Ontario

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the report’s conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by NANCY E. ADLER, University of California, San Francisco, and JOHANNA DWYER, Office of Disease Prevention, National Institutes of Health. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

 

Preface

The Supplemental Nutrition Assistance Program (SNAP) touches the lives of millions of people in the United States in good and particularly in bad economic times. Over the last decade participation in the program has increased from less than 20 million to 46 million in 2012 in the wake of the post-2008 recession. As administered by the U.S. Department of Agriculture’s Food and Nutrition Service (USDA-FNS), SNAP is intended to supplement the ability of individuals and households to purchase food for consumption at home with a benefit allotment that is delivered to them most commonly in the form of Electronic Benefit Cards that they can spend in food stores. With one in seven people in the United States currently receiving SNAP benefits, an assessment of the science and evidence base for defining adequate allotments is important to the well-being of these participants, as well as to the functioning of the program.

Two intertwined aspects of SNAP allotments affect the definition of an adequate benefit that supports the opportunity for participants to attain the program goals of food security and access to a healthy diet. First, a SNAP allotment may be more or less adequate for any given participant or household, depending on their circumstances. Does a particular participant have sufficient time to shop for and prepare nutritious meals, particularly from basic ingredients? How are the time and cost entailed in preparing meals affected by store availability, transportation, and the prices of foods in the participant’s shopping area? How does a participant’s nutrition knowledge and budgeting skills affect the definition of adequacy? Second, the program’s formula for calculating the dollar amount of the SNAP allotment itself directly affects adequacy. For example, does the formula

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
×

account realistically for participants’ ability to devote their own income to food purchases?

The circumstances in which foods are purchased and prepared and the food budget, including the SNAP benefit, are intertwined because they both are constraints on the opportunity of a SNAP individual or household to attain the outcomes of food security and access to a healthy diet. The definition of adequacy of SNAP allotments must weigh the importance of both aspects in affecting these outcomes. The committee members’ reasoned assessment about the evidence on these two aspects resulted in its focus on defining adequacy based on individual, household, and environmental factors, as well as program factors; instituting systems to monitor the program outcomes of food security and access to a healthy diet over time, as well as to facilitate future adjustments to the definition of adequacy; and conducting research on the impacts on adequacy of nutrition knowledge and buying skills and access to retail outlets.

The day-to-day diets of millions of people in the United States are supported by the SNAP program; its impact is particularly prominent in periods of economic downturn. The committee offers its recommendations for defining and monitoring SNAP benefit allotment adequacy based on its review and analysis of a broad range of evidence, with the goal of providing USDA-FNS with a road map to establish an objective definition of the adequacy of SNAP allotments and to assist with identification of data requirements to support that effort. Ultimately this effort is aimed at providing SNAP participants with greater opportunities to become more food secure and to have access to a healthy diet.

I am deeply appreciative of the dedication and effort of the 10 committee members who worked together over a short period of time from January to December 2012 to evaluate the evidence on the multiple factors that may be important in defining the adequacy of SNAP allotments. We received outstanding support in our work from Ann Yaktine, study director. I thank her for her knowledge, skill, and tireless care devoted to this project. As research associate, Julia Hoglund provided excellent scientific support to the project. Geraldine Kennedo served as administrative assistant with efficiency and warmth. I also appreciate the consultation provided by Gooloo Wunderlich, senior program officer with the Committee on National Statistics. Finally, I thank Linda Meyers, director of the Food and Nutrition Board of the Institute of Medicine, for her wisdom in guiding the project.

Julie A. Caswell, Chair                                  
Committee on Examination of the Adequacy
of Food Resources and SNAP Allotments    

Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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Suggested Citation:"Front Matter." Institute of Medicine and National Research Council. 2013. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy. Washington, DC: The National Academies Press. doi: 10.17226/13485.
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For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families.

In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments.

Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.

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