01/25/2013 10:14 am ET Updated Mar 27, 2013

SNAP to It: Why We Need Changes to Food Assistance

In 2011, the United States spent upwards of $75 billion -- more than the amount allocated for all other food assistance programs combined -- for the Supplemental Food Assistance Program, colloquially known as food stamps. More than 44 million Americans use food stamps (an increase over the historical average due to the recent recession), and nearly half of those are children.

Estimates show that while 15 percent of Americans are food insecure, over 35 perecnt are obese--and there is much overlap in those categories. These numbers represent the changing face of food insecurity in America. Food insecurity historically referred to those who could not get enough calories, and that is what the food stamps program was originally created to combat. There is no question that this type hunger in America is still an issue, but the more prevalent problem now is that while many families have access to enough calories--due to the comparatively lower cost of less nutritious food--they do not have near enough access to calories of a high quality.

Low-income families are more likely to purchase soft drinks, they are more likely to be overweight, and they are more likely to suffer from chronic diseases like diabetes. Consequently, seven times as many children from low-income families are overweight than underweight. Having access to high-quality food is vitally important for children in particular: they need adequate amounts of vitamins and minerals and healthy macronutrients in order to properly develop physically and mentally. This change in food insecurity deserves a corresponding change in SNAP, which needs adjusting to appropriately and effectively help these populations.

Many groups are coming out in favor of changes to SNAP, including the three medical doctors David Ludwig, Susan Blumenthal and Walter Willett, who recently published an essay in the Journal of the American Medical Association advocating for the restructuring of SNAP. As they point out, the image of food insecurity now is an overweight child with a low-quality diet, and SNAP should be changed to reflect that.

One popular proposed solution for changing SNAP is eliminating sugar-sweetened beverages from the eligible foods list. Restricting what can and cannot be bought is commonplace for many other federal food assistance programs, including the National School Breakfast Program, the National School Lunch Program, and most notably, WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children). The WIC food packages were recently redesigned to better emulate the federal dietary guidelines, and research recently published in Obesity shows that for New York WIC children in the two years since the change, the obesity rate declined six percent in children aged one to two and declined nearly three percent in children aged two to four. Children also increased their intake of fruits, vegetables, and whole grains.

So why hasn't this happened yet with SNAP? The idea of restriction is not new to SNAP: the ineligible list includes alcohol and prepared foods in addition to vitamins and non-food products. However, many are afraid that any changes to SNAP will challenge its funding. Though that assumption may be unfounded, considering the House Republicans advocated for deep cuts, to the tune of $16 billion over 10 years, last summer without any changes. If SNAP benefits are going to be cut regardless, we should be concentrating the benefits on the foods that are most suited to improving nutritional stats. Also, many people have not had enough exposure to the aforementioned new image of food insecurity in America. We no longer need to prioritize all calories -- we should be focusing on healthier ones.

There are also prevailing concerns regarding the ethics of restricting choice for lower-income groups and creating an exclusion that will target them. Dr. Anne Barnhill did a fantastic job studying these concerns in a 2011 article published in the American Journal of Public Health. Bottom line: shouldn't the most important thing be that SNAP is doing whatever it can to fulfill its mission? Decreasing hunger and improving health and nutrition for low-income people is the mission of SNAP. By including sodas on the eligible foods list, they are failing on both accounts. As many have pointed out, 200 calories of soda is far less satiating than 200 calories of a healthier snack, and the deleterious health effects of sugar-sweetened beverages have been well-publicized.

Some critics of these reforms, including the USDA itself, also claim that such changes may be too complicated and too costly. The issue of prevention versus treatment is a big one in this country, and SNAP is a perfect example. SNAP participants use their benefits to purchase $4 billion worth of soda, so why are we funding that and paying for the consequences in health care costs instead of focusing more on prevention? If we continue on trend and fail to adequately assist these families, imagine the future costs to the economy due to the weight problems of their children.

Many people are also proposing less "controversial" solutions, such as increasing the purchasing power of food stamps when they're being used for healthy foods, advocating the use of food stamps at farmers' markets, and increasing nutrition education in these groups. These and similar ideas are currently being tested in small populations, but the only way we can begin to find out how these tactics compare to a more direct intervention of restricting sugar-sweetened beverages (and what drawbacks will arise with such an intervention) is by conducting pilot studies, which require USDA approval -- and a recent petition by New York was denied.

USDA: SNAP to it.