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U.S. Nutrition Assistance, 2018 — Modifying SNAP to Promote Population Health

Published: March 2017
Bibliographic reference: Sara N. Bleich, Ph.D., Eric B. Rimm, Sc.D., Kelly D. Brownell, Ph.D., U.S. Nutrition Assistance, 2018 — Modifying SNAP to Promote Population Health. N Engl J Med 2017; 376:1205-1207 DOI: 10.1056/NEJMp1613222.

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Expanding SNAP’s health emphasis would allow it to better address diet-related diseases that affect millions of low-income Americans. We believe the Farm Bill should continue to incorporate SNAP programs that promote public health. Congress could recommend and allocate funding for pilot programs that could prevent diet-related diseases and reduce government spending on health care for low-income families. At the same time, researchers should consider possible unintended consequences of any intervention and ways of attenuating them, as well as ways of minimizing the complexity of enrollment to make SNAP accessible to all in need.

The Supplemental Nutrition Assistance Program (SNAP) is the cornerstone of the nutrition safety net in the United States, helping 45 million low-income Americans — nearly half of them children — pay for food each month. SNAP is authorized by Congress through the Farm Bill, which also covers agricultural programs such as crop insurance and land-conservation measures. With an annual cost of $74 billion, the program accounts for roughly 80% of the spending authorized by the bill. As an entitlement program, SNAP is responsive to economic fluctuations — enrollment can expand rapidly when the economy weakens and shrink when it improves. SNAP is scheduled to be reauthorized in the 2018 Farm Bill, which will set U.S. food policy for the next 5 years and beyond. As Congress deliberates, it’s important to consider what changes to the program are feasible and also have the potential to improve population health. Above all, we believe SNAP should be protected — and, ideally, expanded, since its current benefits don’t allow most families to purchase adequate food to maintain a healthy diet.