“Now I Feel a Little Bit More Secure”: The Impact of SNAP Enrollment on Older Adult SSI Recipients

In June 2019, California expanded Supplemental Nutrition Assistance Program (SNAP) eligibility to Supplemental Security Income (SSI) beneficiaries for the first time. This research assesses the experience and impact of new SNAP enrollment among older adult SSI recipients, a population characterized by social and economic precarity. We conducted semi-structured, in-depth interviews with 20 SNAP participants to explore their experiences with new SNAP benefits. Following initial coding, member-check groups allowed for participants to provide feedback on preliminary data analysis. Findings demonstrate that SNAP enrollment improved participants’ access to nutritious foods of their choice, contributed to overall budgets, eased mental distress resulting from poverty, and reduced labor spent accessing food. For some participants, SNAP benefit amounts were too low to make any noticeable impact. For many participants, SNAP receipt was associated with stigma, which some considered to be a social “cost” of poverty. Increased benefit may be derived from pairing SNAP with other public benefits. Together, the impacts of and barriers to effective use of SNAP benefits gleaned from this study deepen our understanding of individual- and neighborhood-level factors driving health inequities among low-income, disabled people experiencing food insecurity and SNAP recipients.

The impact of financial incentives and restrictions on cyclical food expenditures among low-income households receiving nutrition assistance: a randomized controlled trial

Background The Supplemental Nutrition Assistance Program (SNAP) is the largest anti-hunger program in the United States. Two proposed interventions to encourage healthier food expenditures among SNAP participants have generated significant debate: financial incentives for fruits and vegetables, and restrictions on foods high in added sugar. To date, however, no study has assessed the impact of these interventions on the benefit cycle, a pattern of rapid depletion of SNAP benefits that has been linked to worsening nutrition and health outcomes over the benefit month. Methods Low-income households not currently enrolled in SNAP (n = 249) received benefits every 4 weeks for 12 weeks on a study-specific benefit card. Households were randomized to one of four study arms: 1) incentive (30% incentive for fruits and vegetables purchased with study benefits), 2) restriction (not allowed to buy sugar-sweetened beverages, sweet baked goods, or candy using study benefits), 3) incentive plus restriction, or 4) control (no incentive or restriction). Weekly household food expenditures were evaluated using generalized estimating equations. Results Compared to the control group, financial incentives increased fruit and vegetable purchases, but only in the first 2 weeks after benefit disbursement. Restrictions decreased expenditures on foods high in added sugar throughout the benefit month, but the magnitude of the impact decreased as the month progressed. Notably, restrictions mitigated cyclical expenditures. Conclusions Policies to improve nutrition outcomes among SNAP participants should consider including targeted interventions in the second half of the month to address the benefit cycle and attendant nutrition outcomes. Trial registration ClinicalTrial.gov, NCT02643576. Retrospectively registered December 22, 2014.

Long-Lasting Effects of the Pandemic on Older Adults’ Food Insecurity: The Urgent Need for Enhanced SNAP Benefits

Despite the start of COVID-19 pandemic recovery in the U.S., food insecurity remains at elevated levels with 10% of American adults reporting food insecurity nearly three times higher than pre-pandemic (Census Bureau’s Household Pulse Survey, June 2021). To gain insight into the long-term impacts of the pandemic on older adults, we examined food insecurity patterns during the last economic recession and the role that the Supplemental Nutrition Assistance Program (SNAP) played in mitigating food insecurity and skipped meals. We analyzed data on adults age 60+ from the Health and Retirement Study, looking at the Great Recession (2008) as a predictor of what to expect in the next decade of pandemic recovery. A key finding was that food insecurity more than doubled among older adults during the Great Recession and remained elevated even 10 years later. Regression analyses showed that SNAP use among older adults weakened the relationship between poverty and food insecurity, but didn’t eliminate it—17% of older adults still reported food insecurity two years after enrolling in SNAP. The data indicates that a growing share of older SNAP users’ benefits have not kept up with rising food costs. In fact, 85% of beneficiaries had monthly benefit amounts below the USDA ‘Thrifty Plan” budget. Congress recently passed the American Rescue Plan which increases SNAP benefits temporarily, yet these enhancements are about to run out. This study underscores the need for permanent SNAP enhancements to help prevent long-lasting hunger facing millions of older Americans.

Do State Agency on Aging Strategic Plans Include Terms Related to Malnutrition?

Demand for federal nutrition assistance programs is increasing as the older population grows and further accelerated with the COVID-19 pandemic. Older adult nutrition programs are based on federal nutrition guidelines that have traditionally focused on healthy populations, yet many older adults have multiple chronic conditions/advanced age. Some guidelines are changing; the 2020 Dietary Guidelines for Americans recognize older adults’ risk for malnutrition and also need for adequate protein to prevent lean muscle loss with age. The 2020 Older Americans Act (OAA) reauthorization included reduction of malnutrition in OAA’s official purpose and added program participant screening for malnutrition. The OAA requires State Agencies on Aging submit multiyear strategic plans to receive program funding, but it is unknown how the plans address risks for malnutrition, including overweight, underweight, and muscle loss (sarcopenia/frailty). We searched 51 State Agency on Aging strategic plans posted at advancingstates.org to determine their frequency of mentioning nutrition, malnutrition/underweight/undernutrition, obesity/overweight, frail/frailty, sarcopenia, and dietary supplements/oral nutrition supplements (DS/ONS)/meal replacements. Every state plan included nutrition but less than a third included malnutrition. There was wide variability in how nutrition and malnutrition were incorporated into state goals and strategies. Very few plans included obesity, frailty, and DS/ONS terms; none included sarcopenia. Although there has been some movement, there is need for many State Agencies on Aging plans to address all aspects of malnutrition including overweight, underweight/other factors related to muscle loss (sarcopenia/frailty) that adversely impact healthy aging. Wide disparities in plan structure/use of terms create opportunities for more common approaches/definitions.