SNAP: Nutrition Aid Can Provide Long-Term Benefits

The Issue:

The Supplemental Nutrition Assistance Program (SNAP), also known as "food stamps", is one of the largest anti-poverty programs in the United States, reaching over 44 million Americans in 2016, at a cost of $73 billion to the Federal Government. Major policy changes up for consideration in Congress as well as the Trump administration's federal budget proposal could lead to dramatic funding cuts to SNAP.

While the costs are easy to tally, the program also has measurable short- and long-term benefits, especially for children.

The Facts:

• The Supplemental Nutrition Assistance Program (SNAP) provides low-income individuals and families monthly additional food resources. It is by far the nation's largest food and nutrition program, and disproportionately reaches families with children. In fiscal year 2017, the average SNAP recipient received US$ 125 each month through vouchers or Electronic Benefit Transfer cards that work like debit cards but can only be used for food purchases. About two-thirds of SNAP benefits go to families with children and 44 percent of SNAP participants in 2015 were children under 18. The wide reach of SNAP is partly due to the fact that its coverage is universal — unlike other social programs, which restrict eligibility to particular groups such as female-headed households, children, the disabled or the elderly. To be eligible, participants must be below certain income and asset thresholds (for instance, gross monthly income must be at or below 130 percent of the poverty line). There are some restrictions: strikers, most college students, some legal immigrants and all undocumented immigrants are ineligible, regardless of their income. Additionally, SNAP is time-limited for able-bodied adults without dependents in many states.
• In the short-term, those receiving food stamps experience greater food security and are better able to weather tough economic times. There is fairly consistent evidence that SNAP leads to a decrease in food insecurity — a condition of limited or uncertain access to adequate food, as defined by the U.S. Department of Agriculture. By one estimate, SNAP receipt reduces food insecurity by roughly 30 percent and the likelihood of being very food insecure by 20 percent. SNAP also plays an important role in reducing poverty: About 3.6 million Americans, including 1.5 million children, were lifted out of poverty in 2016 as a result of the program.
• SNAP improves birth outcomes and infant health. Douglas Almond, Diane Schanzenbach and I have found that when an expecting mother has access to SNAP during her pregnancy, particularly her third trimester, it decreases the likelihood that her baby will be born with  low birth weight. We found that African American and white babies are respectively 6 percent and 2.4 percent less likely to be born at very low birth weight defined as below 1,500 grams (or 3 pounds 5 ounces). These improvements are largest in more vulnerable populations, such as babies born in high poverty counties and babies with the lowest birth weights. (See this policy brief for a summary of research findings on SNAP's impact.)
• But, there is also evidence that the benefits of nutrition support can persist well into adulthood for those who have access to the program before birth and during early childhood. The roots of today's SNAP program originated with a food stamp pilot in 1961 and expanded gradually on a county-by-county basis until 1975, when all U.S. counties had a food stamp program in place. (The food stamp program was renamed SNAP in the 2008 Farm Bill, see here for a history of the program.) Since the program was introduced on a county-by-county basis over 50 years ago, it is possible to observe adult health and other outcomes of comparable individuals who differ in the age at which Food Stamps became available, depending on their county of birth. Doing this comparison, our research finds that having access to nutrition support before birth and in early childhood leads to a significant reduction in the incidence of obesity, high blood pressure, heart disease and diabetes in adulthood (see chart). The largest effect was for those children who were born after the Food Stamp Program had been implemented in their county of birth. Their mothers had access to the program during pregnancy, and it continued to be available throughout their entire childhood. In contrast, there was no reduction in the incidence of these metabolic diseases for children who were in the later stages of childhood when the Food Stamp Program was implemented in their county. In addition to the health effects, women with access to the program as children were also more likely to graduate from high school, earn more, and rely less on the social safety net as adults than those who did not.
• The findings of benefits from SNAP that persist into adulthood are consistent with a growing consensus that the environment before birth and in early childhood can have a long-term impact on a person's earnings, health, and mortality. The periods before birth and during early childhood are critical to a person's development. Negative or positive events during this stage of life can have lasting consequences. Children exposed to extreme deprivation during episodes of war, disease, or famine, have been shown to be more likely to suffer from chronic health conditions as adults (for example see the effects of the influenza pandemic of 1918). Alternatively, children who are given the opportunity to participate in high-quality early education programs have been shown to have higher earnings as adults, to have better health, and to be less likely to be engaged in criminal activity.
• How might SNAP provide benefits that persist into adulthood? One way this might happen is through the impact that the program has on preventing low birth weight. There is evidence linking low birth weight with school achievement, adult health and adult economic outcomes later in life. In addition, there may be benefits from reducing family stress or being able to pay more attention in school because of reduced hunger. The reduction in metabolic disorders from improved nutrition in utero and during early childhood is also consistent with what is known as the Barker hypothesis. The idea is that there are critical periods in development during which a body takes cues from the current environment to predict and adapt to what it might face in the future. For example, a child’s metabolic system may adapt in a manner that improves chances of survival in an environment with chronic food shortages. However, problems arise if there is no long-run food shortage. In that case, early life metabolic adaptations are a bad match to the actual environment, and will increase the likelihood of an individual developing high blood pressure, diabetes, obesity, and cardiovascular disease. Evidence from the Dutch Hunger Winter, a seven-month period at the end of World War II when people in the Netherlands experienced severe food restrictions, found that the children who were exposed to malnutrition in utero were more likely to be obese and have a higher incidence of heart disease in middle age.