A new study shows obesity rates among children from low-income families declined in 19 states and U.S. territories between 2008 and 2011. That's good news, as those children are less likely to be obese as adults, and more likely to avoid the health problems that often accompany obesity. But $40 billion in Republican cuts to food stamps could stop this trend in its tracks, and the long-term health benefits for children with it.
The obesity rate among preschool-age children from poor families fell in 19 states and United States territories between 2008 and 2011, federal health officials said Tuesday — the first time a major government report has shown a consistent pattern of decline for low-income children after decades of rising rates.
Children from poor families have had some of the nation’s highest rates of obesity. One in eight preschoolers in the United States is obese. Among low-income children, it is one in seven. The rate is much higher for blacks (one in five) and for Hispanics (one in six).
Several cities have reported modest drops among school-age children, offering hints of a change in course. But gains were concentrated among whites and children from middle- and upper-income families, and were not consistent across the country.
There were hints that obesity rates among children from low-income families were in decline, but this study — based on the weight and height measurements of 12 million children ages 2 to 4 who participate in federally funded nutrition programs, and including data from 40 states and U.S. territories — has provided the most detailed picture yet of obesity among low-income Americans. Everything until now had been patchwork.
But while the data answers one question about obesity rates among low-income Americans, it raises another one. Why have obesity rates fallen among low-income children?
SNAP Gets HIP
The New York Times article claims the cause of the decline is a "mystery," but suggests some compelling answers.
Among the most compelling possible causes offered is "changes in the food offered in federal nutrition programs for women and children." The biggest such federal program is Supplemental Nutrition Assistance Program (SNAP), a.k.a "food stamps." During the period covered by the study, SNAP implemented a program that could have a big impact on childhood obesity rates.
The 2008 farm bill (the Food, Conservation, and Energy Act of 2008) included $20 million to be spent on pilot project to determine whether incentives would cause food stamp participants to purchase more fruits, vegetables, and other healthy foods. The result was the Healthy Incentives Pilot (HIP), which ran for 14 months ended in December 2012. Fifteen states were interested in having the pilot program, five states submitted applications, and Hampden County, and Massachusetts was ultimately chosen as as the pilot site.
HIP basically provided an "incentive" for 7,500 select households to purchase more fruits and vegetables, by offering a 30% subsidy (essentially a discount) on produce, which were often difficult for food stamp recipients to purchase. Produce, for HIP's purposes, was defined as "fresh, frozen, canned, or dried fruits and vegetables that do not have any added sugar, salt, fat, or oil."
The idea was that reducing the high price of fresh produce might make it easier for food stamp recipients to purchase food with higher nutritional value. As a bonus, it was thought the subsidy might also encourage sellers to offer more fruits and vegetables. Once the pilot wrapped, SNAP would analyze the difference between HIP households and non-HIP households, to find out the pilot encouraged healthier eating habits.
HIP Helps
So, did it work? Did offering food stamp recipients an incentive lead to the kind of healthier eating habits that can lower obesity rates? Yes, it did.
Just a couple of weeks ago, Agriculture Secretary Tom Vilsack announced the results of the Healthy Incentives Pilot, and outcome shows that even small investments can lead to a huge impact. The USDA's interim report on HIP showed that an ongoing investment of less than 15 cents per person per day may result in a 25 percent increase in fruit and vegetable consumption among adults. And if more adults in low-income households are eating more fruits and vegetables, you can bet that children in those households are eating their veggies too.
It's no magical solution, certainly. There is no magical solution for our poor diet choices and obesity problems. That requires a massive attitude adjustment that no amount of legislating can produce. A recent Gallup poll shattered the myth that low-income Americans are more likely to eat fast food. According to the poll, more than half of those earning $75,000 or more a year ate fast food at least once a week, compared to 39 percent of those earning $20,000 or less annually.
There may be little any program can do to change the habits of Americans who can afford to eat healthier foods, but bye success HIP shows how programs like SNAP and other nutrition assistance efforts can help make healthy food choices more appealing. HIP did this by alleviating the financial burden and making it easier for low-income families to purchase healthy foods, while also empowering with the knowledge and skills to purchase and prepare healthier foods — with their food stamps.
Based on those results, SNAP is announcing two new pilots to help food stamp recipients purchase healthier foods. Double Up Food Bucks, a pilot with the Fair Foods Network, will issue up to $10 per week in coupons for locally grown produce to food stamp recipients who purchase fruits and vegetables at three locally-owned grocery stores in Detroit, Michigan. The Minnesota Department of Human services, through its SNAP+ pilot project, is offering food stamp recipients $5 coupons to buy locally grown fruits and vegetable at select stores in three geographical areas of Minnesota.
It's worth noting that the HIP approach was basically all "carrot" and no "stick." Rather than focusing on restricting food choices, HIP's approach combined education on healthy food choices with incentives for making healthier food choices.
Beyond HIP
Of course, a small pilot like HIP can't be the only source of declining obesity rates. Its impact combines with those of countless other local, state, and federal policies and programs.
Another explanation is that some combination of state, local and federal policies aimed at reducing obesity is starting to have an effect. Michelle Obama has led a push to change young children’s eating and exercise habits and 10,000 child care centers across the country have signed on.
Whever she is, Sarah Palin is probably pissed off about this outcome. A couple of years ago, Sarah Palin used her reality show to take pot shots at First Lady Michelle Obama's "Let's Move" program. It was so far "out there" that Republicans declined to come to Palin's defense.
At the time, I had some fun with Palin, suggesting that she might be onto something. Given that the obesity epidemic was proving good for the funeral industry, which was doing a booming business providing bigger (and more expensive) caskets, crypts and mausoleums to accommodate bigger bodies. Now business is booming, and even more companies are cashing in on America's obesity epidemic, and selling a wide range of products.
But it's no laughing matter.
Pay Now, Or Pay Later
According to the CDC, obese children have a higher risk of developing cardiovascular disease, high cholesterol, high blood pressure, and a condition called "pre-diabetes." They's also more likely to have sleep apnea, as well as bone and joint problems. And that's before they grow up. As adults, they're more likely join the 42 percent of Americans predicted to be obese by 2030, and to have heart disease, type 2 diabetes. They'll also be more at risk for many types of cancer.
The personal costs in terms of health, quality of life, and lifespan can't be calculated in dollars. The cost of treating the health problems above as already been calculated. The cost of treating obesity-related health problems already costs Americans more than smoking in health care spending, to the tune of about $190 billion per year. In 20 years, the cost could rise to more than $550 billion.
But, as the HIP example shows, an investment of just 15 cents per person per day can go a long way towards promoting healthier eating, and thus reducing the likelihood of obesity. It seems simple. We can pay a little now, or pay a lot more later. The $40 billion Republicans want to cut from food stamps would spell the end of SNAP's pilot programs to subsidize and incentives healthy food choices for food stamp recipients, which help produce results like lowering childhood obesity rates for the first time in decades.
Rather than pay now, by investing just pennies a day in a healthier future for millions of American children, Republicans would rather we all — but especially our children — pay a lot more later.
