OPINION | Eduardo Ochoa and Diana Cutts: Opportunity Waits

Originally posted on the Northwest Arkansas Democrat Gazette.

Last week, the United States Department of Agriculture (USDA) released its re-evaluation of the Thrifty Food Plan (TFP). The TFP is how benefits in the Supplemental Nutrition Assistance Program (SNAP) are determined, and its recent re-evaluation led the USDA to increase benefits in the program by 27 percent, or 40 cents per meal.

As pediatricians and public health researchers, we were pleased to see that this revision took a close examination of the evidence on today’s real cost of a healthy diet and made scientifically sound decisions for improving the cost basis of SNAP benefits.

Children thrive when their needs are consistently met. This is particularly important during early childhood. which is the foundation for healthy growth and development and necessary for lifelong well-being. Unfortunately, millions of children live in families that struggle to afford food and other basic needs.

Before the pandemic, approximately one in seven families with children struggled to afford enough food–a condition known as food insecurity–in the United States. During the pandemic, researchers estimate that food insecurity more than doubled, impacting an unprecedented nearly one in three U.S. families with children.

While this is an unfathomable number to grasp, we see the impact of economic hardship on our young patients room-by-room in our clinics. Children in families experiencing food insecurity struggle to maintain a healthy weight, have weakened immune systems that are unable to fight off diseases effectively, and show behavioral, emotional, and cognitive changes in their development that threaten their future potential.

Our research at Children’s HealthWatch over the last two decades and the research of many others consistently demonstrates the importance of food security on health outcomes from the prenatal period through adulthood. We know that even brief periods of deprivation and food insecurity at the lowest measured levels have a negative impact on health, especially for young children.

Our nation’s federal nutrition assistance programs are evidence-based policies for reducing food insecurity and promoting health. They work, and could work even better! Specifically, SNAP, the largest nutrition program in the U.S., has been overwhelmingly shown to improve food security and health.

SNAP is a critical public health program and, in many ways, it acts similar to a vaccine–protecting the population from the consequences of food insecurity and bolstering community health.

While we know that SNAP is effective treatment, evidence also strongly shows that the dose of SNAP is too low to fully eliminate food insecurity. Multiple studies including research from the National Academies of Science, Engineering, and Medicine (formerly the Institutes of Medicine), our own work at Children’s HealthWatch, and other researchers, including recent research from the Center on Budget and Policy Priorities and the Urban Institute, show SNAP benefits are inadequate for a healthful diet.

It is thus no surprise that, when families run out of benefits at the end of the month, researchers have documented increased hospital visits among adults and poor test scores among children.

We learn this in our clinics, too. We hear from parents that when SNAP benefits are administered, they can purchase fresh fruits and vegetables and stock up on healthy grains and protein sources to try to stretch through the month, but near the end of the month, their allotment is exhausted. Most often, parents then decrease their own food intake in order to spare their children, but without additional assistance, they may be forced to decrease the quality and quantity of their child’s meals.

We know that no parent desires to go hungry or make the agonizing decision to cut meals for children, but this is a reality for too many families.

As pediatricians and researchers, we value evidence-based solutions for addressing food insecurity and applaud the USDA for making this scientifically sound choice to increase benefits in SNAP.

Our work is not done. We look forward to continuing to work with the USDA, members of Congress, and the administration to advance solutions to further improve SNAP. While the changes to the TFP are a critically important, science-driven enhancement that will support child and family health, more work is needed for benefit levels to match the cost of a healthy diet.

Dr. Diana Cutts is a pediatrician, co-lead principal investigator of Children’s HealthWatch, and chair of the Department of Pediatrics at Hennepin County Medical Center in Minneapolis. (Email: diana.cutts@hcmed.org) Dr. Eduardo Ochoa is a principal investigator of Children’s HealthWatch, a UAMS faculty member, and practicing pediatrician at Arkansas Children’s Hospital. (Email: OchoaEduardoR@uams.edu)