Understanding Impacts of SNAP Fruit and Vegetable Incentive Program at Farmers’ Markets: Findings from a 13 State RCT

Abstract

Disparities in healthy food access and consumption are a major public health concern. This study reports the findings from a two-year randomized control trial conducted at 77 farmers’ markets (FMs) in 13 states and the District of Columbia that sought to understand the impact of fruit and vegetable (FV) incentive vouchers, randomly issued at varied incentive levels to Supplemental Nutrition Assistance Program (SNAP) recipients, for use at FMs. Measures included FV and overall household food purchasing; FV consumption; food insecurity; health status; market expenditure; and demographics. A repeated-measures mixed-effects analysis and the Complier Average Causal Effect (CACE) were used to examine outcomes. Despite 82% reporting food insecurity in the prior year, the findings showed that financial incentives at FMs had statistically significant, positive effects on FV consumption; market expenditures increased with added incentives. SNAP recipients receiving an incentive of USD 0.40 for every USD 1.00 in SNAP spent an average of USD 19.03 per transaction, while those receiving USD 2 for every USD 1 (2:1) spent an average of USD 36.28 per transaction. The data showed that the incentive program at the highest level (2:1) maximally increased SNAP FM expenditure and FV consumption, increasing the latter by 0.31 daily cups among those who used their incentive (CACE model).

Improving Fruit and Vegetable Accessibility, Purchasing, and Consumption to Advance Nutrition Security and Health Equity in the United States

“…Further, within the context of GusNIP, rigorous Randomized Control Trials (RCT) are often difficult to employ [ 68 ]. Karpyn and colleagues (2022) [ 69 ] used a multi-state RCT conducted at farmers markets to test varied nutrition incentive strategies on dietary quality. They found that participants who used a high nutrition incentive (USD 2.00) (compared to moderate and low financial incentives) increased FV consumption by 0.31 cups/day.…”

“…They found that participants who used a high nutrition incentive (USD 2.00) (compared to moderate and low financial incentives) increased FV consumption by 0.31 cups/day. Higher incentive levels were also associated with more local farmers market spending [ 69 ]. These promising results suggest higher nutrition incentive dollar amounts to have a substantial impact on dietary quality among Americans with lower incomes, especially if complemented with local strategies to improve participants’ usage of vouchers [ 69 ], which requires future exploration.…”

Advancing Equity in the Farm Bill: Opportunities for the Gus Schumacher Nutrition Incentive Program (GusNIP)

“…Nutrition incentives (NIs) help people purchase and consume FVs by providing financial subsidies, rebates, or discounts for FVs, thus making them more affordable. A robust body of evidence shows that NIs increase purchase and consumption of FVs [38][39][40][41][42][43][44][45][46][47][48][49], improve food security [44,49,50], and provide economic benefits to impacted communities [44,51,52]. Microsimulation and econometric models suggest that NIs lead to improved health outcomes and are cost effective [53,54].…”