Posts Tagged: food security
Reduction of SNAP benefit deepens crisis of inflation, high cost of living, low wages
Starting this month, many of the estimated 3 million people in the CalFresh program – California's version of SNAP (Supplemental Nutrition Assistance Program) – will be facing hunger and making difficult decisions to meet their most basic needs. In late March, participants received the last of the pandemic-related emergency aid that significantly boosted their monthly benefits. The reduction varies by household size and income; for example, in April a single-person household could see a drop from $281 per month to $23.
“The emergency food allotments had a tremendous impact in our communities and across the nation,” said Shannon Klisch, academic coordinator for the Youth, Families and Communities Program for UC Cooperative Extension in San Luis Obispo and Santa Barbara counties. “One study estimated that these allotments kept more than 4 million people out of poverty across the U.S. in the last quarter of 2021, and reduced child poverty by 14%.”
SNAP increases during the pandemic made many Californians more food-secure, with some participants reporting that their allotments finally had been enough to feed their families for the month, according to Wendi Gosliner, a project scientist at the Nutrition Policy Institute (a program of UC Agriculture and Natural Resources). But, with the benefit reductions, food insecurity is emerging again as a serious concern.
“It is inconceivable that a nation this wealthy should have so many people experiencing hunger,” Gosliner said. “And here in California, with the high cost of living, ongoing inflation and extreme income and wealth disparities, people are being forced to explore every possible avenue just to feed themselves and their families.”
To help ensure they are receiving the maximum allotment, Klisch recommends that CalFresh participants – especially those who applied during the pandemic and are relatively new to the program – double-check their information.
“If the county doesn't have your most up-to-date information, call your county worker if you've changed your address, if you've experienced decreased income, if your housing costs have gone up, or if you have new expenses – like child or dependent care expenses or medical expenses – these can help you qualify for more CalFresh funds,” she explained.
For families with school-aged children, Klisch said they can stretch their food dollars and promote healthy eating by encouraging their children to eat breakfast and lunch at school through California's universal free school meals, and all families with children under 18 can watch for the next issuance of the P-EBT (Pandemic EBT) card, worth potentially hundreds of dollars.
In addition to these options for food assistance, Klisch pointed to programs that can help people save money on other household expenses, such as California Alternate Rates for Energy Programs (CARE) and Affordable Connectivity Program. Local food banks are also gearing up across the state to handle an expected surge in clients in need of emergency food; a list of California food banks can be found at cafoodbanks.org/our-members.
“We ask a lot of low-income families and workers to navigate and piece together various programs, applications, and benefits when we don't commit to a strong safety net,” Klisch said. “On the other hand, when people have enough money for food, everyone benefits through decreased health care costs and increased economic activity.”
Gosliner also said that people should look into their eligibility for WIC (Special Supplemental Nutrition Program for Women, Infants and Children), as well as the federal Earned Income Tax Credit (EITC) and CalEITC, poverty-alleviation benefits underused by Californians.
“People should make sure they are accessing all the safety net benefits for which they are eligible,” Gosliner said.
Market Match, other nutrition incentive programs can help
Through programs like Market Match, available at about 300 farmers markets across California affiliated with the Ecology Center, CalFresh participants can have their EBT benefits “matched” by their local market (usually up to $10 or $15 per visit).
“People are looking to get creative about how to stretch their food dollars, and Market Match is one way to do that,” said Klisch, who has led UCCE efforts to help promote the program along the Central Coast since 2017.
Striving to expand access to fresh fruit and vegetables and to support local farms, UCCE and CalFresh Healthy Living, UC worked with partners to increase CalFresh redemption at farmers markets in San Luis Obispo and northern Santa Barbara counties.
In 2017, about $48,000 in CalFresh and Market Match benefits were redeemed at farmers markets in the area. In 2022, the total was more than $207,000 – a 327% increase. According to Ecology Center figures for the entire state, CalFresh and Market Match spending at farmers markets jumped 161% from 2019 to 2021, up to $13 million.
Gosliner, whose research has shown that these nutrition incentive programs are associated with increased food security, noted that “the people who use Market Match absolutely love the program and feel it is incredibly helpful.” She also added that the California Department of Social Services is developing a pilot program that would offer match incentives for purchasing fruits and vegetables at larger food retailers.
Although the biggest of its kind, Market Match is just one of the programs across California that provide “matches” for healthy food purchases under the California Nutrition Incentive Program, which in turn is primarily funded by GusNIP (the nationwide Gus Schumacher Nutrition Incentive Program).
GusNIP dollars – and SNAP overall – are governed by the federal Farm Bill, typically renewed every five years and currently being negotiated by Congress./h3>/h3>
Study finds even fewer screened during virtual appointments
As jobless rates rose during the COVID-19 pandemic, millions more Americans experienced food insecurity because they lacked consistent access to food. National health organizations recommend primary care providers screen patients for food insecurity, since not having access to enough food can lead to chronic diseases.
But research from the University of California, Davis, finds that only 7% of primary care providers screened patients for food insecurity. If the appointment was virtual or telehealth, only 3% asked patients about their access to food. The American Journal of Preventive Medicine published the research.
“These rates are surprising and seem relatively small in comparison with what seems like a growing awareness of food insecurity during the pandemic,” said lead author Cassandra Nguyen, an assistant professor of Cooperative Extension in the UC Davis Department of Nutrition.
She said the findings may indicate that health care providers were prioritizing emergency responses to COVID-19. The research showed that once people had access to COVID-19 vaccines, screening for food insecurity increased to 10%.
Barriers to telehealth screenings
Screening for food insecurity at telehealth appointments remained low even after vaccines became available. Nguyen said that may suggest telehealth appointments have unique barriers.
“One of those barriers could be a concern about privacy and whether the patient is alone or feels comfortable discussing a potentially stigmatizing experience such as food insecurity. This may deter a primary care provider from asking about it,” Nguyen said.
Screening might also be more difficult if patients aren't familiar with the technology needed or if there are technological disruptions during telehealth appointments. Nguyen said more study is needed about potential barriers given the increased popularity of telehealth appointments since the pandemic.
The research examined electronic health records and clinic data from a national network of more than 400 community health centers in 16 states. It examined encounters between March 11, 2020, and Dec. 31, 2021. Screening typically involves a primary care provider asking the patient to answer that either or both of the following two statements is often true or sometimes true:
- Within the past 12 months we worried whether our food would run out before we got money to buy more.
- Within the past 12 months the food we bought just didn't last and we didn't have money to get more.
Co-authors include Rachel Gold with OCHIN Inc. and Kaiser Permanente Northwest Center for Health Research; Alaa Mohammad, Dedra Buchwald and Clemma Muller with Washington State University; Molly Krancari, Megan Hoopes and Suzanne Morrissey with OCHIN Inc.
The National Center for Advancing Translational Sciences of the National Institutes of Health, and the National Institute of Diabetes and Digestive and Kidney Diseases supported the research./h3>/h3>
The COVID-19 pandemic exacerbated food and nutrition challenges. Many families initially lost access to meals offered by school and childcare facilities, experienced unemployment or work reductions, and faced increasing prices for food and other necessities. National and state policies and programs provided food and cash assistance to mitigate impacts on food security. Researchers at the Nutrition Policy Institute, a research center of University of California Agriculture and Natural Resources, evaluated safety-net policies implemented during the pandemic to better support families with low incomes in the U.S.
Benefits of universal school meals
The National School Lunch Program and the School Breakfast Program meet the nutritional needs of approximately 30 million K-12 students in America each day. Typically, students from families meeting income eligibility criteria receive school meals for free or a reduced price, while others pay full price.
NPI researchers Wendi Gosliner, project scientist, and Lorrene Ritchie, director and UC Cooperative Extension specialist, are co-leading studies of school meals in California in collaboration with researchers from the NOURISH Lab for Health Inclusion Research and Practice, who study school meals in Maine and other states.
During the COVID-19 pandemic, Congress funded school meals for all students at no charge, in order to address the dramatic increase in food insecurity among families with children after schools shut down in March 2020. This federal provision allowing for meals to be free for all students ended after the 2021-2022 school year, but some states elected to continue providing universal school meals with state funding, in recognition of the importance of these meals for student health and academic success.
California was the first state to adopt a statewide Universal Meals Program starting in the 2022-23 school year. To support the program's development, $650 million were invested to help schools improve kitchen infrastructure and provide staff training and technical assistance. Investments include Farm to School programs and other mechanisms to help update and improve school meals. Maine and several other states also have adopted universal school meals at least through the 2022-23 school year.
“States often act as incubators – things that work well in states sometimes get translated into federal policy,” Gosliner said. Identifying the success of the programs – and their challenges – can lead to improvements and help inform advocates and policymakers considering universal school meals policies at the state and national level.
Two of the team's research studies in California and Maine documented the benefits and challenges of universal school meals, as reported by school food authorities. Among 581 school food-service leaders in California who responded to the survey, nearly half (45.7%) reported reductions in student stigma as a result of providing free school meals to all students. Among 43 respondents in Maine, over half (51%) reported lessened stigma related to school meals being free for all. In both studies, nearly three-quarters of respondents reported increases in student meal participation. These and other data suggest that universal school meals are meeting their aim, to increase student participation while providing nutritionally balanced meals.
But when the child leaves campus, the responsibility to put a nutritious meal on the table falls on the caregiver.
“Universal school meals provide food and can ease families' budgets, but for too many families, wages as well as time and other resources are not adequate for access to and consumption of enough healthy foods and beverages,” Gosliner noted.
That is when other public programs are helpful, for example the Earned Income Tax Credit, or EITC.
Many eligible families do not claim Earned Income Tax Credit
The Earned Income Tax Credit is a national program designed to lift families out of poverty. The supplemental income can contribute up to nearly $7,000 per year for a family. Despite the EITC's known ability to improve participants' health, research shows that many EITC-eligible households in California and across the nation don't receive the benefits for which they are eligible, leaving $2 billion unclaimed in California in 2018 alone.
Gosliner led a study along with Lia Fernald from UC Berkeley and Rita Hamad from UC San Francisco to document levels of awareness, barriers to uptake, and benefits of participation in the EITC. Their recent publication reported that among 411 EITC-eligible California female caregivers, those who were younger, spoke languages other than English, and had less awareness of the EITC were less likely to receive the tax credit.
Developing a user-friendly system for providing safety-net support and, in the meantime, providing information and support to help more EITC-eligible families receive these benefits are suggested to help alleviate financial stressors. In the long term, these strategies may reduce poverty and improve the health of children.
Increasing WIC Cash Value Benefit a boon to health
In addition to universal school meals and EITC, families with low income may be eligible for the Special Supplemental Nutrition Assistance Program for Women, Infants and Children, or WIC. The program supports women and children up to 5 years old through nutrition education, nutritious foods and access to other health and social services.
One component of the WIC food packages, the Cash Value Benefit, provides participants a fixed dollar amount to supplement their family's diet with fruits and vegetables. During the pandemic, the U.S. Department of Agriculture increased this benefit from $9 to $35 per month, which was later revised to $24 per month per child in October 2021.
Ritchie contributed to a growing body of evidence on the importance and multidimensional benefits of the WIC Cash Value Benefit increase.
“Nine dollars buys only a quarter of what a child is recommended to eat every day,” Ritchie said. “The increase in Cash Value Benefit during the pandemic was an ideal natural experiment to investigate its impact.”
In collaboration with Shannon Whaley and her team at the Public Health Foundation Enterprises-WIC, NPI launched a longitudinal cohort study of nearly 2,000 California WIC participants. They found that the increased Cash Value Benefit improved WIC participant satisfaction with the program and allowed families to purchase greater quantities and varieties of fruits and vegetables.
“The increased Cash Value Benefit enabled WIC families to expose young children to new fruits and vegetables. Early exposure to a variety of fruits and vegetables is critical to establishing lifelong healthy habits,” said Ritchie.
The researchers found that the benefit increase also reduced food insecurity. It is hoped that the increase in program satisfaction translates into more eligible families enrolling and continuing to receive WIC. In November 2022, the U.S. Department of Agriculture proposed making the increased Cash Value Benefit a permanent part of WIC.
In 2021, all state WIC agencies were invited to participate in a WIC satisfaction survey. Of the 12 WIC state agencies that opted to participate, Connecticut, Inter Tribal Council of Arizona, Nevada, New Hampshire and New Mexico added questions on the survey to understand how the increased Cash Value Benefit impacted children's dietary intake.
The study showed consumption of fruits and vegetables by children on WIC increased by one-third cup per day on average, which is sizable when considering the impact across the WIC population.
NPI research on universal school meals, the EITC and WIC constitute a small part of a more comprehensive approach to make healthy food more accessible, affordable, equitable and sustainable for all. The NPI provides resources such as policy briefs, peer-reviewed publications and technical assistance on several research areas such as safe drinking water, childcare and education. To learn more, please visit the Nutrition Policy Institute website.
Cooperative Extension researcher: Nutrition course a boon for UC Berkeley students
College students across the nation are struggling to meet their basic food needs. Within the University of California system of 280,000 students, 38% of undergraduate students and 20% of graduate students report food insecurity.
As part of the UC Global Food Initiative, in 2015 the Nutrition Policy Institute (a UC Agriculture and Natural Resources statewide research center) identified student food insecurity as a UC systemwide problem, prompting the UC Regents and campuses to collectively address the issue.
All 10 UC campuses now have on-site basic needs centers, providing food, emergency housing and support services. The UC system and campus working groups recognize that meeting basic needs, such as food, is a multidimensional challenge.
In response to the 2022 White House Conference on Hunger, Nutrition, and Health, which called for national efforts to reduce diet-related disease and food insecurity, UC renewed their commitment to cut the proportion of students facing food insecurity in half by 2030. Campuses will partner with local counties to maximize enrollment in the Supplemental Nutrition Assistance Program (also known as CalFresh in California), provide food for students who do not qualify for CalFresh, and allocate campus food resources to historically underserved student populations.
NPI's collaborative researchers continue to monitor the impact of these efforts, in addition to other interventions, such as supporting students in building basic culinary skills, to improve food security. One multipronged approach to address food insecurity at UC Berkeley is a 14-week course on Personal Food Security and Wellness with a Teaching Kitchen laboratory component.
Sarah Minkow, who teaches the Personal Food Security and Wellness course at UC Berkeley, shared that students learn about nutrition and gain culinary skills through the Cal Teaching Kitchen.
The curriculum is designed with consideration for the time, cost and convenience of healthy eating. Discussions include food safety, calculating nutrient needs, mindful eating and reading nutrition labels. The Teaching Kitchen laboratory brings the lessons to life through knife skills, “no-cook” cooking, microwave cooking and sheet pan meals.
Minkow enthusiastically highlighted her students' “overwhelmingly positive [response to the] lecture and lab,” suggesting the benefits of an interactive learning environment to garner student engagement.
“Students often give feedback that they wish this was a required course for all UC Berkeley students,” said Minkow. She noted one barrier to reaching more students: capacity of the Teaching Kitchen space.
Susana Matias, a Cooperative Extension specialist at the UC Berkeley Department of Nutritional Sciences and Toxicology and collaborative researcher with the NPI, evaluated the impact of the Personal Food Security and Wellness course at UC Berkeley.
Matias reported that increasing food literacy and culinary skills among students has shown to increase intake of fruits and vegetables, and frequency of cooking, and reduce the number of skipped meals. Her study on the impact of the 14-week nutrition course also found a significant decrease in student food insecurity.
Across the UC System, students are benefiting from their campus Teaching Kitchens, including UC Berkeley, UC Davis, UCLA and UC Riverside. Other campuses such as UC San Diego, UC San Francisco, UC Santa Cruz and UC Santa Barbara offer basic student cooking classes as well.
Katherine Lanca, UC Global Food Initiative fellow working with NPI, attended the 2022 Teaching Kitchen Research Conference as part of her fellowship to learn about the latest research on teaching kitchens supporting equitable health outcomes.
The conference was hosted at UCLA by Harvard T.H. Chan School of Public Health Department of Nutrition in association with the Teaching Kitchen Collaborative. Teaching kitchens are a promising approach to supporting food security and cultivating lifelong habits, especially among a college student population./h3>
Nutrition Policy Institute researchers contribute to studies that inform policy changes
Marcela Gonzalez, who had wanted to be a physical therapist since she was a teenager, was in the final stage of realizing her dream.
But when she started in the PT program at the University of California San Francisco in 2021, a vexing struggle of her undergraduate years came back. Academic pressures and stomach troubles, compounded by financial worries, drained her of any energy and capacity to feed herself.
“I didn't eat; I lost a lot of weight because I just couldn't eat,” Gonzalez recalled. “I was too stressed out all the time; I was a mess.”
During her first year at UCSF, Gonzalez, for whom food has “always just been hard,” discovered that she qualified for CalFresh (California's version of the Supplemental Nutrition Assistance Program, formerly known as “food stamps”). Her participation in the program – as well as the presence of a campus food pantry – helped lift a heavy mental burden and allowed her to refocus on school.
To understand the mechanisms that connect eligible students with CalFresh benefits, which could greatly improve their lives and education, University of California researchers interviewed UC campus staff responsible for guiding undergraduate and graduate students through the application process. Their recently published study, which involved researchers at UC Agriculture and Natural Resources' Nutrition Policy Institute, illuminated several major facilitators and barriers to CalFresh enrollment.
Campus-county coordination, boosting staffing key factors
Ensuring that college students have access to CalFresh is especially crucial, given that food insecurity affects that segment of the population roughly four times the rate of the general population, according to the study's principal investigator and co-author Suzanna Martinez, an associate professor in the department of epidemiology and biostatistics at UCSF.
It's estimated that more than 40% of college students face uncertain access to healthy food – and inflation, the rising cost of attending college and increasingly unaffordable housing are likely to swell those numbers.
That's why researchers say it's critical for campus staff who work on CalFresh outreach to collaborate with the financial aid office and the county office that administers the CalFresh program locally. Through close coordination, staff members can determine if students meet the necessary exemptions and help them with the paperwork.
“When that happens, it's much easier than when a student applies without their campus Basic Needs coordinator, or when they just go to the county and apply on their own,” Martinez explained. “Maybe they don't know all of the verification documents that have to be included, or they might not know their financial aid status.”
Erin Esaryk, NPI research data analyst and first author of the study published in the Journal of Nutrition Education and Behavior, also highlighted the need for increased campus staffing to help with CalFresh enrollment, as well as more outreach by campus and county staff to student populations about the benefits.
“When there's a lot of outreach, that helps alleviate some of the stigma, to normalize the receiving of CalFresh,” Esaryk said.
Helping others worry less about food
Given her own history of travails, Gonzalez, the physical therapy student, wanted to help others at UCSF “de-stress” about food. In summer and fall 2021, she served as a “CalFresh ambassador” for her cohort of new PT students, developing presentations and guides that break down how to apply for or renew CalFresh benefits.
She became the go-to person for her classmates' questions on the logistics and details of applying for the program, and also encouraged fellow health-professional students who, like herself, did not think they would qualify.
“To take out less loans, or to not worry about food a little bit every week, is a great thing,” said Gonzalez, pointing out that subtracting food costs allows students to shave down their loans.
After helping introduce her classmates to CalFresh, she transitioned to working at the food pantry at the Parnassus campus. In addition to setting up and distributing the items, Gonzalez also posts on Instagram and TikTok (@ucsf_basicneeds) to promote the “food market,” which attracts about 100 students and campus community members every Thursday afternoon.
“You never know what you're going to get, but there's so much really good, fresh produce,” she said.
Campus food pantries deliver health benefits
Researchers are also studying how campus food pantries affect students' overall health, including easing the challenges of anxiety, depression and sleep deprivation. Another recent study published in the Journal of Nutrition Education and Behavior analyzed health-survey responses of 1,855 undergraduate and graduate students at all 10 UC campuses – before and after access to a campus food pantry.
“What we found was that students reported improvements in their perceived health and sufficient sleep,” said UCSF's Martinez, the lead author. “We also found that they reported fewer depressive symptoms, compared to before having access to the food pantry.”
By 2019, all UC campuses had established food pantries, although nationwide only about 25% of four-year colleges have one. The significant health benefits reported by UC students in this study give researchers hope that campus food pantries will see additional governmental support, in California and beyond.
“It was important to evaluate whether the food pantries were actually making a difference…if you don't have numbers or evidence, then you're not going to get funded to support future programming,” Martinez said.
Research guides state policy changes
Studies of food insecurity in the college setting have already informed policymaking aimed at smoothing the application process for CalFresh – benefits regarded by Martinez as a better long-term solution than food pantries, which constitute an emergency “short-term response” to the problem.
One example of the research's impact is a law passed last year in California that requires community colleges and California State University campuses to designate a campus-county liaison who would help students procure social services, including CalFresh. A separate law expanded the list of training programs within which students would potentially qualify for CalFresh, and another bill currently under consideration by the state Legislature would make the processing of students' CalFresh applications more consistent from county to county, through more standardized training of staff.
Meanwhile, on the research front, Esaryk, Martinez and their colleagues are completing a follow-up study on students and CalFresh enrollment, this time looking at the perspectives of county staff. And while their broader goal remains clarifying and streamlining student eligibility rules and processes at all levels, they remain focused on students and meeting their needs.
“Right now, our main mission is just to try to increase awareness of CalFresh for students and to let them know they may be eligible,” Martinez said, “and then assist them through that application process so they can actually get the benefits.”
In addition to Esaryk and Martinez, NPI director Lorrene Ritchie and Laurel Moffat of Washington State University are also authors of the CalFresh/SNAP benefits study, while co-authors of the college food pantry study are Ritchie, Gwen Chodur of UC Davis, Sevan Kaladijian of UC Irvine and Michael Grandner of the University of Arizona./h3>/h3>/h3>/h3>/h3>