Posts Tagged: nutrition

UC ANR experts offer counsel as CalFresh benefits shrink, participants face hunger

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.

Universal school meals increased student participation, lessened stigma

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.

Knowing the proven benefits of the WIC program, Ritchie and colleagues from the National WIC Association, and Loan Kim at Pepperdine University, also engaged with WIC participants in other states.

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.

Can food banks better promote nutrition and health?

New tool helps assess policies and practices

An estimated 53 million people in the U.S. turned to food banks and community programs for help putting food on the table in 2021. In recent decades, food banks have adopted policies and practices to make sure people not only have access to food but also healthy and nutritious food. 

But until now, food banks have had few ways to evaluate those initiatives. 

University of California, Davis, Assistant Professor of Cooperative Extension Cassandra Nguyen led a team of researchers to develop the Food Bank Health and Nutrition Assessment to address that concern. Their findings were published in the journal Public Health Nutrition.

“This tool will allow food banks to reflect on their current practices and determine whether they can adopt additional strategies to promote nutrition and health. It also serves as a benchmark, which they can use to track their progress over time,” said Nguyen, with the UC Davis Department of Nutrition.

Nutrition policy is more than what's on the shelf

Food banks face some common challenges in promoting nutrition, health and equity. While food banks could assess the nutritional quality of their inventory, Nguyen said promoting nutrition requires more than knowing the types of food on the shelf.

“Food banks can have nutrition policies that outline where they source food and which foods they prioritize when funding is available. They can also ensure that food pantry clients are either represented on advisory boards or are able to provide feedback about foods they would like to receive,” Nguyen said.

Additionally, food banks can take steps to make sure nutrition education materials and information about federal assistance programs for health and nutrition are available in languages spoken by recipients. 

Partnerships with outside organizations and local farmers can also increase the variety and availability of nutritious foods. Food banks with diverse connections may also adapt better to unexpected spikes in need, such as during the COVID-19 pandemic. 

The Food Bank Health and Nutrition Assessment was designed to evaluate these and additional objectives so food banks can identify areas of success as well as potential strategies they hadn't considered before. 

Importance of data

“By having data from this assessment to show that some practices to promote nutrition and health may be difficult to implement, several food banks can raise their voices to advocate for policy changes,” Nguyen said. 

Food banks with Feeding America and the Midwest Food Bank in four Midwestern states participated in the initial development of the Food Bank Health and Nutrition Assessment. In this small initial sample, most food banks asked food recipients about their preferences or whether diet-related diseases (for example, diabetes) were common, but few had current or former charitable food recipients on advisory boards. 

The assessment is available for free through Feeding America, the largest nonprofit organization supporting the charitable food system, and online through the University of Illinois Extension. Food bank staff and partnering community-based professionals such as extension staff can use the assessment to improve promotion of nutrition and health.

Other authors include Caitlin Kownacki, Veronica Skaradzinski, Kaitlyn Streitmatter, Stephanie Acevedo and Jennifer McCaffrey with the University of Illinois at Urbana-Champaign; Stephen D. Ericson with Feeding Illinois; and Jessica E. Hager with Feeding America.

Funding for the research was supported by the Supplemental Nutrition Assistance Program-Education, or SNAP-Ed, in Illinois

Study probes why 1 in 4 eligible Californians do not receive poverty-alleviation benefit

UC researchers identify barriers to Earned Income Tax Credit, which provides up to $7K each year per family

About 1 out of 4 Californians who are eligible for the Earned Income Tax Credit do not actually receive it – and University of California researchers are digging deeper to learn why they are not taking up this crucial benefit, which can provide nearly $7,000 annually for each family.

“The EITC is the largest poverty alleviation program in the country for families with kids, lifting millions of people out of poverty every year,” said Rita Hamad, associate professor at the University of California, San Francisco in the Institute for Health Policy Studies. “We know from previous work – including our own studies – that the EITC is effective at improving health, including birth weight, child development, household food security, and parents' mental health.”

Hamad is the co-lead author of an article on EITC take-up, recently published in Health Affairs, which begins to answer why only 74% of Californians receive the EITC benefit for which they are eligible.

“Billions of dollars are going unclaimed by families who could really use the money to improve their families' health and well-being,” said Hamad, who is also director of UCSF's Social Policies for Health Equity Research Program.

More broadly, about 80% of eligible families across the country take advantage of the EITC, according to previous research. But those studies only looked at tax records, and do not shed light on the specific circumstances of households that missed the credit.

“What our study did was reach out to those families and start to collect some richer information on what's happening – why aren't people getting the benefit, and what can we learn to help more people get something that can make a big difference for families,” said co-lead author Wendi Gosliner, project scientist at the Nutrition Policy Institute, a program of UC Agriculture and Natural Resources.

On EITC, ‘the more we know, the better'

Surveying 411 EITC-eligible Californians with children, researchers found that roughly 25% of respondents did not receive the benefit (including the 9% that did not file taxes). And although the sample is non-representative, the study did produce some significant findings.

For example, take-up of the EITC and CalEITC (its California state counterpart) was less likely among eligible individuals who do not speak English, had no prior knowledge of the programs, and are younger.

The age factor – correlated with inexperience in tax filing – underscores the need to clarify eligibility verbiage and materials. Gosliner noted that several respondents thought all people under the age of 25 were ineligible, when in fact those under 25 who have dependents would qualify for the federal credit (for the CalEITC, all individuals over 18 are eligible).

Such findings help fine-tune the education and outreach activities of advocacy groups such as Golden State Opportunity, a nonprofit that works to create financial stability for low-income workers across California.

“Knowing that a barrier for younger people is lack of knowledge, we can increase our outreach to community colleges and other youth-serving organizations with messaging that reaches them where they are,” said Amy Everitt, president of Golden State Opportunity. “Thanks to this research we can better understand the diverse audiences we need to reach – when it comes to the EITC, the more we know, the better.”

Need for clearer tax information, better processes

The researchers are currently analyzing the qualitative data they gathered from the interviews to produce a follow-up paper. But Gosliner shared that some of the respondents' concerns were worries about owing the government, the belief that filers must pay back the EITC money, and lack of understanding about the tax system in general and the EITC specifically.

“It's very user-unfriendly,” Gosliner said. “Even the name of the program doesn't make sense to people – they don't understand it, they don't know what it means...it's like we intentionally create these hurdles to receive the benefit.”

Both Gosliner and Hamad recommended that the government simplify the tax process, while providing free, high-quality filing services in multiple languages to ensure families are receiving the benefits that can help reduce health inequities.

“Our study speaks to the fragmentation of the social safety net, with families needing to fill out multiple redundant applications to participate in each different program,” Hamad said. “A better solution would be to have government agencies coordinate with one another, so that families who are cash-strapped with limited time can fill out just one streamlined application.”

Information on federal EITC: https://www.irs.gov/credits-deductions/individuals/earned-income-tax-credit-eitc

Information on CalEITC: https://www.caleitc4me.org/

The full article can be found at: https://www.healthaffairs.org/doi/10.1377/hlthaff.2022.00713

The other authors of the study are: Erika M. Brown, UCSF; Mekhala Hoskote, UC Berkeley and UCSF; Kaitlyn Jackson, UCSF; Elsa M. Esparza, UC Berkeley; and Lia C. H. Fernald, UC Berkeley.

Teaching Kitchen course helps improve college students’ food security

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.

Read more