The federal government runs a variety of national nutrition programs to combat hunger and food insecurity among children and families, and yet roughly 37 million Americans were still food insecure in 2018, and 6 million of them were children, according to the U.S. Department of Agriculture (USDA). The problem is particularly acute among low-income households in areas with limited public transportation and no major supermarkets nearby, where families tend to rely on smaller retailers with limited produce, higher prices, and lower quality food than what would be available at a larger store that is farther away.
On this episode of On the Evidence, we talk about a demonstration using home-delivered boxes packed with fruit, vegetables, and other shelf-stable foods selected by registered dieticians to address food insecurity among children in Chickasaw Nation territory in rural Oklahoma. Our guest is Phil Gleason, a senior fellow at Mathematica, who helped evaluate the demonstration for the Food and Nutrition Service (FNS) at the USDA. Click here to listen to the full interview or read the following abridged and edited Q&A blog based on our conversation.
What would you point to as some of the key findings of the report?
The most important finding was related to the program’s main objective: to reduce childhood food insecurity. We found that the program did not affect child food insecurity in the households that were participating in this study. Families that were eligible to receive these food boxes had a rate of child food insecurity of about 29 to 30 percent, as did the families that were in our control group that weren’t getting these boxes. [At the conclusion of the study,] the rate [of food insecurity] in the treatment group was a little bit lower than the rate in the control group, but it wasn’t lower by a statistically meaningful amount.
Despite the fact that there weren’t impacts on food insecurity among children, there were reductions of food insecurity among adults in these households. A year into the study, about 38 percent of the households that weren’t getting these food boxes had a food-insecure adult. Among the families that got the food boxes, [the rate of adult food insecurity] was about 35 percent.
Why would food insecurity be reduced among adults but not among the children in the household?
We don’t have a definitive answer, but building on research that suggests adults tend to shield their children from food insecurity when they hit economic hard times, we think that’s a potential explanation here. In other words, adults themselves will forego food before they’ll deny food from their children. If that’s the case, and if there’s some additional food assistance that comes into the household, the adults then may be the ones to use the additional food that they’re no longer forgoing.
How did the food boxes affect the quality of foods children ate?
We found that the project led to an increase in children’s consumption of fruit and vegetables and whole grain products, two food groups that are thought of as nutritious foods that policymakers want to encourage. There were no impacts on some of the less nutritious food options, such as foods high in added sugars or sugar-sweetened beverages. In that sense, there were some positive effects on the foods that we’d like to see kids eat more of and no effects on other less nutritious foods.
The one caveat is that the effects on consumption of fruit and vegetables and grain products were pretty small. The typical child on the typical day for the families that were getting food boxes consumed about 2.35 cups of fruit and vegetables. (The dietary recommendation for children varies from 2-3 cups for younger children to 3.5-6.5 for older children, depending on calorie intake.) The typical daily consumption for children in the control group, who weren’t getting these boxes, was about 2.25 cups. So [the difference] was a 10th of a cup. Over the course of a month, this would amount to about 3 cups of fruit and vegetables, so it wasn’t large, but it was at least moving in the right direction.
Did the project’s findings challenge any of your prior ideas about nutrition aid?
The biggest surprise was that these food boxes did not lead to a reduction in child food insecurity. This was a surprise for two reasons. First, logic indicated to me that to address the problem of food insecurity, the first obvious solution seems to be, you provide more food—and that’s what this was doing. The other reason it was surprising is that there is other research that suggests that food assistance programs, including some programs that are similar to this one, have led to improvements in households’ food security. There’s a lot of research suggesting that SNAP [the Supplemental Nutrition Assistance Program] and WIC [Special Supplemental Nutrition Program for Women, Infants, and Children] have favorable effects on food security.
There was another demonstration program that was implemented a couple of years ago in 2012 and 2013 by the USDA that examined a program that provided food assistance during the summertime to low-income households with school-age children. The idea was that during the school year, these households are getting benefits from the school meal programs, but in the summertime, for most families, that’s lost. This program was intended to fill that gap. It went to households that were very similar in terms of their characteristics to the programs that we evaluated in this [food boxes] study. In fact, that [summer electronic benefits transfer (EBT) for children] demonstration program included the Chickasaw Nation as a site. That [summer EBT for children] program found that the benefits that households received led to large reductions in child food insecurity. So, the fact that we did not find [reductions] here [with the food boxes] was surprising.
Do you have any educated guesses as to why the results were different this time?
We wondered whether the benefits just weren’t large enough to make a dent [in food insecurity among children], especially for the most disadvantaged families. In the case of the summer EBT program, compared with this one, we wondered whether providing the benefits in the summer specifically would make a difference. In our case, [with the food boxes,] the benefits were provided over a two-year period, but most of the time, we measured food insecurity during the school year, so that could have made a difference.
Another possible explanation is that [the strength of the economy affected the study outcomes]. In research on policy, context matters. This study was conducted during a period of relative economic growth. Compared with the 2012–2013 [summer EBT for children] study, the unemployment rate was much lower at the time these food boxes were provided. During this study, the unemployment rate in this area of the Chickasaw Nation continued to drop. It started out at 5.2 percent and went down to 3.9 percent. People were getting jobs in this area, and a program like providing these food boxes may have a bigger bang for the buck, at least with respect to . . . food insecurity when households have fewer options for feeding their families.
What’s the next step in sharing your findings from this body of work?
The final report is out. This study was part of a larger evaluation of five grants that the Food and Nutrition Service had given out to different states and Indian Tribal Organizations to implement different strategies to address childhood hunger in low-income families with children. We are currently partnering with FNS in putting together a collection of papers that will include the results of four of those five studies along with commentary from FNS. Hopefully, they’ll be published in 2020 in a journal focused on nutrition issues.
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