A new study published today in the November issue of Health Affairs underscores the positive impact of the Healthy Helping produce prescription program that provided North Carolinians facing food insecurity with $40 a month to spend on fruits and vegetables during the COVID-19 pandemic.

Researchers from the University of North Carolina at Chapel Hill and nonprofit Reinvestment Partners found that Healthy Helping participants doubled their purchases of fruits, vegetables, nuts, and legumes while enrolled in the program, spending $27 more every month on these healthy foods. What’s more, their spending at the participating supermarket chain increased by $57 per month—more than the $40 incentive amount—suggesting that they may have prioritized this retailer for their grocery shopping during the intervention.

Together, these findings indicate that healthy incentive programs like Healthy Helping can achieve double-duty action, addressing health concerns by improving the nutritional profile of grocery purchases among a high-need population while also supporting local economic development during a time of great economic uncertainty.

The study builds on findings from previous research on the Healthy Helping program finding that prevalence of food insecurity among participants fell by 11 percentage points and that participants were thankful for the benefit and appreciated the flexibility to choose more and a greater variety of nutritious foods that would normally be outside their budget. This research is timely given the announcement in September of the White House’s new National Strategy on Hunger, Nutrition, and Health and the upcoming Farm Bill renewal process in 2023.

“As discussions around the upcoming Farm Bill begin, policymakers should consider the growing evidence around these innovative COVID-relief efforts,” said senior author Shu Wen Ng, Distinguished Scholar in Public Health Nutrition and Associate Professor of Nutrition at the Gillings School of Global Public Health and co-director of the Global Food Research Program.

“Programs like Healthy Helping tackled both food and nutritional insecurity by improving access to healthier items. Going forward, we need to more adequate and permanent support for regulatory changes that build resiliency in non-emergency times.”

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This research was supported by the North Carolina Department of Health and Human Services from their Coronavirus Aid, Relief, and Economic Security (CARES) Act allocation via a grant to Reinvestment Partners.

AUTHORS

Caitlin Lowery
Richard Henderson
Neal Curran
Sam Hoeffler
Molly De Marco
Shu Wen Ng

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Read the study in Health Affairs

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READ MORE ABOUT FOOD ASSISTANCE DURING THE COVID-19 PANDEMIC:

Participant experiences in the Healthy Helping program

Changes to nutrition assistance programs during COVID-19

Increased WIC cash vouchers for fruits & vegetables

A new health policy brief from Health Affairs, titled “COVID-19 Pandemic-Era Nutrition Assistance: Impact And Sustainability,” joins Health Affairs’ ongoing series of policy briefs on the social determinants of health.

Its authors, including Global Food Research Program faculty Shu Wen Ng write that COVID-19 became “a stress test” for the ability of the United States to feed those in need.

Early in the pandemic, a record number of households, including nearly fourteen million children, reported not having enough to eat, with Black and Latinx households being more severely affected than their White and Asian counterparts. The existing federal nutrition programs, detailed in the brief, primarily flow through the Department of Agriculture (USDA). For programs such as the USDA’s National School Lunch and School Breakfast Programs, the COVID-19 school closures made the normal distribution channels unavailable to recipients and their families.

The brief describes efforts undertaken by the federal government in the beginning of the pandemic, such as the Families First Coronavirus Response Act of 2020 and other legislation, which allowed the USDA to expand program eligibility, change how programs were accessed, and develop new programs offering novel experiments in nutritional assistance without compromising safe social distancing.

For example, a normal requirement of the USDA’s Supplemental Nutrition Assistance Program is an in-person enrollment interview. By replacing that requirement and allowing telephonic signatures for recertification, researchers estimate that some six million participants were able to be enrolled in the first few months of the pandemic.

The brief also describes some of the innovative temporary federal programs, such as the Farmers to Families Food Box Program, that were made possible with discretionary USDA funding, as well as complementary efforts by states, localities, tribes, and the private sector.

As Congress and the Biden administration prepare for the reauthorization of the Farm Bill in 2023, the authors recommend that many of the expansions, flexibilities, and new programming developed in response to the pandemic be allowed to continue. They note that these changes could help address the structural forces that create food insecurity. In addition, as policy makers also consider the next Child Nutrition Reauthorization, the authors suggest restoring and building on the 2010 federal nutrition standards and working to explore schools’ expanded role in providing high-quality food year-round to students and families.

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Funding support for this Health Policy Brief was provided by the Robert Wood Johnson Foundation.

AUTHORS

Caitlin Caspi
Rudd Center for Food Policy and Health, University of Connecticut

Hilary Seligman
Departments of Medicine and of Epidemiology and Biostatistics, University of California, San Francisco

Jerica Berge
Department of Family Medicine and Community Health, University of Minnesota

Shu Wen Ng
University of North Carolina at Chapel Hill

James Krieger
School of Public Health and School of Medicine, University of Washington

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Read the full policy brief in Health Affairs