Addressing Food Insecurity in the United States Craig Gundersen University of Illinois Soybean Industry Endowed Professor of Agricultural Strategy, Department of Agricultural and Consumer Economics

Reasons for Looking at Food Insecurity Serious consequences in own right negative health outcomes Not completely characterized by income The central goal of USDA is to alleviate food insecurity

Measurement

Defining Food Insecurity A household’s food insecurity status is based on responses to 18 questions in the Core Food Security Module (CFSM) Examples of questions: “I worried whether our food would run out before we got money to buy more” “Did you or the other adults in your household ever cut the size of your meals or skip meals because there wasn’t enough money for food” “Were you ever hungry but did not eat because you couldn’t afford enough food” “Did a child in the household ever not eat for a full day because you couldn’t afford enough food” Categories food insecure if have 3 or more affirmative responses very low food security among children if have 5 or more affirmative responses to child-specific questions

Overall food-insecurity rates

CHILD food-insecurity rates

Determinants

Determinants of Food Insecurity Resources Lower incomes Low levels of education Not a homeowner Being unemployed Not receiving child support Lack of access to social capital Declines in asset levels Non-working teenagers

Determinants of Food Insecurity Household structure Having someone with a disability in the household Being in a single-parent household Immigrants in household Having a non-custodial father who does not visit regularly Older children More children Not having a grandparent in the household Having a grandchild in the household Changes in household composition

Determinants of Food Insecurity Race/ethnicity Household head is non-Hispanic black Household head is non-Hispanic Household head is American Indian Other Having a parent who was every incarcerated Lack of financial management skills Being at high risk of homelessness Summertime Not speaking English in the home Having a cigarette smoker in the home Changes in residence Declines in child health Declines in mental health

Health Outcomes

Health Consequences Associated with Food Insecurity Children birth defects anemia lower nutrient intakes cognitive problems aggression and anxiety being hospitalized being in poorer general health having asthma behavioral problems depression worse  oral health Adults lower nutrient intakes mental health problems diabetes hypertension hyperlipidemia poor outcomes on health exams being in poor or fair health poor sleep  outcomes depression having limitations in activities of daily living

Food Insecurity and Health Care Costs What is the impact of food insecurity on health care costs? Does this differ by severity of food insecurity? Data from Canada matched administrative records from Ontario health care system with food security survey information 67,033 observations between 18 and 64 difficult to do for U.S. selection issue lack of health care information to be matched with survey data Results differences in health care costs when compared to individuals in fully food secure households marginally food insecure: 23% higher moderate food insecure: 49% higher severely food insecure: 121% higher

Food Assistance Programs

Supplemental Nutrition Assistance Program (SNAP) Primary goal is to alleviate hunger USDA issues food stamps to families (via Electronic Benefit Transfer (EBT) cards) which can be used in retail food outlets Benefit levels function of income and family size maximum benefit level is $688 for a family of four average benefit level is about $300 for a family of four Size of program serves over 42 million persons total cost is about $70 billion per year Eligibility criteria gross income test net income test asset test

SNAP Does it reduce labor supply? What is the extent of fraud in SNAP? there are no “cliff effects” no studies have found recipients work less may want to reduce “tax” associated with SNAP benefit levels What is the extent of fraud in SNAP? redeeming benefits for cash at retailers very difficult to do with EBT system most benefits redeemed at reputable retailers selling benefits to others have to give PIN to do this more difficult to enforce error rates in benefit distribution less than 5 percent need to recognize trade-offs with this

Does SNAP Participation Lead to Higher Probabilities of Obesity? Theoretical perspective Ambiguous Common Sense Perspective No Consistent with descriptive evidence Empirical evidence from credible studies Some evidence that will lead to declines

Likely Direct Consequences of Restrictions Fall in participation among eligible households Increases in stigma SNAP participants singled out as irresponsible one of the justifications from USDA for denying waiver requests more signaling in checkout lines that SNAP participant Increases in transactions costs need to ascertain whether or not a product is eligible smaller stores likely to stop accepting SNAP

Likely Direct Consequences of Restrictions Redirection of federal resources Make decisions on over 300,000 food products needs to be done on recurring basis Need to enforce new laws prosecution of stores prosecution of individuals Higher costs to consumers UPC codes do not have relevant information each item would have to be individually coded especially expensive to smaller store Labelling of products as eligible (or ineligible)

Likely Indirect Consequences of Restrictions Higher rates of food insecurity Fewer SNAP participants strong effect of SNAP in reducing food insecurity Higher food costs Gregory et al. (2013) Increased medical care costs Worse health outcomes due to increases in food insecurity (Gundersen and Ziliak, 2015) Higher health care costs associated with food insecurity (Trasuk et al., 2015) No impact on obesity

National School Lunch Program (NSLP) Serves over 30 million children every day during the school year Expected to have a positive impact on the well-being of children lunch is provided guidelines imposed Eligibility Criteria income free if household income is less than 130% of the poverty line reduced price (40 cents) if household income is between 130% and 185% of the poverty line full price if household income is above 185% of the poverty line must attend a school with NSLP

Paths to Improving Food Assistance Programs SNAP What are effective ways to increase participation? Who do we especially need to reach? How can transactions costs be reduced? Consider removing portions of the application process that are least likely to lead to fraudulent reports Increase recertification periods How can the benefit formula be improved? Increase of $15 billion lead to 55% decline in food insecurity among SNAP participants with children School Meal Programs How can these be expanded to reach children over the summer? How should the competing demands of children of different income levels be met?