April 2, 2025 • 21 mins
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Welcome to the second episode in a special four-part series from Health Affairs on the intersection of food, nutrition, and health. This special series compliments the release of a theme issue on food, nutrition, and health to be released April 7, 2025.
In this episode, Health Affairs' Jessica Bylander speaks with Diane Schanzenbach from Northwestern University on the topic of food support programs and their impacts on very young children.
Pre-order the Food, Nutrition, and Health Issue.
Related Links:
- Food Support Programs and Their Impacts On Very Young Children (Health Policy Brief)
- SNAP's Short- and Long-Term Benefits (Northwestern Institute for Policy Research)
- Long-Run Impacts of Childhood Access to the Safety Net (American Economic Association)
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jessica Bylander (00:12):
Hello and welcome to Health Affairs four
part podcast miniseries on food,nutrition and health. I'm
Jessica Bylander, a deputyeditor at Health Affairs. We're
releasing four episodes of thisminiseries on Wednesdays leading
up to and continuing with thepublication of our April 2025
theme issue on food, nutritionand health. In today's episode,
(00:32):
we're focusing on the topic offood support programs and their
impacts on very young children.I'm so pleased to be here with
Doctor.
Diane Whitmore Schonsenbach, whois an economist and the Margaret
Walker Alexander Professor ofHuman Development and Social
Policy at NorthwesternUniversity. Doctor. Schonsenbach
is the coauthor with Doctor.Betsy Thorne of a health policy
(00:54):
brief we published on this topicin 2019. Welcome, Doctor.
Schonzenbach.
Diane Schanzenbach (01:00):
Thanks for having me.
Jessica Bylander (01:02):
So first, to set the stage, what do we know
generally about the healthimpacts of food and nutrition
insecurity on very youngchildren, which I think you
define as zero, age zero tofour.
Diane Schanzenbach (01:13):
That's right. Those ages zero to four
are particularly sensitive timeswhere if you don't have access
to adequate nutrition, it haslifetime impacts on you. Right?
So that period of time, ofcourse, you know, your brain's
growing, your body's growing ata very rapid rate. And it's
(01:36):
really important that we protectkids from any sort of negative
shocks, you know, whether theirparents lose their jobs or
there's a recession or just forwhatever reason, there's not
enough food in the house thatcan not only harm kids in the
short run, but then there'sincreasing evidence that it
hurts them in the long run aswell.
Jessica Bylander (01:55):
Yeah. And just thinking about health equity and
what we know, do do we seedifferences in the experiences
of food and nutrition insecurityby certain demographic factors?
Diane Schanzenbach (02:06):
First, I want to say that households with
children are more likely toexperience food insecurity. So
compared to everyone else, kidsare more likely to be exposed to
this. And the second is theracial and ethnic gaps are
large. So in general, foodinsecurity rates for black
families and for Hispanicfamilies are about twice the
(02:29):
level as they are among whitefamilies. So the the disparities
are quite large.
Jessica Bylander (02:37):
And in your health policy brief, you you
write about a couple of majorfederal food support programs
that young children access. Soso what are these programs?
Diane Schanzenbach (02:47):
So the big two are SNAP, the Supplemental
Nutrition Assistance Program,and WIC, the Special
Supplemental Nutrition Programfor Women, Infants and Children.
So SNAP and WIC are doing thelion's share of the work here.
And they're different in someimportant ways. And so let's
(03:07):
unpack that for a minute. Sofirst, is a large program.
It's not just for kids. It's notjust for families and kids.
Something like fourteen percentof people in The United States
participate in SNAP. On SNAP,you get a card that you can take
to the grocery store or farmersmarkets or other places, and
(03:31):
it'll debit off of your yourbenefits. And so you can choose
most foods that are available atgrocery stores.
There are some exceptions. Andyou face prices and, you know,
decide, you know, how you wantto allocate your your resources.
Most families also have cashincome that they bring to that.
(03:53):
So the first letter in SNAP isfor supplemental, and right? It
means that most families, youknow, have to bring multiple
types of resources to thegrocery store.
Now, WIC, on the other hand, isa much more narrow program
that's right there in the nameof it. Right? Women, infants and
children. It impacts a largenumber of children in this age
(04:18):
range, especially infants. Soyou might remember or certainly
anybody who's had an infantremembers how expensive infant
formula can be.
Oh, yes. It provides infantformula for babies who are
either not fully breastfeedingor are only partially
(04:39):
breastfeeding or notbreastfeeding at all during that
first year of life. After youturn one, you get vouchers for
very specific goods that areknown to be very important
nutritionally, especially forthese young children. So think
about, you know, gallons of milkor orange juice or, you know,
(05:01):
peanut butter, you know, othersources of protein, things like
that. And so something that'sinteresting about it is these
are vouchers not for dollaramounts, but for actual, you
know, containers of formula orgallons of milk, etcetera.
And so between these twoprograms, that's sort of our
front line of defense againstfood insecurity for the youngest
(05:25):
children in The United States.
Jessica Bylander (05:27):
Yeah. And do a lot of families use both or, you
know, is one more I don't knowif popular is the word, but one
more utilized than the other?
Diane Schanzenbach (05:36):
More families with young children are
eligible for WIC just because ofthe way that it's set up. It's a
little more generous in terms ofthe income cutoffs that you're
allowed to have. And somethinglike 80% of people who are
eligible for, especially thoseinfant formula benefits,
(05:58):
participate in the program. Iwant to say that something like
half of all infants in TheUnited States get WIC in that
first year of life. So it's avery, very large program and
just extremely important forthat first year of life when it
would just be unconscionable tolet a child go hungry.
(06:20):
Well, I guess it's alwaysunconscionable to let a child go
hungry, but especially with thebrain development in that first
year. So then, you know, what wesee is after that infant formula
benefit ceases, participation inWIC falls off quite
substantially, such that by agefour, only about thirty percent
(06:46):
of those who are eligible forWIC are participating in it. In
the brief that we produced forhealth affairs a few years ago,
we showed that actually thereare more three year olds on SNAP
than there are on WIC. That'snot true for zero, you know, for
newborns. But because of justthe way that this evolves over
(07:11):
time, lots of families don'tcontinue to use the benefits as
their children age.
Jessica Bylander (07:18):
And in the brief, it seemed like, you know,
it's hard to get a handle onexactly how many kids are using
both programs or like whatpercent. So I think you you all
estimated at the time thattwenty nine percent of children,
zero to four participated inSNAP and also twenty nine
percent in WIC. And that was, Ithink, 2016 number. So is there
(07:40):
a sense of of whether thenumbers have remained pretty
stable or have they changed,especially, you know, with the
pandemic and everything goingon?
Diane Schanzenbach (07:47):
Exactly. Exactly. So we've seen a couple
of trends since then. And you'reright. Our brief was written a
couple of years ago and it'sjust hard to get the data to
study this in all of the waysthat we'd like to.
So, you know, apologies forthose limitations. So we've seen
(08:09):
a decline in the number ofchildren who are eligible for
WIC, and that seems to beprimarily driven by declines in
the population in this age.We've seen a decline in
newborns, etc, whereasconditional on being eligible
share of the population thatparticipates has been pretty
(08:30):
stable over the last five toeight or so years. On the other
hand, SNAP increasedsubstantially during the
pandemic. We made the benefitsmore generous in some ways and
participation has gone up about15% since the pandemic.
(08:52):
Now, some of that was alsobecause were before the
pandemic, we were at a prettygood economic place. And, you
know, then, of course, thebottom fell out and lots of
families lost their jobs. And,you know, it takes a while to
you to get back on your feetafter that. But, you know, I
think we've seen, you know,overall SNAP participation go
(09:13):
up. WIC, you know, has gone downa little bit, but that seems to
be driven primarily by thenumber of people in the
population that are of that age.
Now, at the same time, I think Iwant to mention that food
insecurity has also gone upsince we wrote this brief. There
(09:34):
was, you know, it went down fora couple more years, you know,
and then we saw some ups anddowns during the pandemic. But
then, of course, more recently,in part due to food price
inflation, other factors aswell. We've seen food insecurity
go up a little bit.
Jessica Bylander (09:51):
Okay. Well, yeah. Yeah, I guess that's I
mean, I'm sure somethingconcerning and something to
watch in terms of ofparticipation and and the
impacts. I am curious sort ofwhat the evidence shows about
how effective SNAP and WIC arefor very young children, sort of
like what we know and what don'twe know.
Diane Schanzenbach (10:12):
So some of the, I guess, most exciting
evidence, if I can call it that,comes from a paper that I wrote
with Hilary Hoynes and DougAlmond a few years ago where we
used variation in the originalintroduction of SNAP. At the
time, it was called the FoodStamp Program, and it was
(10:32):
launched as part of the war onpoverty in the 1960s and the
1970s. And not to bore thelisteners, but because of the
way that it was rolled out, wecan do a real tight study of
what happens when you live inthe same state, you have access
to SNAP because of the countythat you live in, but your
(10:53):
neighbors don't. And so we cando some comparisons. So we find
a couple of things.
The first is that incidence oflow birth weight goes down when
moms have access to SNAPbenefits when they're expectant
mothers, and birth weights goup. That was particularly the
case for Black families. And soas a result, the SNAP benefits
(11:19):
improve outcomes for everybody,but disproportionately for black
families. Looking at the sixtiesand seventies, the Hispanic
population was much smaller atthe time, so we couldn't look at
them. So then we've been able tofollow people who were children
when food stamps were originallyintroduced.
(11:39):
And we can look to see whathappens if you had access to the
program, let's say between thetime of conception through age
five, on your long termoutcomes. What we find is
twofold. The first is health isimproved substantially. So in
particular, in that we measurewhat's called metabolic syndrome
(12:03):
or markers of metabolicsyndrome. So we find that if you
have access to adequatenutrition because of SNAP in
early life, you grow up to beless likely to be obese, less
likely to have heart disease,diabetes, etc.
Also, there's evidence that justasking adults, you know, how is
(12:24):
your health? Are you excellent,good, fair, poor? They're more
likely to report that they're ingood health in adulthood because
of what happened to them inearly life. And we also find
that economic outcomes getbetter for these children.
They're more likely to graduatefrom high school and
(12:44):
particularly among women, wefind that they're less likely to
be in poverty, themselves lesslikely to be on food stamps in
adulthood and earning more andmore likely to be employed, etc.
Now all of this, I think, comesback to where we started, which
is this is a particularlysensitive time. Making sure that
(13:06):
kids have adequate nutritionduring this time period impacts
both their physical developmentof, all sorts of body systems
and also their braindevelopment. And that pays
dividends over a lifetime. Basedon that, you know, my real
(13:26):
concern is we need to make surethat no child in this
developmental period experiencesfood hardship. Even if we're in
a recession, you know, even if,you know, all sorts of negative
shocks, you know, are happeningaround them, as a society, it's
really important to protectespecially the youngest, most
(13:49):
vulnerable kids.
Jessica Bylander (13:50):
Yeah. I'm I'm just struck by, you know, how
hard it would be to concentratein school and, you know, to to
achieve your academic goals ifyou're hungry or if you're just
not getting the right food. Sothat really resonates to me,
especially as a parent. I'mcurious, since you published the
brief in 2019, what, ifanything, has changed in the
(14:12):
evidence base? You know, haveany exciting new findings been
released, new data sources,anything like that?
Diane Schanzenbach (14:19):
Of course, there was that pandemic that's
happened between here and there.And one of the most exciting
pieces of evidence to come outof the pandemic was the impact
of the fully refundable childtax credit. So again, to walk
out for just a quick second, innormal times, the child tax
(14:40):
credit primarily goes tofamilies that are employed. And
what that means is the lowestincome children either don't get
any child tax credit or don'tget the full amount. Now during
the pandemic, that changed.
Everyone got the child taxcredit, and in fact, they
(15:01):
boosted the amount of thebenefits for everyone and even
more for the youngest children.The results, you know, I think
are very impressive. We reducedchild poverty by 50%. There's
evidence that food insecuritydropped, that people spent this
(15:22):
money in ways that invested inkids, etcetera, etcetera.
Unfortunately, we rolled backthat fully refundable child tax
credit after this time period.
And I think that that policy isready for prime time. Until we
get to that, we also want tothink about how SNAP and how WIC
(15:47):
stepped up during the pandemic.And then how to continue to make
sure that they're as fortifiedas possible so that kids aren't
falling through the cracks.
Jessica Bylander (16:00):
Yeah. Yeah. Thinking about sort of the
recent policy landscape and someof the initiatives, it does seem
like a lot was driven by thepandemic. So I think you've
mentioned a few of the pandemicrelated changes, child tax
credit, increasing SNAPbenefits. So I guess, mean,
first of all, has everythingduring the pandemic, all of
(16:22):
those changes been rolled backat this point and sort of what
do you think about in terms ofpolicy initiatives, what's
needed or sort of what currentlyis being implemented that that
sort of has the best chance ofof improving health for these
very young children.
Diane Schanzenbach (16:43):
One of the policies that has not been
rolled back was that during thepandemic, the Department of
Agriculture revamped the ThriftyFood Plan, which is the amount
of money that SNAP benefits arebased on. The Thrifty Food Plan
had gotten really out of date.It had only really been updated
(17:06):
for inflation over the last, youknow, many decades and USDA had
to do, you know, increasingly,you know, sort of gymnastics to
try to make to try to show thatyou could make ends meet and eat
a healthy diet on the oldThrifty Food Plan. And so USDA,
after being instructed to do soby Congress, tried to find a new
(17:30):
way. So the upshot of this isthat there was about a 20%
increase in SNAP benefits acrossthe board.
Now, this is particularlyimportant for young kids. You
might remember from the briefthat about half of young
children who are on SNAP live inhouseholds with incomes less
(17:53):
than 50% of the poverty line.These are some of the lowest
income and most vulnerablechildren. And this wonky change
in the Thrifty Food Plan thatincreased benefits by 20% means
that all families on SNAP, butparticularly those families,
(18:16):
have more resources to spend.You know, their benefits can
last longer in the month.
They can get, you know, morenutritious foods, a more, you
know, more variety of foods,etcetera. Now I'm concerned that
we're going to roll that back. Ithink that that will be a shame.
(18:36):
Right? Reducing SNAP benefitswill come at a cost of food
insecurity, you know, protectionamong the of the vulnerable,
etcetera.
Jessica Bylander (18:50):
Are there where are the kind of the
biggest policy gaps? I think inthe brief, you talk about sort
of there's like an age rangewhere it's a little bit of a no
man's land between between theselike policy programs that are
available. Can you talk a bitabout the gaps?
Diane Schanzenbach (19:03):
Everybody knows about school meals. And
once you get into kindergarten,you know, in many places,
there's universal free mealsand, you know, free and reduced
price lunch, etcetera. But WICstops at age four and a lot of
kids don't start kindergartenuntil age five. And so there's
this year or so that is just ano man's land. Sure, they're
(19:27):
still eligible for SNAP, butthese other policies that prop
up families incomes and makesure that no kids are falling
through the cracks, There's justthis cavern for those between
age four and five.
The other point, which I'llreiterate, is how important it
(19:49):
is for us to try to understandwhy do families drop out of WIC
when they've got a one year oldor a two year old or a three
year old and find ways toencourage participation among
those ages. Again, sort ofcoming back to just the
tremendous importance of makingsure that we're protecting kids
(20:12):
in these age ranges, that we'redeveloping their brains and
their bodies and that they'vegot enough healthy food to eat.
Jessica Bylander (20:20):
Well, thank you so much, Doctor. Shonson
Bach, for joining us. I mean,this conversation has been so
interesting and like obviouslyso timely with, you know, as as
we know the high cost ofgroceries and everyone sort of
feeling it economically. So Ireally thank you for unpacking
your brief and sort of updatingus on what's going on more
(20:43):
recently.
Diane Schanzenbach (20:45):
Thanks so much for having me.
Jessica Bylander (20:48):
Great. So we'll put a link to the health
policy brief on this topic inthe show notes. To our
listeners, be sure to visitHealth Affairs to read the April
issue on food, nutrition andhealth and listen to the other
episodes in this podcast series.Thank you.
Hello and welcome to Health Affairs four
part podcast miniseries on food,nutrition and health. I'm
Jessica Bylander, a deputyeditor at Health Affairs. We're
releasing four episodes of thisminiseries on Wednesdays leading
up to and continuing with thepublication of our April 2025
theme issue on food, nutritionand health. In today's episode,
(00:32):
we're focusing on the topic offood support programs and their
impacts on very young children.I'm so pleased to be here with
Doctor.
Diane Whitmore Schonsenbach, whois an economist and the Margaret
Walker Alexander Professor ofHuman Development and Social
Policy at NorthwesternUniversity. Doctor. Schonsenbach
is the coauthor with Doctor.Betsy Thorne of a health policy
(00:54):
brief we published on this topicin 2019. Welcome, Doctor.
Schonzenbach.
Diane Schanzenbach (01:00):
Thanks for having me.
Jessica Bylander (01:02):
So first, to set the stage, what do we know
generally about the healthimpacts of food and nutrition
insecurity on very youngchildren, which I think you
define as zero, age zero tofour.
Diane Schanzenbach (01:13):
That's right. Those ages zero to four
are particularly sensitive timeswhere if you don't have access
to adequate nutrition, it haslifetime impacts on you. Right?
So that period of time, ofcourse, you know, your brain's
growing, your body's growing ata very rapid rate. And it's
(01:36):
really important that we protectkids from any sort of negative
shocks, you know, whether theirparents lose their jobs or
there's a recession or just forwhatever reason, there's not
enough food in the house thatcan not only harm kids in the
short run, but then there'sincreasing evidence that it
hurts them in the long run aswell.
Jessica Bylander (01:55):
Yeah. And just thinking about health equity and
what we know, do do we seedifferences in the experiences
of food and nutrition insecurityby certain demographic factors?
Diane Schanzenbach (02:06):
First, I want to say that households with
children are more likely toexperience food insecurity. So
compared to everyone else, kidsare more likely to be exposed to
this. And the second is theracial and ethnic gaps are
large. So in general, foodinsecurity rates for black
families and for Hispanicfamilies are about twice the
(02:29):
level as they are among whitefamilies. So the the disparities
are quite large.
Jessica Bylander (02:37):
And in your health policy brief, you you
write about a couple of majorfederal food support programs
that young children access. Soso what are these programs?
Diane Schanzenbach (02:47):
So the big two are SNAP, the Supplemental
Nutrition Assistance Program,and WIC, the Special
Supplemental Nutrition Programfor Women, Infants and Children.
So SNAP and WIC are doing thelion's share of the work here.
And they're different in someimportant ways. And so let's
(03:07):
unpack that for a minute. Sofirst, is a large program.
It's not just for kids. It's notjust for families and kids.
Something like fourteen percentof people in The United States
participate in SNAP. On SNAP,you get a card that you can take
to the grocery store or farmersmarkets or other places, and
(03:31):
it'll debit off of your yourbenefits. And so you can choose
most foods that are available atgrocery stores.
There are some exceptions. Andyou face prices and, you know,
decide, you know, how you wantto allocate your your resources.
Most families also have cashincome that they bring to that.
(03:53):
So the first letter in SNAP isfor supplemental, and right? It
means that most families, youknow, have to bring multiple
types of resources to thegrocery store.
Now, WIC, on the other hand, isa much more narrow program
that's right there in the nameof it. Right? Women, infants and
children. It impacts a largenumber of children in this age
(04:18):
range, especially infants. Soyou might remember or certainly
anybody who's had an infantremembers how expensive infant
formula can be.
Oh, yes. It provides infantformula for babies who are
either not fully breastfeedingor are only partially
(04:39):
breastfeeding or notbreastfeeding at all during that
first year of life. After youturn one, you get vouchers for
very specific goods that areknown to be very important
nutritionally, especially forthese young children. So think
about, you know, gallons of milkor orange juice or, you know,
(05:01):
peanut butter, you know, othersources of protein, things like
that. And so something that'sinteresting about it is these
are vouchers not for dollaramounts, but for actual, you
know, containers of formula orgallons of milk, etcetera.
And so between these twoprograms, that's sort of our
front line of defense againstfood insecurity for the youngest
(05:25):
children in The United States.
Jessica Bylander (05:27):
Yeah. And do a lot of families use both or, you
know, is one more I don't knowif popular is the word, but one
more utilized than the other?
Diane Schanzenbach (05:36):
More families with young children are
eligible for WIC just because ofthe way that it's set up. It's a
little more generous in terms ofthe income cutoffs that you're
allowed to have. And somethinglike 80% of people who are
eligible for, especially thoseinfant formula benefits,
(05:58):
participate in the program. Iwant to say that something like
half of all infants in TheUnited States get WIC in that
first year of life. So it's avery, very large program and
just extremely important forthat first year of life when it
would just be unconscionable tolet a child go hungry.
(06:20):
Well, I guess it's alwaysunconscionable to let a child go
hungry, but especially with thebrain development in that first
year. So then, you know, what wesee is after that infant formula
benefit ceases, participation inWIC falls off quite
substantially, such that by agefour, only about thirty percent
(06:46):
of those who are eligible forWIC are participating in it. In
the brief that we produced forhealth affairs a few years ago,
we showed that actually thereare more three year olds on SNAP
than there are on WIC. That'snot true for zero, you know, for
newborns. But because of justthe way that this evolves over
(07:11):
time, lots of families don'tcontinue to use the benefits as
their children age.
Jessica Bylander (07:18):
And in the brief, it seemed like, you know,
it's hard to get a handle onexactly how many kids are using
both programs or like whatpercent. So I think you you all
estimated at the time thattwenty nine percent of children,
zero to four participated inSNAP and also twenty nine
percent in WIC. And that was, Ithink, 2016 number. So is there
(07:40):
a sense of of whether thenumbers have remained pretty
stable or have they changed,especially, you know, with the
pandemic and everything goingon?
Diane Schanzenbach (07:47):
Exactly. Exactly. So we've seen a couple
of trends since then. And you'reright. Our brief was written a
couple of years ago and it'sjust hard to get the data to
study this in all of the waysthat we'd like to.
So, you know, apologies forthose limitations. So we've seen
(08:09):
a decline in the number ofchildren who are eligible for
WIC, and that seems to beprimarily driven by declines in
the population in this age.We've seen a decline in
newborns, etc, whereasconditional on being eligible
share of the population thatparticipates has been pretty
(08:30):
stable over the last five toeight or so years. On the other
hand, SNAP increasedsubstantially during the
pandemic. We made the benefitsmore generous in some ways and
participation has gone up about15% since the pandemic.
(08:52):
Now, some of that was alsobecause were before the
pandemic, we were at a prettygood economic place. And, you
know, then, of course, thebottom fell out and lots of
families lost their jobs. And,you know, it takes a while to
you to get back on your feetafter that. But, you know, I
think we've seen, you know,overall SNAP participation go
(09:13):
up. WIC, you know, has gone downa little bit, but that seems to
be driven primarily by thenumber of people in the
population that are of that age.
Now, at the same time, I think Iwant to mention that food
insecurity has also gone upsince we wrote this brief. There
(09:34):
was, you know, it went down fora couple more years, you know,
and then we saw some ups anddowns during the pandemic. But
then, of course, more recently,in part due to food price
inflation, other factors aswell. We've seen food insecurity
go up a little bit.
Jessica Bylander (09:51):
Okay. Well, yeah. Yeah, I guess that's I
mean, I'm sure somethingconcerning and something to
watch in terms of ofparticipation and and the
impacts. I am curious sort ofwhat the evidence shows about
how effective SNAP and WIC arefor very young children, sort of
like what we know and what don'twe know.
Diane Schanzenbach (10:12):
So some of the, I guess, most exciting
evidence, if I can call it that,comes from a paper that I wrote
with Hilary Hoynes and DougAlmond a few years ago where we
used variation in the originalintroduction of SNAP. At the
time, it was called the FoodStamp Program, and it was
(10:32):
launched as part of the war onpoverty in the 1960s and the
1970s. And not to bore thelisteners, but because of the
way that it was rolled out, wecan do a real tight study of
what happens when you live inthe same state, you have access
to SNAP because of the countythat you live in, but your
(10:53):
neighbors don't. And so we cando some comparisons. So we find
a couple of things.
The first is that incidence oflow birth weight goes down when
moms have access to SNAPbenefits when they're expectant
mothers, and birth weights goup. That was particularly the
case for Black families. And soas a result, the SNAP benefits
(11:19):
improve outcomes for everybody,but disproportionately for black
families. Looking at the sixtiesand seventies, the Hispanic
population was much smaller atthe time, so we couldn't look at
them. So then we've been able tofollow people who were children
when food stamps were originallyintroduced.
(11:39):
And we can look to see whathappens if you had access to the
program, let's say between thetime of conception through age
five, on your long termoutcomes. What we find is
twofold. The first is health isimproved substantially. So in
particular, in that we measurewhat's called metabolic syndrome
(12:03):
or markers of metabolicsyndrome. So we find that if you
have access to adequatenutrition because of SNAP in
early life, you grow up to beless likely to be obese, less
likely to have heart disease,diabetes, etc.
Also, there's evidence that justasking adults, you know, how is
(12:24):
your health? Are you excellent,good, fair, poor? They're more
likely to report that they're ingood health in adulthood because
of what happened to them inearly life. And we also find
that economic outcomes getbetter for these children.
They're more likely to graduatefrom high school and
(12:44):
particularly among women, wefind that they're less likely to
be in poverty, themselves lesslikely to be on food stamps in
adulthood and earning more andmore likely to be employed, etc.
Now all of this, I think, comesback to where we started, which
is this is a particularlysensitive time. Making sure that
(13:06):
kids have adequate nutritionduring this time period impacts
both their physical developmentof, all sorts of body systems
and also their braindevelopment. And that pays
dividends over a lifetime. Basedon that, you know, my real
(13:26):
concern is we need to make surethat no child in this
developmental period experiencesfood hardship. Even if we're in
a recession, you know, even if,you know, all sorts of negative
shocks, you know, are happeningaround them, as a society, it's
really important to protectespecially the youngest, most
(13:49):
vulnerable kids.
Jessica Bylander (13:50):
Yeah. I'm I'm just struck by, you know, how
hard it would be to concentratein school and, you know, to to
achieve your academic goals ifyou're hungry or if you're just
not getting the right food. Sothat really resonates to me,
especially as a parent. I'mcurious, since you published the
brief in 2019, what, ifanything, has changed in the
(14:12):
evidence base? You know, haveany exciting new findings been
released, new data sources,anything like that?
Diane Schanzenbach (14:19):
Of course, there was that pandemic that's
happened between here and there.And one of the most exciting
pieces of evidence to come outof the pandemic was the impact
of the fully refundable childtax credit. So again, to walk
out for just a quick second, innormal times, the child tax
(14:40):
credit primarily goes tofamilies that are employed. And
what that means is the lowestincome children either don't get
any child tax credit or don'tget the full amount. Now during
the pandemic, that changed.
Everyone got the child taxcredit, and in fact, they
(15:01):
boosted the amount of thebenefits for everyone and even
more for the youngest children.The results, you know, I think
are very impressive. We reducedchild poverty by 50%. There's
evidence that food insecuritydropped, that people spent this
(15:22):
money in ways that invested inkids, etcetera, etcetera.
Unfortunately, we rolled backthat fully refundable child tax
credit after this time period.
And I think that that policy isready for prime time. Until we
get to that, we also want tothink about how SNAP and how WIC
(15:47):
stepped up during the pandemic.And then how to continue to make
sure that they're as fortifiedas possible so that kids aren't
falling through the cracks.
Jessica Bylander (16:00):
Yeah. Yeah. Thinking about sort of the
recent policy landscape and someof the initiatives, it does seem
like a lot was driven by thepandemic. So I think you've
mentioned a few of the pandemicrelated changes, child tax
credit, increasing SNAPbenefits. So I guess, mean,
first of all, has everythingduring the pandemic, all of
(16:22):
those changes been rolled backat this point and sort of what
do you think about in terms ofpolicy initiatives, what's
needed or sort of what currentlyis being implemented that that
sort of has the best chance ofof improving health for these
very young children.
Diane Schanzenbach (16:43):
One of the policies that has not been
rolled back was that during thepandemic, the Department of
Agriculture revamped the ThriftyFood Plan, which is the amount
of money that SNAP benefits arebased on. The Thrifty Food Plan
had gotten really out of date.It had only really been updated
(17:06):
for inflation over the last, youknow, many decades and USDA had
to do, you know, increasingly,you know, sort of gymnastics to
try to make to try to show thatyou could make ends meet and eat
a healthy diet on the oldThrifty Food Plan. And so USDA,
after being instructed to do soby Congress, tried to find a new
(17:30):
way. So the upshot of this isthat there was about a 20%
increase in SNAP benefits acrossthe board.
Now, this is particularlyimportant for young kids. You
might remember from the briefthat about half of young
children who are on SNAP live inhouseholds with incomes less
(17:53):
than 50% of the poverty line.These are some of the lowest
income and most vulnerablechildren. And this wonky change
in the Thrifty Food Plan thatincreased benefits by 20% means
that all families on SNAP, butparticularly those families,
(18:16):
have more resources to spend.You know, their benefits can
last longer in the month.
They can get, you know, morenutritious foods, a more, you
know, more variety of foods,etcetera. Now I'm concerned that
we're going to roll that back. Ithink that that will be a shame.
(18:36):
Right? Reducing SNAP benefitswill come at a cost of food
insecurity, you know, protectionamong the of the vulnerable,
etcetera.
Jessica Bylander (18:50):
Are there where are the kind of the
biggest policy gaps? I think inthe brief, you talk about sort
of there's like an age rangewhere it's a little bit of a no
man's land between between theselike policy programs that are
available. Can you talk a bitabout the gaps?
Diane Schanzenbach (19:03):
Everybody knows about school meals. And
once you get into kindergarten,you know, in many places,
there's universal free mealsand, you know, free and reduced
price lunch, etcetera. But WICstops at age four and a lot of
kids don't start kindergartenuntil age five. And so there's
this year or so that is just ano man's land. Sure, they're
(19:27):
still eligible for SNAP, butthese other policies that prop
up families incomes and makesure that no kids are falling
through the cracks, There's justthis cavern for those between
age four and five.
The other point, which I'llreiterate, is how important it
(19:49):
is for us to try to understandwhy do families drop out of WIC
when they've got a one year oldor a two year old or a three
year old and find ways toencourage participation among
those ages. Again, sort ofcoming back to just the
tremendous importance of makingsure that we're protecting kids
(20:12):
in these age ranges, that we'redeveloping their brains and
their bodies and that they'vegot enough healthy food to eat.
Jessica Bylander (20:20):
Well, thank you so much, Doctor. Shonson
Bach, for joining us. I mean,this conversation has been so
interesting and like obviouslyso timely with, you know, as as
we know the high cost ofgroceries and everyone sort of
feeling it economically. So Ireally thank you for unpacking
your brief and sort of updatingus on what's going on more
(20:43):
recently.
Diane Schanzenbach (20:45):
Thanks so much for having me.
Jessica Bylander (20:48):
Great. So we'll put a link to the health
policy brief on this topic inthe show notes. To our
listeners, be sure to visitHealth Affairs to read the April
issue on food, nutrition andhealth and listen to the other
episodes in this podcast series.Thank you.
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