April 29, 2025 • 21 mins
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Health Affairs' Senior Deputy Editor Rob Lott interviews Mary Kathryn Poole of Harvard University to discuss her recent paper that breaks down and compares economic assistance models on food security and diet quality.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Rob Lott (00:31):
Hello, and welcome to a health podocy. I'm your host,
Rob Lott. As listeners of thispodcast and readers of health
affairs likely already know, theApril issue of health affairs is
dedicated entirely to theintersection of food, nutrition,
(00:55):
and health. When we think aboutthose topics as circles on a
Venn diagram, where they overlapis really where it gets
interesting. It's where researchand study can sharpen our focus
and it's where difficultquestions typically arise,
especially for policymakerscharged with assessing the
(01:17):
potential impact and efficacy ofvarious policy interventions
aimed at improving people'shealth and well-being.
For health affairs and ourauthors, the goal is to inform
those decisions with evidence.But what happens when the
evidence is mixed and whathappens when different
interventions pose trade offsfor individuals, communities and
(01:42):
society at large? That's thesubject of today's health
podocy. I'm here with Doctor.Mary Katherine Poole, a
postdoctoral research fellow atHarvard University's Chan School
of Public Health.
She's the lead author of anarticle on the April issue of
Health Affairs. It's a rapidreview aimed at understanding
(02:04):
and comparing economicassistance models to improve
food security and diet quality.This is some really important
work and I can't wait to dig in.Doctor. Mary Katherine Poole,
welcome to A Health Odyssey.
Mary Kathryn Poole (02:19):
Thank you so much for having me.
Rob Lott (02:21):
So Doctor. Poole, bear with me here, but can you tell
me if I'm even thinking aboutthis correctly in the first
place? Because I think there aremultiple issues at play here,
right? Multiple public policychallenges. One challenge is
that people might not be able toput enough food on the table.
(02:42):
Another challenge is thathowever much food is on the
table, it might not be very goodfor them or good for their
health. And another challenge isbasically in a word poverty,
right? Too many peoplestruggling with low or no
income, which of coursecontributes to and is
(03:03):
exacerbated by food insecurityand diet quality. So is that a
fair take? And if so, maybe youcan talk about how we as a
society have tried to addressthose challenges.
Mary Kathryn Poole (03:15):
Yeah, I think it's definitely a fair
take. And as you alluded to, youknow, these issues often co
occur in the same populationsand are often very much
intertwined. And so The US hasmade significant efforts through
the years to help address theseissues of food insecurity and
(03:36):
diet quality on populationlevel. So one in four Americans
have been reached by a USDAprogram of some kind, which are
generally geared towardsoffering food and nutrition
assistance. So in terms of theprimary interventions that on
(03:58):
the federal level have beenimplemented through the years,
some of the programs take theapproach of offering cash like
assistance that can be spent onfood with the idea that if if
families have this assistance ateach month, they can put that
towards food to help alleviatefood insecurity.
(04:19):
And then some programs also takethe approach of providing food
directly to families. Themajority of the programs I'll
talk about today take the cashlike approach of putting
resources in the pockets offamilies to use on food. But
within these federal programs,some, you know, focus only on
(04:40):
food security and then some tryto focus on food security and
diet quality. So an example,most people are familiar with
SNAP, the Supplemental NutritionAssistance Program, and that's
the largest kind of foodsecurity program in the country
where households receive cashlike benefits each month that
(05:02):
they can use to spend on food.There's also the program the
second largest program is calledWIC, which takes a more
integrated approach of providingcash like assistance to pregnant
mothers and their infants andchildren through the first years
of life.
But there's nutritionrestrictions incorporated into
(05:24):
that program. So the familiescan use the funds to purchase
food, but they have to meetcertain guidelines. And then WIC
also incorporates kind ofwraparound services with
nutrition counseling. So it'smuch more of a diet quality and
health focused program as well.
Rob Lott (05:40):
Can you say a little bit about what some of those
dietary restrictions are theprogram?
Mary Kathryn Poole (05:48):
Yeah. So with WIC, you know, the mission
of the program is to helppregnant women and young
children get a healthy start tolife. And so there's a WIC food
package that has been developedbased on the latest nutrition
science. And within that packageare foods that are demonstrated
(06:09):
to help fuel healthy growth anddevelopment. So fruits and
vegetables, whole grains,limiting things that might be
harmful like too much sugarydrinks and refined carbohydrates
and those types of things.
Rob Lott (06:24):
So it's against this backdrop that you conducted a
review, synthesizing theevidence around these different
interventions. Hopefully, thatthose findings then allow us to
make some comparisons. Can yousay a little bit about how this
review sort of represents anadvance over what we already
(06:44):
know about these programs? Whywas this a good time to do this
review and sort of what were youhoping to learn new from that
process?
Mary Kathryn Poole (06:55):
Yeah, so the evidence for these large federal
nutrition assistance programs ispretty robust for their
effectiveness. Like we know thatSNAP does a great job at helping
to improve food security. Weknow that WIC is equally as
effective as for food securityand nutrition. And and there are
many other smaller programs thatalso have strong evidence.
(07:18):
However, the the trends in foodinsecurity and diet quality are
persistent or and poor nutritionare are persistent in the
country.
And so there's been increasingattention, I think, with the
pandemic, which reallyhighlighted some of the
(07:39):
challenges many Americans havein accessing food and having
enough food to lead a healthylife. I think it became more a
part of, like, dailyconversation and dialogue in the
public. And then I think there'salso been more dialogue in the
policy arena around, like, howhow do we address these
(08:02):
persistent trends and what's theright approach? So is it, you
know, increasing and expandingupon what we're already doing or
is there a need for new kind ofinterventions or solutions? So
these conversations have beenhappening a lot in the policy
world and then also in theresearch world.
And there are several policytimely policy discussions going
(08:25):
on right now related to, youknow, SNAP benefits, either
increasing or decreasing benefitamounts or adding nutrition
restrictions. And so as a team,we felt like with all of the
discussion in the last few yearsand also a lot of innovation
that happened during thepandemic around helping to get
food to people, we wanted totake a look at the evidence and
(08:48):
see, like, where do we stand nowand how can a review of this
evidence potentially informcurrent policy decisions.
Rob Lott (08:55):
Okay. I I understand that the farm bill is up for
renewal later this year and someof these programs fall under
that bill. So was that also onesort of one piece of the the
elements on the calendar thatinspired this review?
Mary Kathryn Poole (09:12):
Yes, for sure. The farm bill authorizes
SNAP and has a lot ofimplications for how SNAP and
SNAP adjacent programs areoperated. So that was a big
piece of it. And then we saw in2021, SNAP was the benefit
amount was increased for thefirst time in many, many years.
(09:34):
It was a 21% benefit increase.
It was permanent permanently tothe benefits and there have been
discussions about, you know,taking that back or whatnot. So
I think there's just a definiteneed to understand, you know,
how well these programs areworking and which way
policymakers might want to gofor for helping American people.
Rob Lott (09:57):
Okay. Well, let's dig in. Can you tell us a little bit
about some of your top linefindings? And I'm curious in
what ways perhaps this synthesismay have confirmed your
suspicions or conversely how itmay have surprised you.
Mary Kathryn Poole (10:15):
Sure. So we basically compared the existing
evidence that had been publishedsince 02/2008. So we wanted to
include studies that were mostrelevant to our current economy.
And we looked for studies thatevaluated either increases to
(10:36):
existing cash like foodassistance programs or nutrition
incentive programs, which aretypically providing like a fruit
and vegetable voucher of somesort to help encourage
nutritious choices. And then wecompared these programs both to
unconditional cash transfers,which have been implemented in
(11:00):
many low and middle incomecountries for decades, but
there's been a growing interestin The US in recent years to see
if, you know, does putting justmore cash in American's pockets
help improve their overallhealth and well-being?
So there have been a lot ofpilot studies in recent years.
(11:21):
So we we reviewed the evidencefor across these three different
types of of economic approachesand overwhelmingly, we found
that the strongest evidence forimpacts on food security was for
increasing benefits to existingprograms or introducing new food
(11:44):
assistance programs. There weresome really great studies that
were in this category that hadreally good impacts on these
outcomes. And then we found thatthe nutrition incentive programs
prompted small increases infruit and vegetable intake
pretty consistently, but less sofor food security, which makes
(12:07):
sense since it's often muchsmaller incentive than receiving
a monthly benefit from SNAP or asimilar program. And then the
evidence for the unconditionalcash transfer pilots that we
reviewed was actually quitelimited.
So there have been a lot ofpilot studies but a lot of them
(12:27):
did not meet our inclusioncriteria. So we didn't really
walk away with any type ofpolicy implication for that type
of program, but we still thinkit's warranted to continue
research in that area because itdoes have the potential to
overcome some of the barriersthat we know exist to
(12:47):
participating in food assistanceprograms that have been well
documented.
Rob Lott (12:52):
Great. Well, I want to hear a little more about the
policy implications of yourfindings. But before we go
there, why don't we go to an adbreak? And we're back. I'm here
(13:22):
with doctor Mary Katherine Poolefrom Harvard University talking
about her recent article inHealth Affairs April issue, all
about the evidence aroundeconomic assistance models to
improve food security and dietquality.
Doctor. Poole, can you say alittle bit about the state of
(13:44):
the research that you examined?How good is the research out
there? Is there something aboutthis field that lends itself to
high quality research or maybeconversely, what's particularly
challenging about doing thiskind of research that might make
it hard to draw some conclusionsin a review like this?
Mary Kathryn Poole (14:05):
Yeah, so we were able to include 23 studies
in our review, which 19 of thosewe rated as fair to good quality
studies. So they all had acomparison group or they were
randomized controlled trials. Sothat's really, you know, the
gold standard for evaluations inthis setting. I'd say the
(14:31):
evidence overall was strong andwe learned a lot from the
studies that we did review. Ithink some of the limitations
were that some of the studiesused like repeated cross
sectional data rather than alongitudinal study where they
(14:52):
were able to follow the samepeople over time.
So that makes it a little moredifficult to have as much
confidence in the effect thatyou're seeing from the results.
And then one of the majorchallenges that we noticed in
some of the studies is finding acomparable group for your
comparison group to theintervention group. And I think
(15:15):
that speaks to the nature ofsome of how food research is
sometimes conducted. And youknow, if there's a policy change
that occurs and you want to lookat it very quickly, you know, a
quick pre post study forevaluating impacts, it's really
hard to just start primary datacollection that quickly. Like
(15:39):
you have to usually find grantfunding and takes a lot of time
and resources.
And so often we rely onsecondary data, which is still
very useful, but is not alwaysthe strongest for having the
most confidence in the outcomesthat you're seeing.
Rob Lott (15:56):
Okay, so going back to sort of your top line findings
that you mentioned before thebreak, I'm curious sort of
what's the next step? Let's sayyou're talking to a policymaker
who's trying to make sense ofyour article and what would you
point them to in terms of maybeopportunities for improving the
(16:16):
status quo?
Mary Kathryn Poole (16:17):
I would say that a big takeaway for me was
that the programs that we dohave in place are working really
well and that cuts to them orremoving programs that are
serving so many families wouldbe very detrimental to food
(16:38):
security and nutrition. I'd alsosay that, you know, I think
there's so many views on thistopic and people have a lot of
ideas about what, you know,there's controversies around
like what should be done, shouldit be more about nutrition
restrictions or should it be,you know, increasing benefits or
should it be more aboutindividual behavior like
(17:02):
nutrition education? I'd sayit's easy to get lost in those
debates. And I think justlooking back to the evidence and
seeing like, you know, from thisreview and many others that have
come before it, like increasingthe benefit amounts to establish
programs does have the potentialto improve health for people.
(17:27):
I'd say another thing that Ithink is important when having
these discussions is, you know,remembering the kind of lived
experiences of people who areengaged and enrolled in these
programs because, you know, foodis something we all do, but it's
very complex and there's, youknow, social and emotional and
(17:48):
environmental components.
And so while it can be easy forus to, think we understand a
certain a certain pro, programexperience, I think having good,
like qualitative researchinvolved in this conversation is
so important because it reallybrings out participant voices
and they can cast a lot of lightonto like what it's like to
(18:11):
participate in a program andwhat they think could make it
better and help their familyhave more food and have a
healthier diet.
Rob Lott (18:18):
Wow. So great advice for policymakers and folks in
this space in general. I'mwondering if you could now maybe
speak to your fellow researchersas well as probably those
funding the research about whereyou'd like to see the field go
next. Where should researchersturn? What are the biggest gaps
(18:40):
in this space that needaddressing?
Mary Kathryn Poole (18:43):
Yes, I think that there needs to be more
studies that directly comparethese different intervention
approaches. So that was kind ofa unique spin of our paper is
that while there have beensystematic reviews that looked
just at WIC and WIC outcomes, wereally wanted to try to compare
(19:04):
these different approaches sideby side. So I think there are a
few studies that we did reviewactually. There were two by Lisa
Harnack that were reallyinteresting where she compared,
you know, effects of receivingSNAP like benefits without
restrictions, SNAP like benefitswith restrictions and then
(19:25):
nutrition incentives. So I thinkthose kinds of studies are
really interesting because it'soften mimicking like what
someone might be experiencing inthe real world because often
families are enrolled inmultiple programs.
And so being able to parse outlike what are the different
effects and, you know,comparative effects between
(19:46):
these programs is important. Ithink another important thing
for the research community istrying to use, you know,
validated and consistentmeasures of food insecurity and
nutrition. We found a lot ofstudies in our review that might
have been eligible to beincluded, but often didn't use a
(20:08):
measure that we could compare toa lot of the gold standard
measures of these outcomes. Sotrying to do that moving
forward, think will be helpful.And then I think also thinking
about other health outcomes inthis work is important.
So yes, you know, diet and foodsecurity are critically
(20:32):
important, but you know, howdoes that relate to mental
health and physical health andoverall well-being? I think the
more studies we can incorporatethose outcomes to paint a better
picture of the large impactthese programs can have.
Rob Lott (20:49):
Wonderful. Well, Doctor. Mary Katherine Poole,
you so much for taking the timeto be here today and tell us all
about your paper. Appreciate youjoining us.
Mary Kathryn Poole (20:58):
Thank you so much.
Rob Lott (21:01):
And to our listeners, thank you for tuning in. If you
enjoyed this episode, recommendit to a friend, subscribe, and
tune in next week. Thanks forlistening. If you enjoyed
today's episode, I hope you'lltell a friend about a health
(21:21):
policy.
Hello, and welcome to a health podocy. I'm your host,
Rob Lott. As listeners of thispodcast and readers of health
affairs likely already know, theApril issue of health affairs is
dedicated entirely to theintersection of food, nutrition,
(00:55):
and health. When we think aboutthose topics as circles on a
Venn diagram, where they overlapis really where it gets
interesting. It's where researchand study can sharpen our focus
and it's where difficultquestions typically arise,
especially for policymakerscharged with assessing the
(01:17):
potential impact and efficacy ofvarious policy interventions
aimed at improving people'shealth and well-being.
For health affairs and ourauthors, the goal is to inform
those decisions with evidence.But what happens when the
evidence is mixed and whathappens when different
interventions pose trade offsfor individuals, communities and
(01:42):
society at large? That's thesubject of today's health
podocy. I'm here with Doctor.Mary Katherine Poole, a
postdoctoral research fellow atHarvard University's Chan School
of Public Health.
She's the lead author of anarticle on the April issue of
Health Affairs. It's a rapidreview aimed at understanding
(02:04):
and comparing economicassistance models to improve
food security and diet quality.This is some really important
work and I can't wait to dig in.Doctor. Mary Katherine Poole,
welcome to A Health Odyssey.
Mary Kathryn Poole (02:19):
Thank you so much for having me.
Rob Lott (02:21):
So Doctor. Poole, bear with me here, but can you tell
me if I'm even thinking aboutthis correctly in the first
place? Because I think there aremultiple issues at play here,
right? Multiple public policychallenges. One challenge is
that people might not be able toput enough food on the table.
(02:42):
Another challenge is thathowever much food is on the
table, it might not be very goodfor them or good for their
health. And another challenge isbasically in a word poverty,
right? Too many peoplestruggling with low or no
income, which of coursecontributes to and is
(03:03):
exacerbated by food insecurityand diet quality. So is that a
fair take? And if so, maybe youcan talk about how we as a
society have tried to addressthose challenges.
Mary Kathryn Poole (03:15):
Yeah, I think it's definitely a fair
take. And as you alluded to, youknow, these issues often co
occur in the same populationsand are often very much
intertwined. And so The US hasmade significant efforts through
the years to help address theseissues of food insecurity and
(03:36):
diet quality on populationlevel. So one in four Americans
have been reached by a USDAprogram of some kind, which are
generally geared towardsoffering food and nutrition
assistance. So in terms of theprimary interventions that on
(03:58):
the federal level have beenimplemented through the years,
some of the programs take theapproach of offering cash like
assistance that can be spent onfood with the idea that if if
families have this assistance ateach month, they can put that
towards food to help alleviatefood insecurity.
(04:19):
And then some programs also takethe approach of providing food
directly to families. Themajority of the programs I'll
talk about today take the cashlike approach of putting
resources in the pockets offamilies to use on food. But
within these federal programs,some, you know, focus only on
(04:40):
food security and then some tryto focus on food security and
diet quality. So an example,most people are familiar with
SNAP, the Supplemental NutritionAssistance Program, and that's
the largest kind of foodsecurity program in the country
where households receive cashlike benefits each month that
(05:02):
they can use to spend on food.There's also the program the
second largest program is calledWIC, which takes a more
integrated approach of providingcash like assistance to pregnant
mothers and their infants andchildren through the first years
of life.
But there's nutritionrestrictions incorporated into
(05:24):
that program. So the familiescan use the funds to purchase
food, but they have to meetcertain guidelines. And then WIC
also incorporates kind ofwraparound services with
nutrition counseling. So it'smuch more of a diet quality and
health focused program as well.
Rob Lott (05:40):
Can you say a little bit about what some of those
dietary restrictions are theprogram?
Mary Kathryn Poole (05:48):
Yeah. So with WIC, you know, the mission
of the program is to helppregnant women and young
children get a healthy start tolife. And so there's a WIC food
package that has been developedbased on the latest nutrition
science. And within that packageare foods that are demonstrated
(06:09):
to help fuel healthy growth anddevelopment. So fruits and
vegetables, whole grains,limiting things that might be
harmful like too much sugarydrinks and refined carbohydrates
and those types of things.
Rob Lott (06:24):
So it's against this backdrop that you conducted a
review, synthesizing theevidence around these different
interventions. Hopefully, thatthose findings then allow us to
make some comparisons. Can yousay a little bit about how this
review sort of represents anadvance over what we already
(06:44):
know about these programs? Whywas this a good time to do this
review and sort of what were youhoping to learn new from that
process?
Mary Kathryn Poole (06:55):
Yeah, so the evidence for these large federal
nutrition assistance programs ispretty robust for their
effectiveness. Like we know thatSNAP does a great job at helping
to improve food security. Weknow that WIC is equally as
effective as for food securityand nutrition. And and there are
many other smaller programs thatalso have strong evidence.
(07:18):
However, the the trends in foodinsecurity and diet quality are
persistent or and poor nutritionare are persistent in the
country.
And so there's been increasingattention, I think, with the
pandemic, which reallyhighlighted some of the
(07:39):
challenges many Americans havein accessing food and having
enough food to lead a healthylife. I think it became more a
part of, like, dailyconversation and dialogue in the
public. And then I think there'salso been more dialogue in the
policy arena around, like, howhow do we address these
(08:02):
persistent trends and what's theright approach? So is it, you
know, increasing and expandingupon what we're already doing or
is there a need for new kind ofinterventions or solutions? So
these conversations have beenhappening a lot in the policy
world and then also in theresearch world.
And there are several policytimely policy discussions going
(08:25):
on right now related to, youknow, SNAP benefits, either
increasing or decreasing benefitamounts or adding nutrition
restrictions. And so as a team,we felt like with all of the
discussion in the last few yearsand also a lot of innovation
that happened during thepandemic around helping to get
food to people, we wanted totake a look at the evidence and
(08:48):
see, like, where do we stand nowand how can a review of this
evidence potentially informcurrent policy decisions.
Rob Lott (08:55):
Okay. I I understand that the farm bill is up for
renewal later this year and someof these programs fall under
that bill. So was that also onesort of one piece of the the
elements on the calendar thatinspired this review?
Mary Kathryn Poole (09:12):
Yes, for sure. The farm bill authorizes
SNAP and has a lot ofimplications for how SNAP and
SNAP adjacent programs areoperated. So that was a big
piece of it. And then we saw in2021, SNAP was the benefit
amount was increased for thefirst time in many, many years.
(09:34):
It was a 21% benefit increase.
It was permanent permanently tothe benefits and there have been
discussions about, you know,taking that back or whatnot. So
I think there's just a definiteneed to understand, you know,
how well these programs areworking and which way
policymakers might want to gofor for helping American people.
Rob Lott (09:57):
Okay. Well, let's dig in. Can you tell us a little bit
about some of your top linefindings? And I'm curious in
what ways perhaps this synthesismay have confirmed your
suspicions or conversely how itmay have surprised you.
Mary Kathryn Poole (10:15):
Sure. So we basically compared the existing
evidence that had been publishedsince 02/2008. So we wanted to
include studies that were mostrelevant to our current economy.
And we looked for studies thatevaluated either increases to
(10:36):
existing cash like foodassistance programs or nutrition
incentive programs, which aretypically providing like a fruit
and vegetable voucher of somesort to help encourage
nutritious choices. And then wecompared these programs both to
unconditional cash transfers,which have been implemented in
(11:00):
many low and middle incomecountries for decades, but
there's been a growing interestin The US in recent years to see
if, you know, does putting justmore cash in American's pockets
help improve their overallhealth and well-being?
So there have been a lot ofpilot studies in recent years.
(11:21):
So we we reviewed the evidencefor across these three different
types of of economic approachesand overwhelmingly, we found
that the strongest evidence forimpacts on food security was for
increasing benefits to existingprograms or introducing new food
(11:44):
assistance programs. There weresome really great studies that
were in this category that hadreally good impacts on these
outcomes. And then we found thatthe nutrition incentive programs
prompted small increases infruit and vegetable intake
pretty consistently, but less sofor food security, which makes
(12:07):
sense since it's often muchsmaller incentive than receiving
a monthly benefit from SNAP or asimilar program. And then the
evidence for the unconditionalcash transfer pilots that we
reviewed was actually quitelimited.
So there have been a lot ofpilot studies but a lot of them
(12:27):
did not meet our inclusioncriteria. So we didn't really
walk away with any type ofpolicy implication for that type
of program, but we still thinkit's warranted to continue
research in that area because itdoes have the potential to
overcome some of the barriersthat we know exist to
(12:47):
participating in food assistanceprograms that have been well
documented.
Rob Lott (12:52):
Great. Well, I want to hear a little more about the
policy implications of yourfindings. But before we go
there, why don't we go to an adbreak? And we're back. I'm here
(13:22):
with doctor Mary Katherine Poolefrom Harvard University talking
about her recent article inHealth Affairs April issue, all
about the evidence aroundeconomic assistance models to
improve food security and dietquality.
Doctor. Poole, can you say alittle bit about the state of
(13:44):
the research that you examined?How good is the research out
there? Is there something aboutthis field that lends itself to
high quality research or maybeconversely, what's particularly
challenging about doing thiskind of research that might make
it hard to draw some conclusionsin a review like this?
Mary Kathryn Poole (14:05):
Yeah, so we were able to include 23 studies
in our review, which 19 of thosewe rated as fair to good quality
studies. So they all had acomparison group or they were
randomized controlled trials. Sothat's really, you know, the
gold standard for evaluations inthis setting. I'd say the
(14:31):
evidence overall was strong andwe learned a lot from the
studies that we did review. Ithink some of the limitations
were that some of the studiesused like repeated cross
sectional data rather than alongitudinal study where they
(14:52):
were able to follow the samepeople over time.
So that makes it a little moredifficult to have as much
confidence in the effect thatyou're seeing from the results.
And then one of the majorchallenges that we noticed in
some of the studies is finding acomparable group for your
comparison group to theintervention group. And I think
(15:15):
that speaks to the nature ofsome of how food research is
sometimes conducted. And youknow, if there's a policy change
that occurs and you want to lookat it very quickly, you know, a
quick pre post study forevaluating impacts, it's really
hard to just start primary datacollection that quickly. Like
(15:39):
you have to usually find grantfunding and takes a lot of time
and resources.
And so often we rely onsecondary data, which is still
very useful, but is not alwaysthe strongest for having the
most confidence in the outcomesthat you're seeing.
Rob Lott (15:56):
Okay, so going back to sort of your top line findings
that you mentioned before thebreak, I'm curious sort of
what's the next step? Let's sayyou're talking to a policymaker
who's trying to make sense ofyour article and what would you
point them to in terms of maybeopportunities for improving the
(16:16):
status quo?
Mary Kathryn Poole (16:17):
I would say that a big takeaway for me was
that the programs that we dohave in place are working really
well and that cuts to them orremoving programs that are
serving so many families wouldbe very detrimental to food
(16:38):
security and nutrition. I'd alsosay that, you know, I think
there's so many views on thistopic and people have a lot of
ideas about what, you know,there's controversies around
like what should be done, shouldit be more about nutrition
restrictions or should it be,you know, increasing benefits or
should it be more aboutindividual behavior like
(17:02):
nutrition education? I'd sayit's easy to get lost in those
debates. And I think justlooking back to the evidence and
seeing like, you know, from thisreview and many others that have
come before it, like increasingthe benefit amounts to establish
programs does have the potentialto improve health for people.
(17:27):
I'd say another thing that Ithink is important when having
these discussions is, you know,remembering the kind of lived
experiences of people who areengaged and enrolled in these
programs because, you know, foodis something we all do, but it's
very complex and there's, youknow, social and emotional and
(17:48):
environmental components.
And so while it can be easy forus to, think we understand a
certain a certain pro, programexperience, I think having good,
like qualitative researchinvolved in this conversation is
so important because it reallybrings out participant voices
and they can cast a lot of lightonto like what it's like to
(18:11):
participate in a program andwhat they think could make it
better and help their familyhave more food and have a
healthier diet.
Rob Lott (18:18):
Wow. So great advice for policymakers and folks in
this space in general. I'mwondering if you could now maybe
speak to your fellow researchersas well as probably those
funding the research about whereyou'd like to see the field go
next. Where should researchersturn? What are the biggest gaps
(18:40):
in this space that needaddressing?
Mary Kathryn Poole (18:43):
Yes, I think that there needs to be more
studies that directly comparethese different intervention
approaches. So that was kind ofa unique spin of our paper is
that while there have beensystematic reviews that looked
just at WIC and WIC outcomes, wereally wanted to try to compare
(19:04):
these different approaches sideby side. So I think there are a
few studies that we did reviewactually. There were two by Lisa
Harnack that were reallyinteresting where she compared,
you know, effects of receivingSNAP like benefits without
restrictions, SNAP like benefitswith restrictions and then
(19:25):
nutrition incentives. So I thinkthose kinds of studies are
really interesting because it'soften mimicking like what
someone might be experiencing inthe real world because often
families are enrolled inmultiple programs.
And so being able to parse outlike what are the different
effects and, you know,comparative effects between
(19:46):
these programs is important. Ithink another important thing
for the research community istrying to use, you know,
validated and consistentmeasures of food insecurity and
nutrition. We found a lot ofstudies in our review that might
have been eligible to beincluded, but often didn't use a
(20:08):
measure that we could compare toa lot of the gold standard
measures of these outcomes. Sotrying to do that moving
forward, think will be helpful.And then I think also thinking
about other health outcomes inthis work is important.
So yes, you know, diet and foodsecurity are critically
(20:32):
important, but you know, howdoes that relate to mental
health and physical health andoverall well-being? I think the
more studies we can incorporatethose outcomes to paint a better
picture of the large impactthese programs can have.
Rob Lott (20:49):
Wonderful. Well, Doctor. Mary Katherine Poole,
you so much for taking the timeto be here today and tell us all
about your paper. Appreciate youjoining us.
Mary Kathryn Poole (20:58):
Thank you so much.
Rob Lott (21:01):
And to our listeners, thank you for tuning in. If you
enjoyed this episode, recommendit to a friend, subscribe, and
tune in next week. Thanks forlistening. If you enjoyed
today's episode, I hope you'lltell a friend about a health
(21:21):
policy.
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