Food price policy and mortality: How to even the playing field for participants in SNAP

A new study modeled the effects of six food subsidy and tax combinations on improving diet quality and mortality from cardiometabolic disease according to Supplemental Nutrition Assistance Program (SNAP) status, with some combinations estimating lower overall mortality, and others estimating reductions in mortality disparities.

Previous research shows that poor diet is a major contributor to cardiometabolic disease, and that mortality and diet quality disparities exist between Americans receiving SNAP assistance and those not participating in the program. The study is published online this month in the Journal of Epidemiology and Community Health.

The research team estimated that a national 10 percent price reduction on four healthy food groups, specifically fruits, vegetables, nuts, and whole grains, could prevent 19,600 deaths annually from cardiometabolic disease with approximately equal percentage reductions in each group: SNAP-participants, SNAP-eligible non-participants, and SNAP-ineligible non-participants.

Combining this subsidy with a national 10 percent tax on unhealthy foods, specifically sugary-sweetened beverages and processed meats, would prevent an estimated 33,700 deaths annually, with the greatest percent reductions in SNAP-participants.

“Taxes have advantages and disadvantages,” said first author Parke Wilde, Ph.D., an economist and food policy professor at the Friedman School of Nutrition Science and Policy at Tufts University, noting the relationship between price increases and mortality reduction in SNAP-participants. “As consumers, we all find subsidies more pleasant, but the study did turn up a distinct disparity-reducing effect of the policies that included taxes.”

The greatest reductions in mortality disparities were projected with the addition of a second healthy food subsidy, targeted only to SNAP-participants. This was included on top of the national tax and subsidy combinations.

Specifically, a 10 percent tax on unhealthy foods with a 10 percent subsidy for healthy foods – combined with an additional 30 percent SNAP-targeted subsidy on healthy foods, projected the prevention of a total of 37,546 annual deaths across the three groups. While this led to estimations of two-to-three times larger reductions in mortality among SNAP-participants compared to the SNAP-ineligible group, the mortality disparity was not projected to be completely alleviated.

The research team used data from the National Health and Nutrition Examination Surveys (NHANES) for 2003-2012 to assess diet at baseline. The effects of price changes on diet were modeled using data from studies regarding changes in food prices and price-responsiveness, and results from a SNAP-targeted intervention study.Baseline mortality data by age, sex, and SNAP status was derived from the National Health Interview Survey, 2000-2009.

The study is part of Food-PRICE (Policy Review and Intervention Cost-Effectiveness) project, a research collaboration working to identify cost-effective nutrition strategies that can have the greatest impact on improving health outcomes in the United States.

This work was supported by awards from the National Heart, Lung, and Blood Institute of the National Institutes of Health (R01HL130735 and R01HL115189). The content of this announcement is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. For conflicts of interest disclosure, please see the study.

Additional authors on this study are Zach Conrad, M.P.H., Ph.D., graduate and former postdoctoral fellow in nutritional epidemiology at the Friedman School of Nutrition Science and Policy at Tufts University; Colin D. Rehm, Ph.D., Montefiore Medical Center; Jennifer L. Pomeranz, J.D., M.P.H., New York University; Jose L. Penalvo, Ph.D., Frederick Cudhea, Ph.D., and Renata Micha, R.D., Ph.D., all at the Friedman School of Nutrition Science and Policy at Tufts University; Jonathan Pearson-Stuttard, M.D., M.Sc., M.A., Imperial College London, Liverpool University; Martin O’Flaherty, M.D., Ph.D., Liverpool University. The last author on the study is Dariush Mozaffarian, M.D., Dr.P.H., Jean Mayer Professor and dean of the Friedman School of Nutrition Science and Policy at Tufts University.

Wilde, P., Conrad, Z., Rehm, C.D., Pomeranz, J.L., Penalvo, J.L., Cudhea, F., Pearson-Stuttard, J., O’Flaherty, M., Micha, R., Mozaffarian, D. (2018). Reductions in national cardiometabolic mortality achievable by food price changes according to Supplemental Nutrition Assistance Program (SNAP) eligibility and participation. Journal of Epidemiology and Community Health. Advance online publication. http://dx.doi.org/10.1136/jech-2017-210381

This news release was written with Anna Derian, a student at the Friedman School of Nutrition Science and Policy at Tufts University.