Tuesday, May 31, 2016

This report is the third in a series on Fair Food Network’s Double Up Food Bucks healthy food incentive program. Read the others on The Consumer Experience and Double Up in Rural Michigan.

The challenges of hunger and food insecurity are complicated in the United States by the seeming paradox of millions of families that are overfed but undernourished. Recent reports from the Council of Economic Advisors and the National Commission on Hunger confirm that the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) does an excellent job of averting deep and widespread hunger but that it cannot ensure participants’ optimal nutrition.1, 2 

While many factors influence food consumption decisions, experiences with Fair Food Network’s Double Up Food Bucks (Double Up) and similar healthy food incentive efforts around the country indicate that such programs can successfully enhance the benefit of the SNAP program by reducing hunger while also improving nutrition.3


Even as the country pulls out of the Great Recession, more than 45 million people depended on monthly SNAP benefits in 2015.4 There are as many hungry people in the United States as the entire population of Washington State.

Poverty forces individuals to make tough choices that can have long-term effects on their individual futures and on our collective economic potential. According to Bread for the World, the immediate health-related cost of hunger and food insecurity in the United States exceeded $160 billion in 2014.5 

Chronic diseases related to diet are exploding in the U.S., and their incidence is higher among low-income individuals. The combined costs of treating diabetes and heart disease and stroke in the U.S. exceeded half a trillion dollars in 2012.6

Blog Quote A

A key problem for low-income families is that even with SNAP benefits, they do not always have enough money to buy food for the whole month. The average American spends about $50 a week on food while the average SNAP benefit for an individual is $29 a week.7 This leaves a $20 per week food spending gap, which helps explain why roughly 80% of SNAP benefits are redeemed within two weeks of receiving them. Research shows that SNAP recipients consume between 10 to 25% fewer calories as the month progresses.7

Fair Food Network’s Double Up Food Bucks program provides low-income shoppers up to an additional $20 per day incentive to buy produce when they use their SNAP benefits on locally grown fruits and vegetables at participating farmers markets and grocery stores. At the most basic level, such healthy food incentive efforts are anti-hunger programs because they increase the food buying power of low-income individuals who might otherwise be hungry.


A team of researchers at the University of Michigan, led by Dr. Alicia Cohen, have been analyzing transaction data for almost 12,000 SNAP shoppers—nearly 5% of all SNAP households in the region—who used Double Up at eight Detroit farmers markets in 2012 and 2013.8

Blog Quote B

Preliminary data show that 90% of Double Up participants in Detroit had annual household incomes of less than 100% of the Federal Poverty Level and were poorer than the area’s SNAP population as a whole. Among focus group participants, almost 40% usually or always worried about having enough money to buy food.9 In addition to deep poverty, these shoppers faced real health challenges, with 41% being overweight, 27% living with diabetes, and 27% with hypertension.

These consumers were worried about their health and worked hard to ensure that their diets were as nutritious as possible. More than half had shopped at a participating farmers market six or more times during the season. They talked about the importance of having additional food dollars to spend and also emphasized the benefits the farmers markets provided, including high-quality fruits and vegetables, wide product selection that allowed them to try new foods, and a positive environment and shopping experience. They also talked about feeling good that the money they spent helped support the farmers and stayed in the local economy.


Based on the positive results of pilot SNAP produce incentive programs around the country, the 2014 Farm Bill established the Food Insecurity Nutrition Incentive program at the USDA.10 This competitive grants program supports projects that incentivize SNAP shoppers to purchase fruits and vegetables. The program allows practitioners to test different approaches to incentivize delivery, to experiment with new technologies, to replicate proven models, and to study the impact incentives have on SNAP participants’ consumption of healthy produce.

In April 2015, Fair Food Network received a $5 million grant, which was matched with private funding. Fair Food Network used the feedback from the Detroit focus groups and years of participant surveys to guide the organization’s plans for the $10 million investment of Double Up in Michigan.


Low-income American families should not have to choose between being hungry and being healthy. Implemented well, SNAP local produce incentive programs such as Double Up are an effective way to ensure families do not have to make that choice.

Fair Food Network’s experience and careful external research indicates that the Double Up Food Bucks approach of incentivizing nutritious produce purchases among SNAP participants is an effective way to both reduce hunger and support healthy diets.



1 Council of Economic Advisers report. Retrieved from https://www.whitehouse.gov/sites/whitehouse.gov/files/documents/SNAP_rep...

2 National Commission on Hunger report. Retrieved from http://cybercemetery.unt.edu/archive/hungercommission/20151216222324/htt... Portals/0/SiteHtml/Activities/FinalReport/Hunger_Commission_Final_Report.pdf

3 Block, J.P. & Subramianian S.V. (2015). Moving beyond “Food Deserts”: Reorienting United States policies to reduce disparities in diet quality. PLos Med, 12(12): e10001914. Doi:10.1371/journal. Pmed.1001914

4http://www.ers.usda.gov/data-products/ag-and-food-statistics-charting-the-essentials/food-security-and-nutrition-assistance.aspx. In 2006 USDA started using new definitions to describe the range of levels of food insecurity in the U.S. Food insecurity is defined as lacking dependable and consistent access to food. Very low food security means that at least one member of a household missed meals as a result of insufficient resources for food. See more detailed descriptions here: http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security.aspx

5 Cook, J.T. & Poblacion, A.P. Bread for the World Institute 2015 Hunger report: Estimating the health-related costs of food insecurity and hunger. Retrieved from http://www.bread.org/about-brea-world-institute

National Association of Chronic Disease Directors report. Retrieved from  https://c.ymcdn.com/sites/www.chronicdisease.org/resource/resmgr/Policy/...

6 Seligman H.K., Bolger A.F., Guzman D., Lopez A. & Bibbins-Domingo K. (2015). Exhaustion of food budgets at months end and hospital admissions for hypoglycemia. Health Affairs, 33(1):116-123. doi: 10.1377/hlthaff.2013.0096

7 Cohen, A.J., Lachance L., Hesterman O.B., Bair R.C. & Zick S.M. “Barriers and Facilitators to Use of a SNAP Incentive Program at Detroit Farmers Market: A Qualitative Evaluation.” Conference presentation at the American Public Health Association Annual Meeting, New Orleans, Louisiana, November 2014.

8 Ibid.

9 Food Insecurity Nutrition Incentive (FINI) Grant Program. Retrieved from http://nifa.usda.gov/program/food-insecurity-nutrition-incentive-fini-gr...

All postings to the Health Policy Forum (whether from employees or those outside the Institute) represent the views of the individual authors and/or organizations and do not necessarily represent the position, interests, strategy, or opinions of Altarum Institute. Altarum is a nonprofit, nonpartisan organization. No posting should be considered an endorsement by Altarum of individual candidates, political parties, opinions or policy positions.



Areas of Expertise