An Equity-Focused Strategy to Improve Food Security and Diet Quality
Report Publish Date: June 1, 2022
This journal article describes a study of pregnant people who received vouchers for fruit and vegetables on top of their benefits from WIC, the federal nutrition program for women and children. The study is a follow-up to an earlier pilot project run in San Francisco; those results were published in 2020.
The authors found that the $40 vouchers for fruits and vegetables did not have significant effects on pregnant people's food security or the amount of fruits and vegetables they ate, compared to pregnant WIC clients in neighboring counties who did not get the vouchers.
The study took place between September 2020 and September 2021, during the COVID-19 pandemic. The authors say the pandemic may have changed families’ grocery shopping patterns and food preparation routines. Emergency cash support—such as increased SNAP benefits, monthly child credits, and stimulus checks—provided to families during the pandemic may also have diluted the vouchers' effect.
The authors had already conducted a pilot study that gave monthly $40 vouchers for fruits and vegetables to pregnant WIC participants. In that earlier study, participants who experienced food insecurity at the start of the study and received vouchers were more likely to be food secure at the end of the pilot compared to a group of WIC participants who were not pregnant and did not receive the vouchers. They also ate more fruits and vegetables every day, and their risk of preterm delivery went down.
The authors wanted to use the infrastructure of their previous study to address its limitations. In this newer study, they had a comparison group of pregnant WIC participants in two nearby counties.
The authors expected the vouchers to help pregnant WIC participants become more food secure and eat more fruits and vegetables, compared to pregnant WIC participants who did not get the vouchers. They provided the vouchers to 304 pregnant people in San Francisco. The comparison group included 226 people in Alameda County and 240 in San Mateo County. Participants completed surveys at the start of the study and after three months.
“The last decade has seen an upswell of evidence that financial incentives can increase fruit and vegetable purchasing as well as consumption for people experiencing food insecurity and low income.”
—Ronit A. Ridberg, Daniel J. Tancredi, and Hilary K. Seligman, University of California, Davis; Ronli Levi, Sanjana Marpadga, and Melissa Akers, University of California, San Francisco
The authors say helping pregnant people with low incomes buy and eat more fruits and vegetables may increase their food security and improve their nutrition and likelihood of having healthy births, but more study is needed.
Women with low household income and from racial/ethnic minority groups are at elevated risk of food insecurity. Food insecurity during pregnancy is associated with overall less healthy diets, lower intake of the pregnancy-supportive nutrients iron and folate, and significant variations in diet across the course of a month. The goal of this study was to explore the impact of an ongoing $40/month supplement for fruits and vegetables (F&Vs) provided to pregnant people enrolled in the Special Supplemental Nutrition Program for Women and Children (WIC). Our primary outcome was food insecurity using the USDA 6-item survey, and our secondary outcome was dietary intake of F&Vs based on the 10-item Dietary Screener Questionnaire. Participants in intervention and comparison counties completed surveys at enrollment and again approximately three months later (n = 609). Mean ± SD food insecurity at baseline was 3.67 ± 2.79 and 3.47 ± 2.73 in the intervention and comparison groups, respectively, and the adjusted between-group change from baseline to follow-up in food insecurity was 0.05 [95% CI: −0.35, 0.44] (p > 0.05). F&V intake (in cup equivalents) was 2.56 ± 0.95 and 2.51 ± 0.89 at baseline in the two groups, and the adjusted mean between-group difference in changes from baseline was −0.06 [−0.23, 0.11] (p > 0.05). Recruitment and data collection for this study coincided with the most intensive of America’s COVID relief efforts. Our results may indicate that small increases in highly targeted food resources make less of a difference in the context of larger, more general resources being provided to individuals and households in need.
Nutrients 2022, https://doi.org/10.3390/nu14112328
This study and report was conducted and created by the following people.
