By Carolyn Lochhead
Read the original article in the San Francisco Chronicle
Food stamps, the nation's premier poverty program, can buy just about anything that passes for edible on a supermarket shelf: chips, soft drinks, candy and all the other items known in common parlance as junk food.
This fact, in tandem with epidemic obesity that afflicts the poor and racial minorities more than other Americans, lurks beneath the brawl dividing Congress over whether to slash funding for the Supplemental Nutrition Assistance Program.
Having quadrupled since 2001 to almost $78 billion a year, the program feeds 1 in 7 Americans. House Republicans have passed legislation that would cut $39 billion over a decade, which Democrats are trying to block in negotiations over the farm bill.
What few on either side want to touch are the conclusions of a report last year by Oakland public health activist Michele Simon, who called food stamps the "the largest, most overlooked corporate subsidy in the farm bill" and urged Congress to enact nutrition standards that would limit purchases of unhealthy food with government assistance.
Her report set off a backlash among advocates for the poor that proved so divisive that many public-health groups refused to take a position on the issue. Some groups do not want even to discuss nutrition standards as they struggle to stave off budget cuts in the food stamp program, known as SNAP nationally and CalFresh in California.
"It's a very uncomfortable debate," said Michael Dimock, president of Roots of Change, a Bay Area group that advocates for sustainable and local agriculture. "People are forced into making purchases of food with little money, and it feels like another injustice for them to be told what they can or cannot buy. At the same time, logically speaking, it's a very difficult situation for us as a nation to be supplementing people's purchase of unhealthy food."
Food industry opposed
The issue also divides the right. The food industry fiercely opposes nutrition standards.
House Republicans adopted almost the entire food stamp plank of the conservative Heritage Foundation - work requirements for able-bodied adults, drug testing and big funding cuts - except for a ban on junk food.
Almost 70 percent of adult Americans and 1 in 3 children are overweight, according to the Centers for Disease Control and Prevention. Obesity fuels such chronic diseases as diabetes, heart disease and cancer, adding an estimated $150 billion each year to U.S. health care costs, including Medicaid, the federal health care program for the poor. Obesity afflicts people of all incomes but is more concentrated among the poor.
Imposing standards
As obesity soared, Congress applied nutrition standards to other federal food programs. In 2009, nutrition standards were tightened for the Women, Infants and Children, or WIC, food program for poor mothers. In 2010, first lady Michelle Obama led an overhaul of the National School Lunch Program that added fruits, vegetables and whole grains and limited calories.
"Why is it," Simon said, "that we're OK telling women what to feed their children on WIC, and certainly we're fine telling schools what to feed children, but somehow food stamps get a big pass?"
Tatiana Andreyeva, director of economics at Yale University's Rudd Center for Food Policy and Obesity, said there is no evidence that food stamps contribute to obesity.
Food stamp recipients "have a problem with lower diet quality in general, but at the same time, everybody's buying junk," Andreyeva said.
Still, she said, ample evidence links obesity, diabetes and overconsumption of sugar-sweetened drinks. "SNAP is paying for a lot of junk, that's for sure," Andreyeva said. "From a nutrition point of view, obviously we should" add nutrition standards.
Open to limits
In June, Mayors Ed Lee of San Francisco and Jean Quan of Oakland joined 15 other mayors in condemning the House's proposed cuts in the food stamp program but also suggested they were open to nutrition standards.
"It is time to test and evaluate approaches to limiting SNAP's subsidization of products, such as sugar-sweetened beverages, that are contributing to obesity," the mayors wrote in a letter to Congress.
But many see government-imposed nutrition guidelines as paternalistic.
"We should have more nutritious food, we should have less toxic food, I don't think we should have food that's crummy, but I don't know why poor people have to bear the burden of what are essentially political choices," said Julie Guthman, a professor of social science at UC Santa Cruz and author of "Weighing In: Obesity, Food Justice, and the Limits of Capitalism." "If we're concerned about having junky food in our food supply, then we should figure out ways to minimize or eliminate junky food."
Defining Junk Food
A 2007 report by the Food and Nutrition Service, which operates the food stamp program for the Department of Agriculture, argued against nutrition guidelines, saying a person's entire diet is what matters, not individual foods.
The report said defining junk food is tricky: Candy bars can have less fat than cheddar cheese, and some potato chips have less salt than some breakfast cereals.
With more than 300,000 foods on the market and thousands added each year, setting nutrition standards is costly and impractical, the report said.
Simon said the WIC program proved that limits can be imposed. Nutrition standards in food stamps, she said, would present "an opportunity to shift the entire food system to a more healthy, sustainable way of providing food."
But it's the level of food stamp benefits, not their nutrition content, that is "the biggest factor in whether or not folks eat nutritiously," said Leslie Mikkelsen, managing director of the Prevention Institute, an Oakland nonprofit that seeks to improve health in poor communities.
Giving incentives
The institute has not taken a position on the nutrition debate in food stamps but strongly endorses taxes on sugary beverages. Mikkelsen said that what most influences purchases among the poor is "their community food environment and what's being marketed to their kids."
The one area where most factions agree is that food stamp recipients should have incentives to buy more nutritious foods. Some programs, pioneered by private groups such as Wholesome Wave in Connecticut, double food stamp benefits for purchases of fresh fruits and vegetables at farmers' markets.
Dimock of Roots of Change said that as obesity-related health care costs rise, "there is going to be more and more pressure to rationalize public investments, and so the pressure is going to build" to impose nutrition standards.