A healthy diet is essential for overall well-being, protecting against chronic noncommunicable diseases like heart disease, diabetes, and cancer. This article explores the multifaceted benefits of ensuring access to healthy food supplies, examining various programs and initiatives aimed at making nutritious food more accessible and affordable.
What Constitutes a Healthy Diet?
A healthy diet comprises a combination of different foods, including staples like cereals (wheat, barley, rye, maize, or rice) or starchy tubers or roots (potato, yam, taro, or cassava), legumes (lentils and beans), fruits and vegetables, and foods from animal sources (meat, fish, eggs, and milk). Eating a variety of foods and consuming less salt, sugars, and saturated and industrially-produced trans-fats are essential components of a healthy diet.
The Importance of Early Dietary Habits
A healthy diet starts early in life. Breastfeeding fosters healthy growth and may have longer-term health benefits, like reducing the risk of becoming overweight or obese and developing noncommunicable diseases later in life. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, followed by the introduction of safe and nutritious complementary foods while continuing to breastfeed until the child is two years old and beyond.
The Role of Fruits and Vegetables
Fruits and vegetables are important sources of vitamins, minerals, dietary fiber, plant protein, and antioxidants. Diets rich in these foods are associated with a significantly lower risk of obesity, heart disease, stroke, diabetes, and certain types of cancer.
Managing Fat Intake
Fats and oils are concentrated sources of energy, and consuming too much, particularly the wrong kinds of fat like saturated and industrially-produced trans-fat, can increase the risk of heart disease and stroke. Using unsaturated vegetable oils (olive, soy, sunflower, or corn oil) rather than animal fats or oils high in saturated fats (butter, ghee, lard, coconut, and palm oil) will help consume healthier fats. Consumption of total fat should not exceed 30% of a person's overall energy intake to avoid unhealthy weight gain.
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Limiting Sugar Intake
For a healthy diet, sugars should represent less than 10% of total energy intake.
SNAP Healthy Incentives
A key barrier to healthy eating is lack of access or enough money to buy nutritious food. SNAP healthy incentives empower Americans to eat more fruits and vegetables, whole grains, and other healthful foods. Improving what we eat can significantly reduce diet-related chronic diseases and disparities.
Eligible Food Categories for Incentives
Retailers can offer incentives for foods in the following food group categories:
- Fruits
- Vegetables, including legumes (beans and peas)
- Whole grains
- Dairy foods
Incentives can apply to specific products or any combination of products as long as they fall into one of the categories above and meet specific criteria. For example, for fruits and vegetables, eligible incentive foods include whole fruits and vegetables (including legumes) and 100% fruit and/or vegetable juice. Any variety of fresh, canned, dried, or frozen whole or cut fruits and vegetables without added sugars, fats, oils, or salt (i.e., sodium) are eligible, as are seeds and plants. For dairy, all varieties of low-fat or non-fat liquid, dry, or evaporated pasteurized cow’s milk, without flavoring or sweeteners, including lactose-free and lactose-reduced products, fortified soy beverages (soy milk), low-fat or non-fat fresh or frozen yogurt, low-fat or non-fat buttermilk, low-fat or non-fat kefir, and low-fat or non-fat cheese are eligible. Cream, butter, sour cream, and cream cheese are not included due to their low calcium content. For whole grains, whole grains, such as amaranth, barley (not pearled), brown rice, buckwheat, bulgur, millet, oats, quinoa, dark rye, and wild rice, and whole-grain products with whole grain listed as the first ingredient (or the second ingredient after water), such as whole-grain cornmeal, whole-wheat bread, whole-wheat chapati, whole-grain cereals, and whole-grain pasta are eligible. Prepared foods (e.g., sandwiches, salad bars, etc.) and accessory foods (e.g., cookies, crackers, ice cream, etc.) are not eligible for SNAP incentives.
How SNAP Incentives Work
Each SNAP healthy incentive program is different. Generally, a SNAP customer earns incentives, such as a coupon, discount at the point of purchase, or extra funds for SNAP purchases, when they purchase eligible incentive foods with their SNAP EBT card. They can then redeem the incentives to purchase more eligible incentive foods or other SNAP eligible foods.
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Types of SNAP Incentive Programs
Several types of SNAP incentive programs exist, including federally funded, state or local government funded, and privately funded programs. Farmers markets also participate by providing incentives to SNAP recipients to make local foods more affordable and support farmers.
Federally Funded Programs
- Electronic Healthy Incentives Pilot (eHIP): Colorado, Louisiana, and Washington were selected to operate statewide eHIP projects. These projects involve upgrading state EBT systems to provide incentives at select retailers.
- SNAP Healthy Incentives Pilot (HIP): This pilot program operated in Hampden County, Massachusetts, and was a precursor to the Gus Schumacher Nutrition Incentive Program (GusNIP).
- Gus Schumacher Nutrition Incentive Program (GusNIP): This competitive grant program is administered by the USDA's National Institute of Food and Agriculture. GusNIP grantees are authorized to provide fruit and vegetable incentives to SNAP recipients. The GusNIP Nutrition Incentive Hub offers information about nutrition incentive projects and includes grantee spotlight stories.
- Healthy Fluid Milk Incentive (HFMI) projects: SNAP participants shopping at select grocery stores receive incentives for purchasing qualifying milk.
State or Local Government Funded Programs
Incentives can be funded by state, local, and tribal governments that partner with SNAP-authorized retailers.
Privately Funded Programs
SNAP-authorized retailers can independently fund incentive programs, or non/for-profit organizations can fund incentives in partnership with stores.
Finding Participating Retailers
The SNAP Retailer Locator allows anyone to locate nearby SNAP-authorized retailers by entering a street address, city and state, or zip code. The “SNAP Healthy Incentive” filter function can be used to search for participating retailers.
Starting a SNAP Incentive Program
The basic steps for starting a SNAP healthy incentive program are:
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- Identify funding: Unless you are a federal grantee, you must identify state, local, or private funding.
- Select SNAP-authorized retailers: Determine which stores will offer incentives.
- Choose your model: Decide how households will earn and redeem incentives.
- Request a waiver: The funding entity or store must get FNS approval to offer healthy incentives. Federal incentive grantees and farmers markets do not need a waiver.
- Train staff and program operators.
- Market and promote: Make sure all SNAP households have an equal opportunity to participate.
A SNAP incentive project must get FNS approval to waive the SNAP equal treatment provision before offering healthy incentives. The SNAP equal treatment provision requires SNAP recipients to be treated the same as other customers. Incentive projects operating at multiple store locations only need one waiver for all locations. A single store may offer incentives funded by multiple sources, but if any portion is funded by a state or local government or private entity, they must first obtain a waiver from FNS. Farmers markets that independently fund incentives for their own market do not need to request a waiver. Incentive projects that are part of one of the federally funded projects, such as GusNIP or HFMI, do not need to request a waiver.
Research on SNAP Incentives
Research suggests that healthy incentive programs can significantly impact dietary habits:
- Healthy Incentives Pilot (HIP): HIP participants consumed almost 1/4 cup (26%) more fruits and vegetables per day than non-participants. HIP households spent more SNAP benefits on fruits and vegetables than non-HIP households in participating supermarkets and superstores.
- Food Insecurity Nutrition Incentives (FINI): FINI increased fruit and vegetable purchases by 12-16% in three of the treatment groups. The overall redemption rate for FINI incentives was about 82%.
- Gus Schumacher Nutrition Incentive Program (GusNIP): Participants redeemed more than $20 million in nutrition incentives and produce prescriptions distributed by GusNIP, generating an economic impact of about $41 million. Participants reported greater fruit and vegetable intake and improvements in hunger reduction.
- Farmers Market Incentive Provider Study: SNAP redemptions and incentive use tended to grow the longer the incentive program was in operation.
Humana Healthy Options Allowance
For Humana members who meet certain criteria, like having qualifying chronic health conditions, an allowance may be used to help pay for eligible food, utilities, phone service, even rent or mortgage payments. Healthy Options Allowance amounts vary by plan and location, with monthly allowances starting at $25/month. The allowance is stored on a member’s Humana Spending Account Card.
Consumer Willingness to Pay for Healthier Foods
Food retail strategies to improve the healthiness of food and beverage options may increase purchasing of healthier options and improve diets. Consumer demand for healthier options is an important determinant of the successful implementation and maintenance of healthy food retail interventions.
Factors Influencing Willingness to Pay
Studies consistently found a positive willingness to pay for foods with reduced fat and wholegrains with additional fruit and vegetables, while willingness to pay for foods with reduced salt or a combination of low fat and sugar, or salt showed mixed results. Adults over 60 years, females, those living with obesity, and consumers who aim to maintain a healthy lifestyle were more likely to pay a price premium for healthier food, whereas younger consumers, consumers with healthy weight, and consumers with higher levels of education were less likely to pay higher prices.
Research Methodology
A systematic review of peer‐reviewed literature was undertaken to explore whether consumers are willing to pay more for healthier foods and to determine the key factors that influence willingness to pay. The review included original peer‐reviewed papers published in English from 2000 to September 6th, 2021, with full‐text available. “Healthy” foods and beverages were defined as fruit; vegetables; grains; lean meat and poultry; milk, yoghurt, cheese, and their non‐diary alternatives; and foods and beverages with limited/reduced content of saturated fat, salt, and sugar.
Key Findings on Willingness to Pay
Twenty three out of the 26 experiments included in this review (88.5%) found consumers would pay a 5.6% to 91.5% (mean 30.7%) price premium for healthier foods. Within these seven experiments, 69.7% to 79% of the participants would pay a price premium (a higher price) for healthier food.
Willingness to Pay by Food Category
- Consumers were willing to pay a mean premium of US$0.72 per meal (a 74.7% price premium) for the addition of a large salad (vegetables), and US$0.07 per meal for the addition of fruit (2 bananas), representing a 7.3% price premium.
- Youth on average would pay US$2.56 (23%) more for the whole grain snack with either fruits or vegetables compared to the whole grain snack alone.
- Consumers were willing to pay a higher price (premium) for lower fat products such as beef, pork, cheese, potato chips, and breakfast cereals with reduced fat content.
Access to Foods That Support Healthy Dietary Patterns
Access to foods that support healthy dietary patterns supports health not only at that point in time but also across the lifespan and possibly for future generations. Consistent evidence demonstrates that a healthy dietary pattern is associated with beneficial outcomes for all-cause mortality, cardiovascular disease, overweight and obesity, type 2 diabetes, bone health, and certain types of cancer. Having access to healthy, safe, and affordable food is crucial for an individual to achieve a healthy dietary pattern.
The Link Between Food Access and Health Outcomes
There is a relationship between the inability to access foods that support healthy dietary patterns and negative health outcomes. For example, residents of neighborhoods with fewer fresh produce sources and plentiful fast-food restaurants and convenience stores were at a higher risk of obesity and diabetes. Lower rates of obesity and diabetes were found in areas with increased access to healthy foods and a higher density of full-service restaurants and grocery stores.
The Impact of the Food Environment Around Schools
The food environment surrounding schools can impact children and adolescents. A study found that students with fast-food restaurants near (within a half-mile of) their schools consumed fewer servings of fruits and vegetables, consumed more servings of soda, and were more likely to be overweight than youth whose schools were not near fast-food restaurants.
Barriers to Accessibility and Availability
There are barriers to, and disparities in, the accessibility and availability of foods that support healthy dietary patterns. Distance to grocery stores and lack of transportation are barriers that can inhibit access to healthy food options. Individuals without a vehicle or access to convenient public transportation, or who do not have food venues with healthy choices within walking distance, have limited access to foods that support healthy dietary patterns. Predominantly Black and Hispanic neighborhoods have fewer large chain supermarkets than predominantly White and non-Hispanic neighborhoods. Lack of access to foods that support healthy dietary patterns may have a greater impact on members of racial/ethnic minority communities, residents of low-income communities, and those living in rural areas, especially older adults, due to the other social and environmental determinants they tend to face. In addition, for those who do not have access to a car or public transportation, the cost of travel time to find healthier options in addition to out-of-pocket expenses may be too high.
The Influence of Affordability
Affordability also influences access to foods that support healthy dietary patterns. Low-income groups tend to rely on foods that are cheap and convenient to access but are often low in nutrients. Fresh fruits and vegetables and other healthier items are often more expensive at convenience stores and small food markets than in larger chain supermarkets and grocery stores. Price reductions of healthier food choices can contribute to increased purchasing of those choices.
Improving Access to Healthy Foods
Improving access to foods that support healthy dietary patterns is one method for addressing health disparities and population health. Several strategies that aim to improve diet by altering food environments are being considered and implemented. Examples of programs to address access to and affordability of healthy foods include: The Gus Schumacher Nutrition Incentive Program, Centers for Disease Control and Prevention (CDC) Food Service Guidelines, and various state and local programs.
UnitedHealthcare Benefits
For eligible members with UnitedHealthcare Medicare Advantage plans, credits will be loaded to your UnitedHealthcare UCard® to help pay for covered over-the-counter (OTC) products. For eligible UnitedHealthcare Medicare Advantage plans, including Dual Special Needs plans (D-SNP), credits will be loaded onto your UnitedHealthcare UCard® to help pay for covered over-the-counter (OTC) products and wellness support. For 2026, verification of a qualifying chronic condition will be required to spend your monthly OTC credit on healthy food and utilities. Credits are loaded to your UCard either quarterly or monthly, depending on the type of plan you have. You can use your credits to shop for a variety of brand name or generic covered products at any of the 65,000 retail locations, including Walmart, CVS and more. To shop online, visit the UCard Hub by signing in to your member site or opening the UnitedHealthcare app.