Reflections on Targeted Poverty Programs in Latin America
October
1. Food Stamp Nutrition
Education:
Promoting Healthy Eating and
Active Lifestyles
Alberta Frost
Karen Walker
Food and Nutrition Service
U.S. Department of Agriculture
2. FNS Programs: Reaching
People Across Generations…
Touching the lives of 1 in 5 Americans each year…
3. FNS Strategic Plan
Mission: Increase food security and reduce hunger in partnership
with cooperating organizations by providing children and low-income
people with access to food, a healthful diet, and nutrition education
in a manner that supports American agriculture and inspires public
confidence.
Goal 1: Goal 2:
Improved nutrition of children Improved stewardship
And low-income people of Federal funds
Objective 1.1: Objective 2.1:
Improved food security Improved benefit accuracy and
reduced fraud
Objective 1.2:
FNS program participants make
healthy food choices Objective 2.2:
Improved efficiency of
Objective 1.3: program administration
Improved nutritional quality of
meals, food packages,
commodities, and other benefits
4. FNS Strategic Goal 1:
Improved nutrition of children
and low income people
Objectives
• Improved food security
• FNS program participants make healthy
food choices
• Improved nutritional quality of meals,
food packages, commodities, and other
program benefits.
5. Federal Expenditures:
Nutrition Education FY2004
Food Safety
Education Food Stamp
$ 2.5M Nutrition Education
$185.8M*
WIC Breastfeeding Child Nutrition
& Promotion Team Nutrition
$70.0M $ 9.8M
WIC
$260.9M
* Represents 50% of State costs,
reimbursed by USDA
6. FNS Nutrition Education
Obligations Per Participant- FY 2004
$33.45
$35.00
$30.00
$25.00
$20.00
$7.87
$15.00
$0.20
$10.00
$5.00
$0.00
Food Stamp* Child Nutrition WIC**
* Represents 50% of State costs, reimbursed by USDA
** Does not include breastfeeding promotion
7. Food Stamp Program
Participants
Over 24
million
participan
ts per
month
nationwid
8. Food Stamp Program Vision:
Shifting the Paradigm
• Change perceptions: from food
assistance to nutrition assistance
• Move from coupons to Electronic
Benefit Transfer (EBT)
• Increase program access
• Connect nutrition education
• Potential change in “Name”
9. Food Stamp
Nutrition Education
Helping participants to make
healthier choices
10. Food Stamp
Nutrition Education
52 State Agencies
have Nutrition
Education Plans
12. Approved Federal Funding for
FSP Nutrition Education,
FY1992 to FY 2004
250.0
200.0
Millions
150.0
Millions
100.0
50.0
0.0
4
2
4
6
8
0
2
'9
'9
'9
'9
'0
'0
'0
Fiscal Year
13. Food Stamp Nutrition Education:
The Flexibility Paradox
States have considerable flexibility:
• Goals and objectives
• Target groups
• Interventions & educational strategies
• Service delivery settings
14. Challenges of FSNE Flexibility
• Messages are fragmented and diluted
• Different interpretations about
appropriate activities and expenditures
that qualify for federal reimbursement
• Nutrition education frequently not
recognized as part of the FSP
• No clear picture of what services are
offered to whom
• Not much is known about achievement
of program nutrition goals
15. 2003 Review of FSP by
Office of Management and Budget
• Assessment: “The program is better designed to reduce
hunger and malnutrition related to inadequate income,
than to achieve further incremental improvements in the
dietary status of low income people.”
• Key Recommendation: “[USDA] will develop a plan for
the use of Federal and state program funds to improve
nutrition among program participants [, including] clear
goals, quantifiable outcomes, and specific
actions to be undertaken…”
16. Re-Engineering
Food Stamp Nutrition Education
Major Components:
• Policy Framework
• Study of FSP Nutrition Education Activities
• Reporting System (EARS)
• Nutrition Education Evaluation Process
• Materials Development
17. The Need for Change:
Rising Obesity Rates
• 65% of adults aged 20-74 are overweight or
obese
• Percentage of children who are overweight has
doubled from 7% to 15% in past 20 years
• Percentage of adolescents who are overweight
has almost tripled from 5% to 16%
• About 60.5% of people who earn $15,000 to
$75,000 are overweight or obese, compared with
56% of people who earn more than $75,000
18. The Need for Change:
Growing Health Problems
• Overweight, obesity and physical inactivity are
major risk factors for chronic diseases such as
diabetes, cardiovascular disease and cancer
• 400,000 deaths a year related to poor diet and
physical inactivity – the second leading cause of
preventable death (after smoking)
• Diabetes has increased by 49% in past 10 years,
reflecting strong correlation with obesity; 1 in 3
persons born in 2000 will develop diabetes if no
change in current health habits
19. The Need for Change:
Major Social Costs
• $123 billion per year in 2001 for overweight and
obesity, direct costs: $64.1 billion, indirect costs:
58.8 billion.
• In 2003, the public paid about $39 billion -- or
about $175 per taxpayer -- through Medicare and
Medicaid programs for obesity-linked illnesses.
• If trends continue through 2020, up to one-fifth of
health care expenditures would be devoted to
treating the consequences of obesity
20. The Need for Change:
Poor Dietary Behaviors
-- Overconsumption
of fats and sweets
-- Underconsumption
of fruits, vegetables
and grains
21. The Need for Change:
Inadequate Physical Activity
• Over 50% of U.S. adults do not get adequate
moderate physical activity (brisk walking,
bicycling, vacuuming, gardening)
• Over 60% of children aged 9-13 years do
not participate in any organized physical
activity during non-school hours; over 20%
do not engage in any free-time physical
activity.
Sources:
Behavioral Risk Factor Surveillance System, CDC
Morbidity and Mortality Weekly Report, CDC
22. Re-Engineering
Food Stamp Nutrition Education
Major Components:
• Policy Framework
• Study of FSP Nutrition Education Activities
• Reporting System (EARS)
• Nutrition Education Evaluation Process
• Materials Development
23. FSNE Policy Framework:
What we want it to accomplish
• Increased focus on food stamp recipients, esp. women
and children
• More focus on a few key messages
• Connect with Food Stamp Program
• Added referrals to nutrition & health services
• More collaboration with other FNS programs
• More involvement from FSP administrators
24. FSNE Policy Framework:
Clearing the Air
• The Food Stamp Nutrition Education
Framework is not:
– An effort to reduce funding for nutrition
education
– A strategy to reduce access to food stamps
– A rejection or prohibition of social marketing
– An attempt to limit nutrition education to
counseling or classes in the food stamp office.
25. FSNE Policy Framework:
Clearing the Air
• USDA is interested in messages, strategies,
audiences, venues, or other aspects of FSNE that
will strengthen the program.
• We are seeking an approach that:
– reflects the interests of our partners
– is consistent with existing legal authorities, and
– meaningfully serves the 24 million persons who
participate in the FSP.
26. FSNE Policy Framework:
Process to Policy, Policy to Implementation
• Collaborative approach: internal and external
consultation.
• Framework posted for public comment at
www.fns.usda.gov/oane/menu/FSNE/FSNE.htm
• Comment period ended in July; FNS received more
than 1,000 comments – for and against
• Key partners involved in compilation
and analysis of comments
27. FSNE Policy Framework:
Process to Policy, Policy to Implementation
• No decisions have been reached about the final
Framework.
• FNS remains open to State and local issues and
concerns, and will take the time necessary to
continue discussions with partners.
• Once complete, FNS will provide a full briefing
on results and recommendations.
• Implementation will occur through
revised FSNE guidance and
timeframes.
28. Thank you!
We look forward to continue working with
you to improve the nutrition and health of the
low-income people we all serve.