Are food restrictions the only way to improve health?

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Last week at the Wisconsin Chapter of the American Academy of Pediatrics meeting, one of our partners - a retired doctor and a fierce advocate for food insecurity screening in primary care settings - and I got into a conversation about improving the health of people with low-incomes by restricting FoodShare benefits. In the lunch line, naturally.

She and I have had this back and forth before - she’s more open to restrictions in the FoodShare program whereas I’m more opposed to them - but this time, she was armed with this New York times article reporting on a recent study that showed that restrictions, when paired with incentives, helped to improve the eating habits of people with low-incomes.  

Since previous studies have already shown that incentives by themselves are effective at improving diet quality for people with limited incomes, I am given to wonder why food restrictions as a policy instrument continue resurface. Last year, there was a state proposal to restrict what FoodShare recipients could buy with their benefits. 

Here’s the thing about food choice restrictions: most people regardless of income eat poorly so any policy intervention to improve diet quality should be broad based and inclusive rather than targeting the people who have the least resources to procure healthful food. The fact that the diet quality of people receiving FoodShare is only marginally worse than those with higher incomes bears this out and so it seems unfair to force low-income families into only buying more expensive food.

Imposing restrictions on FoodShare just feels like punching down at people who are poor. That is to say, it would be easier to simply restrict what people can buy with FoodShare than it would be to punch upwards to make unhealthful food the less desirable, hard choice and ensure that healthful food is accessible, affordable, desirable, and the easy choice for everybody regardless of income. 

On any given day, families with low-incomes deal with any number of small indignities that build up over time. Being told what they can and cannot buy or what kinds of food are right for them and their families should not be one of them. I can't help but believe that there are better, more effective and empowering ways to fight hunger and improve health. 

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