Food Stamp Nutrition Education:

Promoting Healthy Eating and Active Lifestyles

Alberta FrostKaren Walker

Food and Nutrition ServiceU.S. Department of Agriculture

FNS Programs: Reaching People Across Generations…

Touching the lives of 1 in 5 Americans each year…

FNS Strategic Plan

Objective 1.3:Improved nutritional quality of

meals, food packages, commodities, and other benefits

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:Improved nutrition of children

And low-income people

Goal 2:Improved stewardship

of Federal funds

Objective 1.1:Improved food security

Objective 1.2:FNS program participants make

healthy food choices

Objective 2.1:Improved benefit accuracy and

reduced fraud

Objective 2.2:Improved efficiency of program administration

FNS Strategic Goal 1:Improved nutrition of children

and low income people

ObjectivesObjectives • Improved food security• FNS program participants make healthy

food choices• Improved nutritional quality of meals,

food packages, commodities, and other program benefits.

WIC Breastfeeding & Promotion

$70.0M

Food StampNutrition Education

$185.8M*

Child NutritionTeam Nutrition

$ 9.8M

WIC$260.9M

Federal Expenditures: Nutrition Education FY2004

Food SafetyEducation

$ 2.5M

* Represents 50% of State costs, reimbursed by USDA

FNS Nutrition EducationObligations Per Participant- FY 2004

$7.87

$0.20

$33.45

$0.00

$5.00

$10.00

$15.00

$20.00

$25.00

$30.00

$35.00

Food Stamp* Child Nutrition WIC**

* Represents 50% of State costs, reimbursed by USDA** Does not include breastfeeding promotion

Over 24 million

participants per month nationwide

Over 24 million

participants per month nationwide

Food Stamp Program Participants

• 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”

Food Stamp Program Vision:Shifting the Paradigm

Food StampNutrition Education

Helping participants to make healthier choices

52 State Agencies have Nutrition

Education Plans

Food StampNutrition Education

Types ofImplementing Agencies

• 45% are CES

• 18% are networks

• 37% are other organizations

0.0

50.0

100.0

150.0

200.0

250.0

'92

'94

'96

'98

'00

'02

'04

Fiscal Year

Mil

lio

ns

Millions

Approved Federal Funding for FSP Nutrition Education,

FY1992 to FY 2004

Food Stamp Nutrition Education: The Flexibility Paradox

States have considerable flexibility:

• Goals and objectives

• Target groups

• Interventions & educational strategies

• Service delivery settings

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

2003 Review of FSP byOffice 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 specificactions to be undertaken…”

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

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

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

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

The Need for Change:Poor Dietary Behaviors

-- Overconsumption of fats and sweets-- Underconsumption of fruits, vegetables and grains

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, CDCMorbidity and Mortality Weekly Report, CDC

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

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

• 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.

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.

FSNE Policy Framework:

Clearing the Air

• 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 compilationand analysis of comments

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 throughrevised FSNE guidance andtimeframes.

FSNE Policy Framework: Process to Policy, Policy to Implementation

Thank you!

We look forward to continue working with you to improve the nutrition and health of the

low-income people we all serve.