healthy eating index, food assistance program, low-income households, Health Economics and Policy,

Lee, Jonq-Ying

English

Research Papers in Economics

 
 
 
 
RESEARCH PAPER 2009-misc-2 
 
 
 
Food Assistance Programs and Healthy Diet  
among Low-Income Individuals 
 
by 
 
Jonq-Ying Lee 
 
 
 
 
 
FLORIDA DEPARTMENT OF CITRUS 
Economic and Market Research Department 
P.O. Box 110249 
Gainesville, Florida 32611-2049 USA 
Phone: 352-392-1874 
Fax: 352-392-8634 
Email: jonqying@ufl.edu  
 
 
www.floridajuice.com 
 Food Assistant Programs and Healthy Diet among Low-Income Individuals 
 
Introduction 
 
One of the major goals of food and nutrition assistance programs is to improve the 
nation’s nutrition and health.  In fiscal year 2006, nearly 27 million people participated in the 
FSP every month, or about one in 11 Americans participated in the Food Stamp Program (FSP) 
(Oliveira 2007) and the WIC served almost half of all infants born in the U.S. and about one-
quarter of all children ages between one and four (ERS/USDA 2007).  The FSP has increased 
household food expenditures; however, there is little evidence that the program has a positive 
influence on food intake patterns (Fox et al. 2004).  Wilde et al. (2000b) found that food stamp 
participation tends to increase one’s intake of meats, added sugars, and total fats; but does not 
significantly change one’s intake of fruits, vegetables, grains, and dairy products.  Past research 
showed that the participation in Women, Infant, and Children program (WIC) increases the 
consumption of certain types of WIC approved foods, i.e., fruit and vegetables juices, low-sugar 
cereals; and decreases the consumption of non-WIC beverages such as soft drinks (Oliveira and 
Chandran 2005).  In a recent study, Duffy et al. (2008) found that both the FSP and the WIC 
were not associated with the consumption of a healthy diet as measured by the 1995 healthy 
eating index (HEI) developed by the USDA.  The finding of the lack of association of the WIC 
and healthy diet was unexpected due to the program’s restrictions on the food that participants 
can purchase. 
 
The purpose of this study is to reexamine the factors that influence consumers’ decisions 
to eat a healthy diet, in particular, the impact of the FSP participation on the demand for a 
healthy diet.  In this study, the NHANES 2001-02 and the 1995 HEI was used to examine the 
demand for a healthy diet.  The current study is different from the Duffy et al. study in two ways: 
(1) we focused on low-income individuals only; (2) we assumed that FSP participation and 
healthy diet are simultaneously determined. 
 
Theoretical Model and Data 
 
Household production theory assumes that the household’s decision-making is concerned 
with the efficient use of market goods (q), time (l), and human and physical capital (k) as inputs 
in the production of utility yielding, non-market goods (z).  At the first stage the household may 
be characterized by cost-minimizing behavior and in the second stage, the household chooses z 
to maximize utility, u.  The solution of this two-stage stage problem is the demand equation for z 
 
(1)   z = z(p, w, m; k). 
 
Where w is a vector of wage rates for different types of labor inputs and m is the 
household income.  In this study, we assume that a healthy diet is one of the non-market goods (z) 
that consumers are interested.  In addition, we assume that the participation of the FSP is a 
significant factor on the demand for a healthy diet.  The relationship can be written as 
 
(2)   HEI  =  γ FSP + β1 x1 + ε1,   FSP  =  β1 x2 + ε2; 
 
where HEI is 1995 healthy eating index; FSP = 1 if the respondent participated in the FSP, 
otherwise, FSP =0; x1 and x2 are vectors of explanatory variables; βs and γ are parameters to be 
estimated; and ε1 and ε2 are disturbance terms.  Equations in (2) were estimated using the 
procedure proposed by Amemiya (1979) (Maddala, 1983, pp. 244-5).  Only the records of those 
participants who were older than 20 years; had a poverty index ratio equal or less than 1.6; and 
were not pregnant were used.  Note that the HEI scores for NHANES 2001-02 in the subsample 
ranged from 21.9 to 99.1; therefore, HEI in (2) was treated as an observed variable. 
 
As shown in equation (1), the explanatory variables of the demand for a healthy diet (z) 
include the prices of market goods (p), wage rates (w), income (m), and capital endowment in the 
household (k).  Input prices were not recorded in the survey; however, since the data covered 
only a one-year period, we assumed that all participants faced similar input prices, thus, input 
prices were not included as explanatory variables.  Wage rates for the participants were not 
recorded; therefore, the household incomes were used as proxies for wage rates.  In addition, we 
assumed that the wage rates for the labor that was used to prepare food were related to the 
household income of the participant. 
 
We assumed that participants’ diet quality varies partially with their knowledge about 
how to prepare food (Carpenter et al. 2002) and this food preparation knowledge is partially 
related to participants’ age, race, ethnicity, diet habits, and lifestyle.  Socio-economic and 
demographic variables include household income, race, Hispanic origin, age, gender, education, 
and marital status.  The dietary variables include if the participant ate breakfast during the one-
day recalls, the number of different dietary supplements the participant took, if the participant 
participated in the FSP and/or WIC, and the adult food security status.  Four variables are closely 
related to participants’ lifestyle – smoking, use of alcohol, hours spent watching TV, and 
exercise.   
 
Results 
 
The coefficient for the FSP variable was not statistically different from zero, while the 
coefficient for WIC is positive and statistically different from zero.  The positive impact of WIC 
on healthy diet found here may indicate the differences in food purchase requirements between 
the FSP and the WIC.  Participants in the WIC are required to purchase certain types and/or 
brands of food, while participants of the FSP face no such restrictions. The coefficient for the 
food security variable is negative indicating that when a participant did not have enough to eat, 
s/he was unable to have a healthy diet. 
 
Results show that demographic, dietary, and lifestyle factors are related to the HEI.  
Females had higher HEI scores than males; female participants of ages over 50 had higher HEI 
scores than those females of ages younger than 50; and older participants had higher HEI scores.  
Household income and marital status had no impact on HEI scores.  Race and ethnicity seem to 
play important roles in the demand for healthy diet.  Specifically, results show that Blacks had 
lower HEI scores than White; and other races had higher HEI scores than White.  Hispanics had 
higher HEI scores than non-Hispanics.  Participants who ate breakfast and those who took more dietary supplements had higher HEI scores than their counterparts.  The hours of watching 
television or using computer had a negative impact on HEI; the intensity of exercise had a 
positive impact on HEI; and pervious smokers and current smokers had lower HEI scores than 
non-smokers. 
Conclusion 
  Results found in this study indicate that the FSP participation had no discernible impact 
on the dietary quality of low-income individuals; however, participation in the WIC improved 
the healthiness of their diet.  One of the major differences between the FSP and the WIC 
programs is that the WIC participants are restricted to purchasing certain types of foods and 
attend classes to learn about nutrition, while the FSP participants are not subject to these 
requirements.  The restriction imposed on the kinds of food items and brands that WIC 
participants can purchase may improve the healthiness of their diets. 
   
 
Table 1.  HEI and FSP participation 
 Coefficient  Standard  Error  t-statistic  p-value 
      
FSP (Instrumental Variable)  -0.0293 0.0666 -0.4410  0.6595
Constant 58.4271 1.7460 33.4630  0.0000
   
Demographics   
   Female  0.7786 0.9862 0.7890  0.4298
    50 yrs and > 34 yrs  -0.4928 0.9274 -0.5310  0.5952
    6 4  and > 50 yrs  2.4829 1.1149 2.2270  0.0259
   > 64 yrs  2.7658 1.1196 2.4700  0.0135
   Income  0.0008 0.0188 0.0430  0.9656
   Married  0.7084 0.8642 0.8200  0.4124
   Divorced  -0.7558 1.0076 -0.7500  0.4532
   College Education  2.3799 0.7597 3.1330  0.0017
   Black  -2.6785 0.8563 -3.1280  0.0018
   Other Race  2.5094 1.8858 1.3310  0.1833
   Hispanic  3.5761 0.8274 4.3220  0.0000
   
Dietary and Meal Pattern   
   Ate Breakfast  3.7654 0.7802 4.8260  0.0000
   # Food Supplements  0.7428 0.2136 3.4780  0.0005
   WIC  2.5365 0.9280 2.7330  0.0063
   Food Security  -0.6404 0.3157 -2.0290  0.0425
   
Self-Evaluation   
   Overweight/obese  -0.6991 1.0451 -0.6690  0.5036
   Under-Assessor  2.1139 1.3424 1.5750  0.1153
   Over-Assessor  -0.2576 1.6942 -0.1520  0.8792
   Excellent Health  0.0683 0.8483 0.0810  0.9358
   Goof Health  -0.0964 0.7404 -0.1300  0.8964
   
Lifestyle   
   Hours TV  -0.0345 0.2095 -0.1650  0.8693
   Exercise (METs)  0.0575 0.0395 1.4550  0.1458
   Former Smoker  -3.0519 0.8532 -3.5770  0.0003
   Current Smoker  -3.8426 0.8083 -4.7540  0.0000
   #Drinks/Day  0.0557 0.1184 0.4700  0.6380
 

Food Assistance Programs and Healthy Diet among Low-Income Individuals

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