The Fruits of Providing Cash Incentives for Healthy Eating in San Diego

The Fruits of Providing Cash Incentives for Healthy Eating in San Diego

File photo by Sam Hodgson

A new study says low-income residents got a big boost from a government program designed to encourage healthy eating and support farmers markets in poor neighborhoods like City Heights.

Local advocates for the needy have warned for years about “food deserts” in poor communities that make it difficult for some residents to find affordable fruits and vegetables. Now, there’s a dose of good news: A new study says San Diego-area low-income residents got a big boost from a government program designed to encourage healthy eating and support farmers markets in poor neighborhoods like City Heights.

Thousands of local residents who get government assistance enrolled in the program and received vouchers to buy nutritious foods like produce, meat, bread and eggs at farmers markets. The participants spent about $330,000 from 2010-2011, or about $93 per person.

There are some caveats. No one knows whether any area residents actually became healthier as a result of the program, which has dwindled from its high point of serving several communities because of funding woes. And participants are only allowed to spend the extra money at farmers markets. They can’t use it to buy food at supermarkets, chain stores like Target or Costco or corner shops.

Still, the incentive program was “definitely a success,” said Blanca Melendrez, who oversees obesity prevention programs sponsored by UCSD and helped establish the farmers market in the City Heights neighborhood in 2008.

The City Heights farmers market was unusual when it opened because it was the first in the county to accept food stamps and benefits from Social Security and the Women, Infants, and Children program.

The new study, led by researchers at San Diego State and published in the Nov. 14 issue of the journal Preventing Chronic Disease, tracked the progress of the Farmers Market Fresh Fund Incentive Program over a year. The $715,000 program, funded through two federal grants, allowed county residents to double up to $20 a month of government assistance for food (like food stamps) if they agreed to take vouchers they could use at certain farmers markets for certain types of healthier food.

A person who gets food stamps, for example, could buy vouchers to buy healthier types of food for $20 and get another $20 worth for free.

“Our goal was to empower the community to eat healthier and be active,” Melendrez said.

The study authors found that almost 7,300 people signed up for the program, which eventually expanded to farmers markets in Linda Vista, southeastern San Diego, San Marcos and Golden Hill.

In 2011, the farmers markets made $1.5 million, including $350,000 in incentives from the Fresh Fund program, Melendrez said. On average, she said, vendors made $47,000.

Could the participants have been able to find cheaper produce and other healthier foods elsewhere? Melendrez doesn’t think so. “Our goal was to work with our farmers to make sure they were offering competitive prices compared to those offered in the surrounding area, or less expensive,” she said. “Our experience is that people feel the produce we offer is affordable, fresh and culturally appropriate.”

Lisa Powell, a professor of health policy and administration at the University of Illinois, reviewed the study findings for Voice of San Diego and said the program has plenty of potential to make a difference in terms of health. “Other research has shown that lower fruit and vegetable prices are associated with lower body weight, particularly among low-income children and women,” she said.

The findings of the study offers support to the idea of testing similar programs “more broadly in supermarkets, and grocery and convenience stores,” she said.

For now, however, the federal grants for the program have run out. The International Rescue Committee offering Fresh Fund incentives in conjunction with the San Diego County Farm Bureau at the City Heights farmers market and independently at the farmers market in downtown El Cajon.

Both markets serve many refugees, said Anchi Mei, who oversees food and health issues for the local branch of the committee. The Farm Bureau and the refugee advocacy organization support the incentives with revenue from the farmers markets and other funds, she said.

However, she said, the organizations have had to limit the number of times that residents can get the incentives due to lack of funding. The only people who can take advantage of the program now are those who weren’t enrolled previously.

Meanwhile, a major cut in the food stamp program has left dozens of City Heights farmers market customers with $36 less a month to spend on food, and more cuts may be on the way. In an interview last month, the market’s manager warned that the cuts could ultimately lower proceeds for farmers and drive them away.

“Every squeeze to food budgets will be another barrier for people to buy food from the farmers markets,” Mei said.

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Randy Dotinga

Randy Dotinga

Randy Dotinga is a freelance contributor to Voice of San Diego and president of the American Society of Journalists & Authors. Please contact him directly at randydotinga@gmail.com and follow him on Twitter: twitter.com/rdotinga

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30 comments
PhillipG
PhillipG

We really just do it to ourselves in the end. The system, or society or call whatever you want, doesn't care enough to make food a priority. We scream about health care costs, but provide little financial incentive to to do better. We go on about 'choice', or the need for less government, and yet, let commercial interests have a free reign over 'the system", convincing us that fast food, is the order of the day, so we can get on with out second job, to pay for more useless crap.Keep your Budget Healthy with Four Rules of Cash Flowhttp://speedyloansearch.com/4-rules-of-cash-flow/Are you looking for the best way to manage your finances? Then, it will be useful for you to consider the major rules regarding the cash flow.

Jim Jones
Jim Jones subscriber

Teabagger? Of course that is OK by VOSD standards, since it is an insult to a right wing group.

Randy, can you post a picture of teabagging here for me, I've heard the term, maybe you can clarify it, since it is a term VOSD doesn't find offensive?.

Jim Jones
Jim Jones subscriber

Ah yes, if you find something inconvenient, attack the messenger. Sew yellow stars on the jews in a past life Suebob?

Go ahead Randy, hide behind "teabaggery" and the pathetic cries of racism from Suebob here and just assume no one would cheat the government even if it was easy and unchecked by a government with incentive to let people cheat.

Suebob
Suebob

Ignore him Randy. He's a Teabagger. In his mind poor or immigrant= Bad! Rich and white= Good!

Jim Jones
Jim Jones

Food stamp fraud is rampant, how do we know these "healthy food" vouchers were not simply cashed in? What controls were in place?

The whole thing is silly anyway, pay poor people to eat healthy? Why? Should we pay them to look both ways before they cross the street?

Jim Jones
Jim Jones subscriber

Food stamp fraud is rampant, how do we know these "healthy food" vouchers were not simply cashed in? What controls were in place?

The whole thing is silly anyway, pay poor people to eat healthy? Why? Should we pay them to look both ways before they cross the street?

Jim Jones
Jim Jones

Teabagger? Of course that is OK by VOSD standards, since it is an insult to a right wing group.

Randy, can you post a picture of teabagging here for me, I've heard the term, maybe you can clarify it, since it is a term VOSD doesn't find offensive?.

Jim Jones
Jim Jones

Ah yes, if you find something inconvenient, attack the messenger. Sew yellow stars on the jews in a past life Suebob?

Go ahead Randy, hide behind "teabaggery" and the pathetic cries of racism from Suebob here and just assume no one would cheat the government even if it was easy and unchecked by a government with incentive to let people cheat.

Chris Brewster
Chris Brewster

Mr. Jones: I challenge the statement that "food stamp fraud is rampant." This is hyperbole, not fact. The link below provides a perspective. Moreover, the type of fraud that is typically alleged in food stamp cases doesn't involve people trying to buy food at farmer's markets. Indeed, this option may lessen the small amount of fraud in the system.

As for the value of encouraging purchases of healthy foods, this would logically lead to healthier families and children who would lessen the overall costs of healthcare. For example, if less people are afflicted with late onset diabetes, costs to treat same are minimized. Same for obesity, etc.

Randy Dotinga
Randy Dotinga

Here's what the study says: "Eligibility for incentives was verified and tracked by using an online database in which Fresh Fund personnel recorded the amount of money used by each participant to purchase tokens each week and their receipt of matched incentive tokens. Vendors accepted these tokens from participants and exchanged them with market management at the end of the day for reimbursement."

If you'd like more information, you can ask my editor to assign me to explore this story further.

Randy Dotinga
Randy Dotinga

They're not getting paid to eat healthy. Nobody's giving them cash as part of this program. They're getting vouchers that they can only use at certain farmer's markets to buy certain food items, as I reported.

I'm not sure how they would "cash in" vouchers for produce, meat, eggs and bread that are only good at specific farmers markets. You're thinking they'd be a black market for these vouchers? If so, wouldn't there be one for food stamps in general? I can't imagine how that would work, but let me know what you're thinking up.

Chris Brewster
Chris Brewster subscribermember

Mr. Jones: I challenge the statement that "food stamp fraud is rampant." This is hyperbole, not fact. The link below provides a perspective. Moreover, the type of fraud that is typically alleged in food stamp cases doesn't involve people trying to buy food at farmer's markets. Indeed, this option may lessen the small amount of fraud in the system.

As for the value of encouraging purchases of healthy foods, this would logically lead to healthier families and children who would lessen the overall costs of healthcare. For example, if less people are afflicted with late onset diabetes, costs to treat same are minimized. Same for obesity, etc.

Randy Dotinga
Randy Dotinga memberauthor

Here's what the study says: "Eligibility for incentives was verified and tracked by using an online database in which Fresh Fund personnel recorded the amount of money used by each participant to purchase tokens each week and their receipt of matched incentive tokens. Vendors accepted these tokens from participants and exchanged them with market management at the end of the day for reimbursement."

If you'd like more information, you can ask my editor to assign me to explore this story further.

Randy Dotinga
Randy Dotinga memberauthor

They're not getting paid to eat healthy. Nobody's giving them cash as part of this program. They're getting vouchers that they can only use at certain farmer's markets to buy certain food items, as I reported.

I'm not sure how they would "cash in" vouchers for produce, meat, eggs and bread that are only good at specific farmers markets. You're thinking they'd be a black market for these vouchers? If so, wouldn't there be one for food stamps in general? I can't imagine how that would work, but let me know what you're thinking up.

Chris Brewster
Chris Brewster

Mr. Jones: I accept that you consider the USDA numbers to be unacceptable. Unfortunately, you are essentially trying to convince me of something I already accept. There is fraud in the SNAP program. There is abuse in the SNAP program. We can argue about the magnitude of it, but neither of us knows for sure. I assume it is in the 1% range based on national numbers from the USDA. You think it is in the 7% range, based on state figures from the entity to which you refer. The reality is that there is fraud and abuse in all corners of our financial life. The Navy is presently dealing with massive contractor fraud by private sector businesses. I don't think we should shut down the Navy or contracting to the Navy, but it needs to be addressed. The retail industry deals with fraud and theft in the +1% range apparently. That doesn't make retailing unsustainable. It's a cost of doing business. I appreciate that you don't like SNAP. I think it is disingenuous to base your concern on fraud, What you don't like, primarily, is government money going to help people who are struggling financially to feed themselves. That's where we differ.

Jim Jones
Jim Jones

Chris, what facts do you have? That the USDA made up an estimate of 1% based on a complete lack of any real method or desire to quantify fraud?

The The Florida Strike Force on Medicaid & Public Assistance Fraud posted their facts, and they have a lot more depth and methodology than the USDA pdf I posted, so the facts are that the most comprehensive study posted here to date has around 7% fraud.

If you have any facts to counter it, let me know. If you are simply going to disregard the study, well then, you proved my point about the futility of trying to convince you, since facts are the last thing you want. There is also one done by rhode island, but again, even if I found it you'd disregard it because it doesn't fit the fantasy that surfer boy dispels.

Chris Brewster
Chris Brewster

Mr. Jones: The Florida Strike Force on Medicaid & Public Assistance Fraud? What in the world is that? The surfer living on food stamps? Maybe I should start getting my news from MSNBC and believing all of it. Let's have a debate based on facts, not extremist drama.

As for your statement, "But I'm not trying to convince you, your mind is made up and you sure are not going to go in depth to dispel your notion that food stamp recipients are all honest folk." Where, pray tell, have you found statements on my part suggesting that all food stamp recipients are honest? Certainly not in this dialog and I don't believe that to be the case. Your assertion was that fraud is rampant. I dispute that, acknowledging though that "rampant" is a term of art, not of science.

Jim Jones
Jim Jones

Chris, first off, as the document I linked to shows the 1% is an estimate that even the USDA has no faith in if you read their caveat, they don't even explain how they get 1%, and they say they don't have the resources to get an accurate estimate.

Unlike store theft, which shows up on a balance sheet food stamp fraud goes undetected unless actively caught.

here is a link to a Florida study that finds it seven times larger than the USDA reports, and they couldn't test for all common fraud methods so it's even higher:

There is one for rhode island as well, don't have it handy but it found fraud substantially higher than the USDA made up 1% number.

That 1% has no real, factual basis, it exists solely so people like you can claim it is only 1%, because the USDA has no real incentive to stop fraud, nor do most states.

I personally know one grocery store that committed massive food stamp fraud, buying food stamps for 50% for cash, and they barely got their hand slapped because they were the only store in the ghetto and the government didn't want to close them, despite them being criminals.

But I'm not trying to convince you, your mind is made up and you sure are not going to go in depth to dispel your notion that food stamp recipients are all honest folk.

http://www.flstrikeforce.com/Documents/FINAL_ERS_Report_on_Florida_SNAP_Program_Fraud.pdfYou Won't Believe This Surfer Living the Food Stamps Dreamhttp://blog.heritage.org/2013/08/15/you-wont-believe-this-surfer-living-the-food-stamps-dream/This is Jason Greenslate's typical day: "Wake up, go down to the beach, hang out with my friends, hit on some chicks, start drinking." He also plays in a rock band. And he's living off food stamps. He has no income-he's not interested in getting a jo...WPRI.comhttp://www.wpri.com/target-12/ebt-funds-spent-at-questionable-venues(1/3)Target 12 Investigators look into how people are spending their government money. (2/3) PROVIDENCE, R.I., (WPRI) - Thousands of dollars in cash assistance were withdrawn from ATMs in liquor stores, bars, smoke shops and even Twin River casino in...

Chris Brewster
Chris Brewster

Mr. Jones: I was suggesting sticking to facts versus hyperbole. You stated that food stamp fraud is rampant. Since rampant is an unquantifiable figure, I was interested to see what it is and found it to be estimated at 1%. You linked a document that states, "Based on the most comprehensive current estimate, trafficking diverted an estimated $330 million annually from SNAP benefits – or about one cent of each SNAP dollar – between 2006 and 2008." It also states that, "While not a cost to the
Federal Government, trafficking diverts benefits from their intended purpose of helping low-income families access a nutritious diet."

As a comparison, in private sector retailing, retailers estimate "shrinkage" (i.e. loss at their stores to theft and the like) to be around 1.5%. Is shrinkage then rampant or is it an inevitable aspect of retailing that retailers seek to control? I would say the latter. You'll note that retail shrinkage was estimated to total $34.5 billion in 2011. Does that make it rampant? Depends on your definition of rampant, but they by and large seem able to deal with that amount. I don't think their inability to control 100% of fraud is indicative of incompetence.

As for your statement that, "I admire the almost frantic efforts on the left to whitewash SNAP," one could easily say the reverse for far right, anti-government folks. I am good with arguing the facts.National Retail Security Survey: Retail shrinkage totaled $34.5 billion in 2011http://blog.nrf.com/2012/06/22/national-retail-security-survey-retail-shrinkage-totaled-34-5-billion-in-2011/This entry was posted in Education, Loss Prevention, Research In New Orleans yesterday, where thousands of senior retail loss prevention executives and solution providers are gathered for NRF's Loss Prevention Conference and Expo, University of Flori...

Jim Jones
Jim Jones

Chris, while I admire the almost frantic efforts on the left to whitewash SNAP (or the buying votes for democrats program as it should be called) fraud, waste and abuse, the facts are the facts. USDA own very limited effort to find fraud (and lets be real, the USDA has no real incentive to find massive fraud, whether it exists or not) reveals that their estimates of fraud are based on making up a 1% figure. They admit themselves they have no real idea.

However, look at page three and four here, they come out with a low estimate of fraud, then revise it later after releasing the low initial estimate, over and over:

http://www.fns.usda.gov/sites/default/files/Trafficking2006Summary.pdf

The biggest fraud is the government looking the other way.

BTW, if three quarters of a billion dollars a year in fraud, and ten times that in "non fraudulent" over-payments isn't rampant, I don't know what is. But I guess as long as it buys votes for the left and keeps the poor down and in their place it's OK, right?

Jim Jones
Jim Jones

Randy, what controls were there to prevent the vendor exchange of these tokens for cash? Nearly $50k in tokens per vendor? Pretty easy and fairly safe crime for a vendor to pay cash for them and reemburse them without the overhead of actually providing fruits and veggies, right?

I'm not going to ask your editor to anything, If old style "America's Finest City" fluff propaganda is your thing, have at it. We know what slant your editor wants, don't we?

Jim Jones
Jim Jones

Randy, as a reporter I would think you would know how this sort of fraud works.

Yes, there is a black market for EBT cards. Do a google search.

The people running the "store", in this case the farmers market stalls can buy these "healthy food stamps" at half value, then the seller uses the cash for booze, drugs, whatever, and the buyer sends it in for their cash along with the ones actually redeemed for produce. This used to be very common with the old food stamp system.

As I asked, what controls were in place?

Chris Brewster
Chris Brewster subscribermember

Mr. Jones: I accept that you consider the USDA numbers to be unacceptable. Unfortunately, you are essentially trying to convince me of something I already accept. There is fraud in the SNAP program. There is abuse in the SNAP program. We can argue about the magnitude of it, but neither of us knows for sure. I assume it is in the 1% range based on national numbers from the USDA. You think it is in the 7% range, based on state figures from the entity to which you refer. The reality is that there is fraud and abuse in all corners of our financial life. The Navy is presently dealing with massive contractor fraud by private sector businesses. I don't think we should shut down the Navy or contracting to the Navy, but it needs to be addressed. The retail industry deals with fraud and theft in the +1% range apparently. That doesn't make retailing unsustainable. It's a cost of doing business. I appreciate that you don't like SNAP. I think it is disingenuous to base your concern on fraud, What you don't like, primarily, is government money going to help people who are struggling financially to feed themselves. That's where we differ.

Jim Jones
Jim Jones subscriber

Chris, what facts do you have? That the USDA made up an estimate of 1% based on a complete lack of any real method or desire to quantify fraud?

The The Florida Strike Force on Medicaid & Public Assistance Fraud posted their facts, and they have a lot more depth and methodology than the USDA pdf I posted, so the facts are that the most comprehensive study posted here to date has around 7% fraud.

If you have any facts to counter it, let me know. If you are simply going to disregard the study, well then, you proved my point about the futility of trying to convince you, since facts are the last thing you want. There is also one done by rhode island, but again, even if I found it you'd disregard it because it doesn't fit the fantasy that surfer boy dispels.

Chris Brewster
Chris Brewster subscribermember

Mr. Jones: The Florida Strike Force on Medicaid & Public Assistance Fraud? What in the world is that? The surfer living on food stamps? Maybe I should start getting my news from MSNBC and believing all of it. Let's have a debate based on facts, not extremist drama.

As for your statement, "But I'm not trying to convince you, your mind is made up and you sure are not going to go in depth to dispel your notion that food stamp recipients are all honest folk." Where, pray tell, have you found statements on my part suggesting that all food stamp recipients are honest? Certainly not in this dialog and I don't believe that to be the case. Your assertion was that fraud is rampant. I dispute that, acknowledging though that "rampant" is a term of art, not of science.

Jim Jones
Jim Jones subscriber

Chris, first off, as the document I linked to shows the 1% is an estimate that even the USDA has no faith in if you read their caveat, they don't even explain how they get 1%, and they say they don't have the resources to get an accurate estimate.

Unlike store theft, which shows up on a balance sheet food stamp fraud goes undetected unless actively caught.

here is a link to a Florida study that finds it seven times larger than the USDA reports, and they couldn't test for all common fraud methods so it's even higher:

There is one for rhode island as well, don't have it handy but it found fraud substantially higher than the USDA made up 1% number.

That 1% has no real, factual basis, it exists solely so people like you can claim it is only 1%, because the USDA has no real incentive to stop fraud, nor do most states.

I personally know one grocery store that committed massive food stamp fraud, buying food stamps for 50% for cash, and they barely got their hand slapped because they were the only store in the ghetto and the government didn't want to close them, despite them being criminals.

But I'm not trying to convince you, your mind is made up and you sure are not going to go in depth to dispel your notion that food stamp recipients are all honest folk.

http://www.flstrikeforce.com/Documents/FINAL_ERS_Report_on_Florida_SNAP_Program_Fraud.pdfYou Won't Believe This Surfer Living the Food Stamps Dreamhttp://blog.heritage.org/2013/08/15/you-wont-believe-this-surfer-living-the-food-stamps-dream/This is Jason Greenslate's typical day: "Wake up, go down to the beach, hang out with my friends, hit on some chicks, start drinking." He also plays in a rock band. And he's living off food stamps. He has no income-he's not interested in getting a jo...WPRI.comhttp://www.wpri.com/target-12/ebt-funds-spent-at-questionable-venues(1/3)Target 12 Investigators look into how people are spending their government money. (2/3) PROVIDENCE, R.I., (WPRI) - Thousands of dollars in cash assistance were withdrawn from ATMs in liquor stores, bars, smoke shops and even Twin River casino in...

Chris Brewster
Chris Brewster subscribermember

Mr. Jones: I was suggesting sticking to facts versus hyperbole. You stated that food stamp fraud is rampant. Since rampant is an unquantifiable figure, I was interested to see what it is and found it to be estimated at 1%. You linked a document that states, "Based on the most comprehensive current estimate, trafficking diverted an estimated $330 million annually from SNAP benefits – or about one cent of each SNAP dollar – between 2006 and 2008." It also states that, "While not a cost to the
Federal Government, trafficking diverts benefits from their intended purpose of helping low-income families access a nutritious diet."

As a comparison, in private sector retailing, retailers estimate "shrinkage" (i.e. loss at their stores to theft and the like) to be around 1.5%. Is shrinkage then rampant or is it an inevitable aspect of retailing that retailers seek to control? I would say the latter. You'll note that retail shrinkage was estimated to total $34.5 billion in 2011. Does that make it rampant? Depends on your definition of rampant, but they by and large seem able to deal with that amount. I don't think their inability to control 100% of fraud is indicative of incompetence.

As for your statement that, "I admire the almost frantic efforts on the left to whitewash SNAP," one could easily say the reverse for far right, anti-government folks. I am good with arguing the facts.National Retail Security Survey: Retail shrinkage totaled $34.5 billion in 2011http://blog.nrf.com/2012/06/22/national-retail-security-survey-retail-shrinkage-totaled-34-5-billion-in-2011/This entry was posted in Education, Loss Prevention, Research In New Orleans yesterday, where thousands of senior retail loss prevention executives and solution providers are gathered for NRF's Loss Prevention Conference and Expo, University of Flori...

Jim Jones
Jim Jones subscriber

Chris, while I admire the almost frantic efforts on the left to whitewash SNAP (or the buying votes for democrats program as it should be called) fraud, waste and abuse, the facts are the facts. USDA own very limited effort to find fraud (and lets be real, the USDA has no real incentive to find massive fraud, whether it exists or not) reveals that their estimates of fraud are based on making up a 1% figure. They admit themselves they have no real idea.

However, look at page three and four here, they come out with a low estimate of fraud, then revise it later after releasing the low initial estimate, over and over:

http://www.fns.usda.gov/sites/default/files/Trafficking2006Summary.pdf

The biggest fraud is the government looking the other way.

BTW, if three quarters of a billion dollars a year in fraud, and ten times that in "non fraudulent" over-payments isn't rampant, I don't know what is. But I guess as long as it buys votes for the left and keeps the poor down and in their place it's OK, right?

Jim Jones
Jim Jones subscriber

Randy, what controls were there to prevent the vendor exchange of these tokens for cash? Nearly $50k in tokens per vendor? Pretty easy and fairly safe crime for a vendor to pay cash for them and reemburse them without the overhead of actually providing fruits and veggies, right?

I'm not going to ask your editor to anything, If old style "America's Finest City" fluff propaganda is your thing, have at it. We know what slant your editor wants, don't we?

Jim Jones
Jim Jones subscriber

Randy, as a reporter I would think you would know how this sort of fraud works.

Yes, there is a black market for EBT cards. Do a google search.

The people running the "store", in this case the farmers market stalls can buy these "healthy food stamps" at half value, then the seller uses the cash for booze, drugs, whatever, and the buyer sends it in for their cash along with the ones actually redeemed for produce. This used to be very common with the old food stamp system.

As I asked, what controls were in place?