Seattle’s Fresh Bucks Program Boosts Food Security And Diet But Benefits Fade When Funding Ends

Cutting disconnected nutrient benefits erodes hard-won dietary gains, while sustained support shows really elemental subsidies tin constrictive wellness gaps and fortify nutrient security.

Study: Healthy Food Benefit Programs, Fruit and Vegetable Consumption, and Food Security. Image Credit: Simxa / Shutterstock

In a caller study published successful the JAMA Network Open, researchers leveraged a cohort study comprising 1,973 participants to analyse nan on-ground benefits of “Fresh Bucks”, a patient nutrient use program. Specifically, nan study evaluated nan program’s effect connected subordinate nutrient information and fruit/vegetable consumption.

Study findings revealed that among caller enrollees, nan programme was associated pinch a 5.5 percentage-point summation successful nutrient information and a 7.5 percentage-point summation successful nan proportionality of participants eating fruits and vegetables 3 aliases much times daily. By contrast, nan study recovered nary statistically important effect connected wide continuous regular consequence and rootlike intake. Conversely, losing nan use was linked to a important diminution successful these outcomes.

These findings supply robust grounds from randomized programme duty that specified programs tin beryllium an effective instrumentality for reducing wellness disparities wrong America. However, nan authors be aware that further investigation is needed to corroborate semipermanent wellness impacts.

Background

Poor fare value is simply a awesome driver of chronic diseases, pinch a increasing assemblage of grounds identifying debased intake of fruits and vegetables arsenic a cardinal contributor. For galore low-income and marginalized communities, nan precocious costs and constricted readiness of caller nutrient create important barriers to patient eating, contributing to nutrient insecurity and widening wellness disparities betwixt nan rich | and nan poor.

To reside these disparities, “food is medicine” initiatives, including nutrient medicine programs, person gained fame arsenic a imaginable solution. These programs purpose to make patient foods much accessible by providing financial incentives.

Unfortunately, a operation of their comparative nascency and nan truth that overmuch of nan existing investigation connected these programs has been hampered by anemic study designs, often lacking a due comparison group, has made empirical validation of these programs’ benefits hitherto impossible. This has fueled disapproval of these initiatives, pinch a increasing sound undermining their impacts.

About nan study

The coming study intends to reside nan ongoing statement connected “food is medicine” initiatives’ societal impacts by conducting a lottery-based cohort study evaluating nan outcomes of Seattle’s Fresh Bucks program, which offers a $40 monthly use for fruits and vegetables.

The study creation treated nan programme arsenic a earthy experiment, leveraging nan program’s oversubscription successful 2022, which required a random lottery to prime participants from a excavation of complete 6,900 applicants. This randomization created earthy curen (initially selected) and power (waitlisted) groups.

The study simulated and examined 2 chopped scenarios: 1. ‘Gaining Access’, wherein 757 recently enrolled participants were compared to a waitlisted power group complete 6 months, and 2. ‘Losing Access’, wherein a abstracted group of 1,216 anterior beneficiaries was studied, comparing those randomly disenrolled (and placed connected nan waitlist) to those randomly selected to proceed receiving benefits for an further 6 months.

Study outcomes of liking included: 1. Food security, assessed utilizing nan validated 2-item Hunger Vital Signs screener, and 2. Fruit and rootlike depletion was measured utilizing a modified Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. Data for study were collected via surveys administered astatine baseline (October 2021) and follow-up (June 2022).

Study analyses included linear regression models (LRMs) to estimate nan program’s effects, controlling for participants’ family size, beingness of children, income, race/ethnicity, preferred language, age, preferred retailer, and baseline result values to summation statistical powerfulness and precision.

Study findings

Study outcomes revealed statistically important grounds of nan Fresh Bucks program’s benefits. Among caller applicants, being randomly selected to person nan $40 monthly use was associated pinch marked improvements successful some fare and nutrient information compared to being placed connected nan waiting list.

Specifically, enrollment led to a 5.5 percent constituent (pp) summation successful nutrient information (95% CI, 0.05-10.91 pp), representing a 31% betterment from nan baseline nutrient insecurity rate. Simultaneously, a 7.5 percent constituent (pp) summation successful nan proportionality of participants consuming fruits and vegetables 3 aliases much times per time (95% CI, 0.39-14.52 pp) was observed, representing a 37% betterment from baseline. However, nan study reported that mean regular consequence and rootlike intake, measured continuously, did not show a statistically important change.

The 2nd portion of nan analysis, which looked astatine what happens erstwhile nan use is mislaid because of random subordinate disenrollment, reinforced these findings. Previously enrolled participants who were randomly disenrolled from nan programme knowledgeable a important diminution successful some outcomes.

Specifically, these participants reported a 4.97 pp simplification successful nutrient information (p = .03) and a 7.34 pp alteration successful nan likelihood of eating nutrient astatine slightest 3 times a time (p = .01) compared to those who continued to person benefits for nan six further months. They besides ate fruits and vegetables 0.37 less times per time connected average.

Importantly, nan study recovered heterogeneity successful outcomes. Gains successful continuous consequence and rootlike intake were important among lower-income participants (≤200% of nan national poorness level), those identifying arsenic White aliases Black, and English speakers. By contrast, effects were weaker aliases absent for Asian participants and Vietnamese speakers, suggesting connection aliases taste barriers whitethorn power programme impact.

Conclusions

The coming study’s findings powerfully propose that “food is medicine” initiatives for illustration Fresh Bucks are a powerful instrumentality for addressing diet-related wellness disparities. The crisp diminution successful outcomes observed upon disenrollment besides highlights nan captious value of sustained backing for these programs to guarantee lasting benefits.

This study hence provides rigorous grounds of meaningful improvements offered by these initiatives, highlighting them arsenic a nonstop and effective measurement to amended organization health. However, fixed limitations specified arsenic a 28.5% study consequence rate, reliance connected self-reported data, and imaginable action bias, nan findings should beryllium interpreted pinch be aware and not yet generalized arsenic a “global model.”