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Grocery Purchase Changes Were Associated With A North Carolina COVID-19 Food Assistance Incentive Program – healthaffairs.org

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Many low-income Americans experience food insecurity, which may have been exacerbated by economic instability during the early stages of the COVID-19 pandemic in 2020. In this study we assessed the impact of Healthy Helping, a short-term fruit and vegetable incentive program aimed at alleviating food insecurity and improving diet quality for Supplemental Nutrition Assistance Program participants, on grocery purchases, using transaction data from a large supermarket chain in North Carolina. We compared Healthy Helping participants’ purchases of key food groups before and during the program with purchases by control shoppers participating in federal food assistance programs during the same period. Healthy Helping enrollment was associated with a $26.95 increase in monthly spending on fruit, vegetables, nuts, and legumes—an increase of 2.5 grams of fiber per 1,000 kilocalories purchased—and other shifts in the composition of food purchases, relative to control shoppers. These findings suggest that the program increased healthy food purchases while also increasing dollar sales at participating retailers. On average, participants did not use the full benefit; future research should explore factors associated with non- or underuse of benefits, to inform program design and outreach.

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Published online 7 November 2022

© 2022 Project HOPE—The People-to-People Health Foundation, Inc.
Preliminary study results were presented in a poster presentation at the Healthy Eating Research Annual Meeting (virtual), April 5, 2022. This work was supported by the North Carolina Department of Health and Human Services from their Coronavirus Aid, Relief, and Economic Security Act of 2020 allocation via a grant to Reinvestment Partners. Additional support came from the Carolina Population Center pilot grant from the National Institutes of Health (NIH) (Grant No. P2C HD050924). Caitlin Lowery received support from a training grant from the NIH (Global Cardiometabolic Disease Training Grant No. T32 HL129969). Neal Curran and Sam Hoeffler report receiving grants from the Gus Schumacher Nutrition Incentive Program, Rockefeller Foundation, and Blue Cross Blue Shield of North Carolina Foundation outside the submitted work. Molly De Marco has received funding from the NIH, Robert Wood Johnson Foundation, Department of Agriculture, Share our Strength, and Department of Transportation. Shu Wen Ng has received funding from Bloomberg Philanthropies, Arnold Ventures, Robert Wood Johnson Foundation, Duke Endowment, and NIH and has worked as a paid consultant for the World Bank and New York City’s Department of Health and Mental Hygiene. The authors are very grateful to the participating supermarket chain for sharing their transaction data that allowed for this study. They also thank Amy E. Lo for research assistance and Sierra Mullen for data management assistance. The findings and conclusions are those of the authors alone and do not reflect the views of any other entities.

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