Making Healthy Eating a Snap

In February 2017, a small crowd gathered on the sidewalk outside of Arteaga’s Super Save Food Center, a neighborhood grocery store in San Jose just south of downtown. What brought the group together — including elected officials, public health advocates, grocery industry leaders, media and SPUR staff — was a shared desire to reduce hunger and improve the health of low-income residents in the Bay Area while also supporting California farmers. More specifically, the group had convened to celebrate the California kickoff of a program that does just that: Double Up Food Bucks. Double Up Food Bucks is a healthy food incentive program that makes fruits and vegetables more affordable for low-income families while increasing revenue for both grocers and California farmers. The program advances recommendations from two of SPUR’s earlier reports: Locally Nourished, which encourages support for locally grown food, and Healthy Food Within Reach, which identified incentive programs as one of the most promising tools to increase low-income families’ purchasing power for healthy food. SPUR started the program with three grocery stores in San Jose and Gilroy and a coalition of committed partner organizations (listed at the end of this article), based on a model pioneered in Michigan by the Fair Food Network. It is similar to other healthy food incentive programs in California and nationally that seek to reduce the economic barriers to healthy food access.

Here’s how the program works: when someone who is enrolled in the CalFresh program (formerly known as food stamps) shops at a participating store and pays with their CalFresh benefits, they receive a coupon that matches, penny-for-penny, the amount of California-grown produce in their basket (up to $10 per day). Then, the next time they shop in the store, they can use that coupon to get a discount on any fresh fruits and vegetables that they purchase.

CalFresh families learn about the program both inside and outside of stores. Signage throughout the store advertises the program, and store cashiers are instrumental in getting the word out when they explain the Double Up Food Bucks coupons they give customers. Our partners have helped spread the word outside of the store as well. Second Harvest Food Bank’s community outreach promotors greet customers at each of the stores. The Santa Clara County Social Services Agency has sent tens of thousands of text messages, voicemails and letters to CalFresh families in the zip codes surrounding the stores. FIRST 5 Santa Clara County staff distributes information about the program through their Family Resource Centers. And the county Public Health Department has promoted Double Up Food Bucks through their extensive community outreach network.

SPUR has now run the program for more than a year, and results show that healthy food incentives work. Between the program launch in February and the end of 2017, at least 1,934 CalFresh households, representing 4,400 to 8,300 individuals, redeemed $85,000 in Double Up Food Bucks coupons for fresh fruits and vegetables. Last summer, SPUR worked with local partners to conduct a survey of customers at all of the participating stores. In response to that survey (which was administered in English, Spanish and Vietnamese and included 300 Double Up Food Bucks participants), more than 95 percent of participants “agreed” or “strongly agreed” that their families were buying and eating more fruits and vegetables because of the program. And 93 percent agreed or strongly agreed that the program helped them stretch their food budget, improving food security. These results track with other studies of similar programs nationally, including a highly rigorous evaluation of a USDA pilot in Massachusetts in 2012.¹

The program also benefits participating stores by increasing their revenue. All three of the stores that participated in Double Up Food Bucks in its first year saw the amount of CalFresh benefits redeemed at their store either increase or stay steady. All the participating stores saw increases in fruit and vegetable sales, ranging from 5 to 12 percent, far outpacing the national average of 1 percent inflation for those same products. And, anecdotally, one of the stores reported that, because of Double Up Food Bucks, they had added an entire new day of produce delivery to the store to keep up with demand. Recognizing the value the program provides, all three stores committed to continuing to offer Double Up Food Bucks after the one-year pilot period and have expressed interest in expanding it to other store locations.

SPUR hopes, by the end of 2018, to double the number of stores in Santa Clara County that offer Double Up Food Bucks from four to eight and begin partnering with a small number of stores in San Francisco as well. Through this expansion, we also aim to double the number of families participating to a total of at least 4,000.

The long-term goal is to see healthy food incentive programs become a permanent supplement to the state’s CalFresh program, available at grocery stores and farmers’ markets statewide. It is with this goal in mind that our work on Double Up Food Bucks bridges implementation and policy. We see two obstacles to the long-term goal.

The first obstacle is scalability. Currently, all the healthy food incentive programs operating in the state run parallel to the state’s Electronic Benefit Transfer (EBT) system for distributing CalFresh. The EBT system, which is similar to a debit card, moved food stamps from a paper system to an electronic one. That change made it simpler for grocers to adopt, easier for customers to use, and cheaper for the state to administer. Double Up Food Bucks, and all the other incentive programs in the state, are not currently integrated into this EBT system. Instead, in our program, customers receive paper coupons that they redeem at the store. The stores, in turn, must process all the coupons by hand and submit them to SPUR for reimbursement. Though this system works, it is cumbersome for everyone involved. Integrating Double Up Food Bucks and other incentives into the EBT system would make it much easier for the programs to scale.

Recognizing this, state Senator Scott Wiener and Assemblymember Joaquin Arambula assembled a bipartisan coalition to introduce the California Fruit and Vegetable EBT Pilot Project (Senate Bill 900). This legislation, and its accompanying budget request — which SPUR is cosponsoring with California Food Policy Advocates — would authorize the state Department of Social Services to test an integration of incentives onto the EBT card by providing funding for on-the-ground pilots with retailers and farmers’ markets in at least three sites across the state. The state legislature included funding and authorization for this project in the budget it passed in June. It now awaits a final decision form Governor Jerry Brown. If the governor approves it, California would be following the lead of Massachusetts, which has already demonstrated that this technological upgrade is possible and effective.²

The second obstacle is permanent, sustainable funding. Currently all of the incentive programs in the state are funded by a mix of private and public grants, including funding from the U.S. Department of Agriculture and the state’s California Nutrition Incentive Grant program.³ While this funding has been instrumental in helping the programs demonstrate their potential, grants are an unstable source of funding. For a full statewide expansion, the funding need is substantial. In 2015, a team of U.C. Berkeley graduate students commissioned by SPUR estimated that such an expansion would cost $100 to $400 million annually.⁴ That level of funding is unlikely to come from the state’s general fund and would instead require a different, dedicated revenue source.⁵

While the long-term funding sources for a fully expanded program are not yet clear, what is clear is the potential impact healthy food incentive programs could have. California is uniquely positioned to take these programs statewide. We are perhaps the only state in the country that could run a year-round program based on fruits and vegetables grown within the state. A statewide program would have tremendous benefits. It would reduce hunger, improve health, and support California agriculture. Ultimately, the question isn’t whether we can implement a statewide healthy food incentive program, but whether we can muster the political will to make it happen.

Partner Organizations

U.S. Department of Agriculture Food Insecurity

Nutrition Incentive Grant Program

Stupski Foundation

FIRST 5 Santa Clara County

The Health Trust

Santa Clara County Social Services Agency

John & Marcia Goldman Foundation

Sunlight Giving

New Belgium Family Foundation

11th Hour Project

Clif Bar Family Foundation

Endnotes

¹ Bartlett, Susan et al. Evaluation of the Healthy Incentives Pilot (HIP): Final Report, prepared by Abt Associates for the U.S. Department of Agriculture, Food and Nutrition Service, September 2014.

²https://mafoodsystem.org/projects/HIP/

³https://nifa.usda.gov/program/food-insecuritynutrition-incentive-fini-grant-program and https://cafarmtofork.cdfa.ca.gov/cnip.html

⁴http://www.spur.org/news/2015-06-30/expandingaccess-healthy-food-low-income-californians

⁵ One long-term funding possibility is a statewide soda tax, which would build on precedents in San Francisco and Seattle where soda tax revenue has been dedicated to programs that make healthy food more affordable. Another potential funding source is the federal Farm Bill. The proposals from both the Republicans and Democrats in the House Agriculture Committee in April included at least doubling the amount of funding for incentives, indicating strong bipartisan support even in our current polarized political climate.