OPINIONS, IDEAS, & PRACTICE
The success of SNAP is attributable
SNAP: The Most
Important Component
of Our Efforts to End
Food Insecurity in the
United States
Craig Gundersen, PhD
ABOUT THE AUTHOR
Craig Gundersen is the Snee Family Endowed Chair in the Baylor Collaborative on
Hunger and Poverty, Baylor University, Waco, TX.
See also Insolera et al., p. 1498.
F ood insecurity, the leading indica-
October 2022, Vol 112, No. 10
tor of well-being among vulnerable
Americans, remains a daunting chal-
lenge for our country. In 2020, 38 mil-
lion persons in the United States lived
1
in food-insecure households. This is
lower than the record highs of 50 million
in 2009 and 2011 but remains unaccept-
AJPH
ably high.
SUPPLEMENTAL
NUTRITION ASSISTANCE
PROGRAM
These food insecurity rates would have
been far higher were it not for the pri-
mary component of the social safety
net against food insecurity, the Supple-
mental Nutrition Assistance Program
(SNAP). The success of this program
has been demonstrated in multiple
studies insofar as SNAP recipients are
up to 45% less likely to be food inse-
cure than eligible nonparticipants once
nonrandom selection into the program
is addressed in econometric models.2,3
Insofar as food insecurity is tied to a
wide array of negative health
1370 Editorial Gundersen
outcomes,4 by reducing food insecurity,
SNAP also leads to lower health care
costs among recipients. These reduc-
tions in health care costs as a result
of SNAP are, not surprisingly, very large.
For example, a recent study found that
SNAP leads to reductions in health care
costs through Medicaid of $2360 per
person per year.5
The results of the study by Insolera et al.
(p. 1498) provide critical further evidence
of the success of SNAP. Using data from
the Panel Study of Income Dynamics,
they find substantial evidence of reduc-
tions in food insecurity years after
receipt of SNAP. Namely, adults who
received SNAP during childhood were
more than three times more likely to
be food secure than adults who did not
participate as children despite being eli-
gible. The results of the study by Inso-
lera et al. are part of a broader set of
articles that demonstrate the longer-
term positive impacts of SNAP on health
6
and other outcomes. We are able to
say that SNAP leads to not only immedi-
ate improvements in well-being but also
improvements years later.
to five main factors. First, it reaches
those who are most in need. Only
those with access to resources so lim-
ited that they are not able to purchase
a food-secure quantity of food with
their current incomes are eligible for
the program. Second, it leverages the
traditional retail sector in the United
States. It does so by allowing SNAP
recipients to use their benefits in more
than 260 000 stores.7 Third, SNAP is
funded as an entitlement program.
As such, there is no need for explicit
authorization by policymakers to
expand or contract during changing
economic conditions. This is particularly
important during times of increased
economic need such as the Great
Recession or the COVID-19 pandemic.
Fourth, SNAP is also an entitlement pro-
gram at the individual level. Although
the average length of time on SNAP is
slightly less than one year, there are
persons who need assistance for longer
time periods and, in some cases, much
longer time periods. With a few minor
exceptions, these particularly vulnerable
individuals can stay on SNAP for as long
as needed. The fifth and most important
reason SNAP works is that it gives dignity
and autonomy to recipients.8 SNAP
recipients are given the dignity of being
able to shop alongside their friends and
neighbors at the food store, and, when
shopping, they are given the autonomy
of being able to make their own food
choices that are consistent with their
preferences, religious beliefs, dietary
requirements, culture, and so forth. This
differs from some other programs that
sharply delineate what recipients can
and cannot obtain. Consequently, it is
not surprising that SNAP participation
rates are very high, especially in com-
parison with other food assistance

programs that do not afford house-
holds the same levels of dignity and
autonomy.
OPPORTUNITIES FOR AND
THREATS TO SNAP
Any comprehensive effort to eradicate
food insecurity in the United States,
then, must have SNAP at its center. The
US Department of Agriculture empha-
sized this importance in their recent
momentous decision to raise the value
of the maximum SNAP benefit by
approximately 20%. This was done to
reflect the high proportion of SNAP
recipients who, although better off
because of receiving SNAP, were still
food insecure. It is estimated that this
increase in benefits will lead to a
decline of approximately 40% in food
insecurity among SNAP recipients.9
One further step would be to expand
eligibility and make enrollment more
seamless. A possible path would be to
have SNAP reconstructed as a modified
universal basic income program whereby
all households with incomes below
400% of the poverty line (approximately
$100 000 for a family of four) would
receive the maximum SNAP benefit. If
this were implemented, there would be
an estimated 98% decline in food insecu-
rity in the United States at a cost of $564
billion.10 Although this is not an inexpen-
sive proposal, any comprehensive cost–
benefit calculation should account for
the subsequent reductions in near-term
and long-term health care costs.
Unfortunately, although support for
the dignity and autonomy of SNAP recipi-
ents and recognition of the importance
of food insecurity is strong in many
circles, this is not universal. A recent
manifestation of this is a belief among
some that we should no longer be con-
cerned with food insecurity and instead
should concentrate on “nutrition
security.” From a research perspective,
11
this is problematic, and we already
know that reducing food insecurity
improves nutrient intakes and reduces
health disparities. I’m much more con-
cerned, though, about the explicit and
implicit encouragement by some
“nutrition security” advocates to make
changes in the structure of SNAP such
that restrictions would be imposed on
what can and cannot be purchased by
SNAP recipients. In essence, these advo-
cates for changes to SNAP are saying vul-
nerable Americans do not have the
capacity to make decisions about what is
best for their families, and, instead, out-
side “experts” should be dictating these
choices. This, of course, is stigmatizing to
an already vulnerable population and
would lead to declines in SNAP participa-
tion, subsequent increases in food inse-
curity (both short term and long term),
declines in health outcomes, and widen-
ing of health disparities. Considering the
evidence found in the study by Insolera
et al. and in multiple other studies about
the profound positive impacts of SNAP,
we should resist the efforts of those who
seek to infantilize SNAP recipients.
CORRESPONDENCE
Correspondence should be sent to Craig
Gundersen, Baylor Collaborative on Hunger
and Poverty, Baylor University, One Bear Place
97320, Waco, TX 76798 (e-mail: craig_gundersen@
baylor.edu). Reprints can be ordered at http://
www.ajph.org by clicking the “Reprints” link.
PUBLICATION INFORMATION
Full Citation: Gundersen C. SNAP: the most impor-
tant component of our efforts to end food inse-
curity in the United States. Am J Public Health.
2022;112(10):1370–1371.
Acceptance Date: July 18, 2022.
DOI: https://doi.org/10.2105/AJPH.2022.307058
CONFLICTS OF INTEREST
The author has no conflicts of interest to declare.
OPINIONS, IDEAS, & PRACTICE
REFERENCES
1. Coleman-Jensen A, Rabbitt M, Gregory C, Singh
A. Household Food Security in the United States
in 2020. Report Number 298. Washington, DC:
US Department of Agriculture, Economic
Research Service; 2021.
2. McKernan SM, Ratcliffe C, Braga B. The effect of
the US safety net on material hardship over two
decades. J Public Econ. 2021;197:104403. https://
doi.org/10.1016/j.jpubeco.2021.104403
3. Gundersen C, Kreider B, Pepper J. Partial identifi-
cation methods for evaluating food assistance
programs: a case study of the causal impact of
SNAP on food insecurity. Am J Agric Econ. 2017;
99(4):875–893. https://doi.org/10.1093/ajae/
aax026
4. Gundersen C, Ziliak J. Food insecurity and health
outcomes. Health Aff (Millwood). 2015;34(11):
1830–1839. https://doi.org/10.1377/hlthaff.2015.
0645
5. Berkowitz SA, Palakshappa D, Rigdon J, et al. Sup-
plemental Nutrition Assistance Program partici-
pation and health care use in older adults: a
cohort study. Ann Intern Med. 2021;174(12):
1674–1682. https://doi.org/10.7326/M21-1588
6. Almond D, Hoynes H, Schanzenbach D. Inside
the war on poverty: the impact of food stamps
on birth outcomes. Rev Econ Stat. 2011;93(2):
387–403. https://doi.org/10.1162/REST_a_00089
AJPH
7. Center on Budget and Policy Priorities. SNAP
Retailers Database. Available at: https://www.
October 2022, Vol 112, No. 10
cbpp.org/snap-retailers-database. Accessed July
27, 2022.
8. Gundersen C. Ensuring the dignity and auton-
omy of SNAP recipients. Physiol Behav. 2020;
221:112909. https://doi.org/10.1016/j.physbeh.
2020.112909
9. Gundersen C, Kreider B, Pepper J. Reconstructing
the Supplemental Nutrition Assistance Program
to more effectively alleviate food insecurity in the
United States. RSF. 2018;4(2):113–130. https://
doi.org/10.7758/rsf.2018.4.2.06
10. Gundersen C. Viewpoint: a proposal to recon-
struct the Supplemental Nutrition Assistance
Program (SNAP) into a universal basic income
program for food. Food Policy. 2021;101:102096.
https://doi.org/10.1016/j.foodpol.2021.102096
11. Poblacion A, Ettinger de Cuba S, Cook JT. For 25
years, food security has included a nutrition
domain: Is a new measure of nutrition security
needed? J Acad Nutr Diet. 2022; E-pub ahead of
print. https://doi.org/10.1016/j.jand.2022.04.009
Editorial Gundersen 1371
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