The study, which relied on 2011 data from the New York State Department of Health and which will appear later this year in the American Journal of Preventive Medicine, is the latest to suggest there’s more to America’s nutrition gap than a lack of healthy choices or health education.
Low-income Americans drink far more soda than their wealthier neighbors, according to the Centers for Disease Control and Prevention. The Supplemental Nutrition Assistance Program, better known as food stamps, has recently come under fire for the amount federal benefits recipients spend on sugary beverages, with some critics calling on the federal government to ban soda purchases.
But this study demonstrates those trends are not entirely the fault of low-income shoppers, who are disproportionately bombarded by junk-food ads, said Alyssa Moran, the lead author of the paper and an assistant professor of health and social policy at the Johns Hopkins Bloomberg School of Public Health.
“People will argue that individuals are ultimately responsible for their choices, but we know that the environment in which we make choices matters,” Moran said. “This study is another example of industry targeting sugary beverage marketing toward lower income families.”
This study is the first to tie food advertising to SNAP distribution patterns. Because food-stamp benefits are dispersed in a lump sum each month, and because many recipients spend those funds within a week of receiving them, stores frequently see higher sales and traffic in the days after benefits get reloaded.
That cycle got Moran and several colleagues wondering whether food companies tried to take advantage of the monthly food-stamp boom. To answer that question, they analyzed a 2011 census of beverage advertising in more than 600 New York state grocery stores by the state Department of Health.
They found that stores were 1.88 times as likely to have soda displays on the first through ninth of the month, when food stamps are distributed in New York.
That figure falls to zero in neighborhoods with few SNAP recipients, and rises to 4.35 in neighborhoods with large numbers of SNAP shoppers.
“I’ve worked with a lot of work with retailers, and I know that retailers are very attuned to when households receive benefits,” Moran said. “When you think about it, it makes a lot of sense: If you operate in a state where everyone receives benefits on the same day, there’s a huge financial incentive on that day to heavily market popular items.”
Moran cautions that her data is only from New York and that patterns may differ in other states. She also can’t say whether grocery stores or soda producers are to blame.
Food companies frequently pay stores to place ads or shelve their products in high-visibility locations, so it’s impossible to say who is responsible for the ads researchers saw during store visits. Coca-Cola, PepsiCo and Dr Pepper Snapple Group, the three largest soda producers in the United States, said they did not consider SNAP when creating their marketing plans. In a statement, the Food Marketing Institute, which represents retailers, also disputed the notion that grocery stores target ads to SNAP recipients.
“Our members have long advocated that there be no distinction made between SNAP customers and traditional customers,” said Heather Garlich, a spokeswoman for the group. “To suggest they would single out a segment of shoppers does not align with our philosophy regarding SNAP.”
Separately, the American Beverage Association — the trade group for soda-makers — noted that Moran’s data was seven years old and that beverage companies had taken numerous steps to encourage consumers to drink less sugar since then. Soda companies have begun offering more diet drinks and repackaged full-sugar sodas in smaller sizes.
But Moran’s study shows that ads for low- and no-calorie drinks did not spike during food-stamp benefit periods. In other words, the data suggests that food companies only targeted SNAP shoppers for full-sugar beverages.
The findings have outraged some anti-hunger and public health groups.
“SNAP recipients need access to healthy food choices just like everyone else,” said Monica Mills, executive director of the left-leaning group Food Policy Action. “It's shameful that they are being zeroed in on by the soda industry, and at the same time, they are scrutinized and even ridiculed for the food choices they make.”
Fortunately, Moran said, the fix for this particular problem may be simple: States could issue food stamps on a rolling basis. On the national level, the Department of Agriculture could extend rules for SNAP-approved retailers to include marketing practices.
But Moran said policymakers need more evidence for a total ban on soda in the food-stamp program. Public health experts and conservative reformers have asked Congress to include such a ban in the 2018 Farm Bill, which they say would save money and improve nutrition.
Moran argues there's no evidence a ban would cut down on soda-drinking, because SNAP recipients could always just buy beverages with cash. Worse, she said, by ignoring marketing and other systemic issues, the ban would address the symptoms — and not the causes — of the income/nutrition gap.
“There’s a huge opportunity to leverage SNAP to improve nutrition and health,” Moran said. “Unfortunately a lot of the national conversation around SNAP policy has revolved around politically contentious issues instead.”