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By Athena Mandros

The social determinants of health have been getting a lot of attention recently, particularly in how they affect health outcomes and the move to value-based purchasing. For more on this, see –  Study: More Collaboration Aids Health Care For At-Risk Populations, Tending To The Social Determinants Of Health – Or Not, Hospitals’ Engagement In Population Health: Moving Past The Medicine And Into The Community, and How Can Physicians Use Data on Social Determinants of Health?

So what are those social determinants of health? They include all of the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks” (see Social Determinants of Health). This includes housing, food, crime prevention, transportation, social supports, education, and employment opportunities.

Although all of the social determinants of health are key, one of the most important areas of health is steady access to nutritional food, and much has been written about the links between diet and the many types of chronic conditions (see Exhaustion of Food Budgets at Month’s End and Hospital Admissions for Hypoglycemia and Food Insecurity And Health Outcomes). And some researchers have even gone so far as to suggest there is a link between mental health and diet, such as a relationship between what people eat and depression (How Nutritional Interventions Can Help Improve Mental Illnesses).

So if you have consumers that are experiencing food insecurity, what nutrition programs are available to address their needs? The federal government funds three key programs:

Supplemental Nutrition Assistance Benefits – This program provides a monthly electronic benefit transfer to purchase nearly any food item provided to families. Eligibility for the program is based on income (individuals must have gross monthly income below 130% of the FPL and net monthly income of less than 100% of the FPL).

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)  – This program provides vouchers or electronic benefits to purchase specific food items included in an individual’s food package, such as infant formula, whole grains, or legumes. Eligibility is based on income and limited to children up to age five, infants up to age one, pregnant women, and post-partum women.

Child Nutrition Programs – This series of programs provide meals to children in grades k-12, children in child care facilities, and adults in day care programs. Depending on an individual’s income, the meal is either free or provided at a reduced price.

For more on the specific eligibility requirements for each of these programs – and a list of the specific benefits available for SNAP and WIC in each state, check out: What Services Are Available For Nutrition Assistance & What Is U.S. Spending On Those Programs?: An OPEN MINDS Market Intelligence Report.

What is the annual spending on these programs? In FY2014, states and the federal government spent $104.2 billion on nutrition assistance programs. Since 2009, spending on nutrition assistance programs has increased by 31.9%; however, spending on nutrition assistance programs peaked in FY2014 at $109.1 billion. Whether this downward trend in spending continues past FY2014 remains to be seen.

SNAP, which in an entitlement program, is always funded by the federal government to meet the needs of all eligible individuals. It is the largest nutrition assistance program (and the largest U.S. non-health social service program) at $77.9 billion. WIC is a federal block grant, but states have never had to create waitlists for individuals in need of assistance. Spending on WIC totaled $20 billion in 2014.

Children Nutrition Programs are an entitled appropriation, meaning the U.S. Congress is expected to fund up to the level of need each year. Spending on child nutrition programs totaled $6.3 billion in 2014.


For a deeper dive into the numbers, be sure to check out our just-released report, What Services Are Available For Nutrition Assistance & What Is U.S. Spending On Those Programs?: An OPEN MINDS Market Intelligence Report. The report answers a number of questions including:

  1. What Nutrition Assistance Programs Are Available For Consumers?
  2. What Are The Eligibility Criteria For SNAP & What Is The U.S. Spending On The Program?
  3. What Are The Eligibility Criteria For WIC & What Is The U.S. Spending On The Program?
  4. What Are The Eligibility Criteria For Child Nutrition Programs & What Is The U.S. Spending On The Program?

And for a guide to other resources on addressing the social determinants of health, check out these other OPEN MINDS Market Intelligence Reports: How Are Permanent Supportive Housing Initiatives Funded?: An OPEN MINDS Market Intelligence Report; Which States Require Drug Testing For Recipients Of Public Assistance?: An OPEN MINDS Market Intelligence Report; and How Are States Using Medicaid To Fund Support Services For Supportive Housing?: An OPEN MINDS Market Intelligence Report.

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