Obesity in Children on Welfare

Representative Sheila Butt filed HB0043 which would prohibit recipients of SNAP (“food stamps”) from using their EBT cards to purchase food that is high in calories, sugar, and fat, as recommended by the US Department of Agriculture, prohibits people or businesses from accepting EBT cards as payment for such foods, and authorizes the Tennessee Department of Human Services to seek a waiver from the US Department of Health and Human Services to establish a list of such prohibited foods. The Bill currently does not have a Senate sponsor. Cari Wade Gervin responded to the Bill at the Nashville Scene, to which I wish to add some additional information.

Rep. Butt’s primary argument in presenting this Bill is that there exists an obesity epidemic in Tennessee, and this Bill is designed to police that obesity by prohibiting welfare funds from being used to purchase unhealthy food. First let’s examine the rates of hunger and obesity in Tennessee, before addressing whether this Bill might actually help solve the problem it is aimed at addressing.

As of 2015, the population of Tennessee was approximately 6,386,663, with 1,171,307 Tennesseans living in poverty. 16.7% of our population had incomes below the poverty line ($24,250 for a family of four), ranking us in the bottom 10 states for ending poverty (Mississippi is the worst, with a 22% poverty rate). 17.5% of Tennessean women live in poverty, compared with 13.8% of Tennessean men. 23.8% of Tennessean children live in poverty. Racially, poverty is distributed among Latino (30.7%), African American (25.4%), Native American (18.6%), White (14.5%), and Asian American (10.3%). 15.1% of our households were food insecure on average from 2013 to 2015, with every 1 in 6 Tennesseans suffering from hunger. This rate is up from 13% in 2010. 6% of the 15.1% suffered “very low” food security, a metric that is closer to actual starvation. As of December 2015, there were 1,149,789 Tennesseans receiving SNAP benefits, representing 17.8% of our population. Tennessee is one of eight states that has a statistically higher rate of food insecurity than the US national average, and we consistently rank in the bottom 10 states for child welfare. As if a quarter of Tennessean children going hungry wasn’t bad enough, Tennessee government suffers from corruption and graft in its child welfare and hunger programs, in addition to consistent cuts and tighter regulations for welfare recipients at the legislative level in recent years. This includes Bills like SB0007 from Senator Mark Green, which would cap the total amount of public assistance benefits including unemployment benefits, food assistance, and child care subsidies allowed for a household at the median household income for the state (currently $47,275, $8,500 lower than the US median household income).

Tennessee’s record of poverty and hunger is well-established, but what of our obesity rate? It’s incredibly unsurprising given the prevalence of poverty and hunger. We are currently the 9th most obese state, a ranking that tracks well with our poverty and hunger rates. The Centers for Disease Control (CDC) published a profile in September 2016 on Tennessee State Nutrition, Physical Activity, and Obesity which provided the following statistics:

The CDC report along with the Tennessee obesity data chart here attempts to analyze some of the behavioral reasons for these obesity rates, such as the consumption of fruit, vegetables, and sugary drinks, as well as physical activity. Only 22.9% of adolescents in the survey participated in daily physical education at school, although 41.3% drank soda daily. Perhaps our students would feel more energized by a little daily exercise than they would by a quick jolt of sugar and caffeine. Interestingly, Representative Bill Dunn filed HB0045 today, which would delete the requirement for LEA’s to provide students with periods of physical activity, allowing schools to eliminate any exercise time for their students (presumably giving them more time to study for their standardized tests). More constructively, Senator Becky Duncan Massey filed SB0049, the “Tennessee Lactation Consultant Practice Act,” which would provide for the licensing of breastfeeding consultants, an important step given the CDC data on how breastfeeding affects child obesity.

Although Tennessee is doing worse at eliminating poverty and food insecurity than it’s in danger of exceeding the national average on obesity, it’s still worth examining the correlation between obesity and SNAP benefits. The USDA noted in 2005 that more research was needed to even begin to examine this correlation, if any correlation even exists. More recent studies have shown that the childhood obesity epidemic of the 80s and 90s has plateaued, with children from wealthier families showing less obesity and children from poorer families showing more obesity. The CDC has completed several studies on the prevalence of obesity among children on welfare. The growing consensus is that childhood obesity is growing among poor children due to a lack of healthy food and safe exercise options, which are provided to their wealthier peers. Poorer kids are getting fatter because they don’t have access to good food and safe exercise, not because they choose bad food and low physical activity.

The many public policy initiatives recommended by the CDC for alleviating poor nutrition, particularly among SNAP recipients, includes:

The emphasis was clearly on the State acting within its authority to improve the lack of healthy options, not on prohibiting hungry children and other SNAP recipients from eating unhealthy foods, which in many cases of food insecurity are the only options readily available in “food desert” neighborhoods. As anyone who has ever tried to feed themselves on the paltry sum provided by SNAP benefits can attest, it is quite a feat to eat well on those benefits even with well-stocked groceries in your neighborhood and plenty of extra time for food preparation. This says nothing of the exercise opportunities available to children in poor areas, often not within walking distance of parks and other facilities, and in some cases too poorly policed to provide a safe environment for children to play. These are all issues which are well within the General Assembly’s power to address if they are serious about improving the obesity rate in Tennessee. Such measures would be far more effective than Butt’s Bill as presented.