Susan Singleton admits to tearing up whenever she goes to the grocery store.
Instead of lean proteins like fish or chicken, she goes for the meat that’s about to expire because it’s what she can afford. Instead of brand-name products, she fills her cart with knock-off items or whatever she has coupons for. The mother of three from Columbia worries about what she is feeding her family.
“When I go to the store, I cannot buy healthy. I buy cheap,” Singleton said.
She pays for her purchases with an EBT card, similar to a debit card, into which the government deposits funds once a month. Singleton is a recipient of the Supplemental Nutrition Assistance Program – formerly known as food stamps – that assists low-income individuals and families in affording nutritious food.
Nutritious is the key word. The 18 percent of South Carolinians on SNAP benefits are restricted from buying alcohol, cigarettes and hot food prepared in the store, like rotisserie chicken. Junk food items like soda, chips and candy are fair game.
That’s why Gov. Nikki Haley, flanked by public health officials, is pushing for a controversial adjustment to the SNAP program that would limit purchases to healthy items only. To do this, Haley needs a waiver from the U.S. Department of Agriculture. Gaining approval to make an already complicated program more complicated will be no easy task, however. Each of the 10 states that has asked for a similar restrictive waiver, most recently in New York, has been turned down. The state Department of Social Services, which implements SNAP, did not have a comment as to why South Carolina would be any more successful.
But Haley has a point. South Carolina is fat. It is America’s eighth-most obese state, where one in every three adults is obese. Of those South Carolinians who are overweight or obese:
Nearly 40 percent have high blood pressure.
Almost 12 percent have diabetes.
Five percent have coronary heart disease.
The result is more than $1 billion in obesity-related medical expenditures for the state in 2003, according to the S.C. Department of Health and Environmental Control. More than half of those costs were financed by Medicaid and Medicare, which are government-sponsored health care programs for low-income individuals and the elderly, respectively.
While it’s true that individuals with lower incomes tend to purchase fewer fruits and vegetables than those with higher incomes, take into account that prices for fruits and vegetables have steadily increased in the past two decades, according to the Yale Rudd Center for Food Policy and Obesity.
People who rely on nutrition assistance programs like SNAP are likely to purchase inexpensive foods, which are generally calorie-dense and nutrient poor. Researchers from the University of Washington have shown that calories from vegetables like zucchini and lettuce are 100 times more expensive than calories from oil, butter and sugar.
Shanelle Johnson, a SNAP recipient and a single mother with two kids, said she is already limited in choices at the grocery store and restricting her options even further is not going to help matters.
“We have to make choices as individuals to eat healthy,” Johnson said. “This is not the way.”
When it comes to taxpayer dollars, however, dietitian Susan White said she feels that sometimes health decisions need to be made for people.
“Food stamps are meant to be a lifeline,” said White, who is from Camden, S.C. “I think we’ve gotten sidetracked by those luxury items like soda and chips and candy. Some people will make healthy decisions, and some people won’t. (Restrictions) are to help the latter category.”
Kathleen Mercer with the South Carolina Academy of Nutrition and Dietetics, an organization comprising food and nutrition professionals, agrees that eating healthy on a very limited budget is hard, but not impossible.
“I think a lot of times when people say the ‘cheap stuff,’ I think they are trying to buy convenience food,” Mercer said.
With prepackaged and frozen foods, for example, the cheaper items are usually more expensive, but learning to cook with foods like dried beans, peas and whole grain pasta are cheap and nutritious options, Mercer said.
While she admitted to being unsure about potential SNAP restrictions, Mercer said that as a dietitian, she has seen how eliminating just soda from someone’s diet can have a huge impact.
“If people are drinking sugary beverages, it’s really going to add calories quickly,” she said.
The USDA does not have a clear definition of what constitutes healthy and unhealthy foods, which would make implementing and enforcing any type of ban difficult. Instead of making a one-size-fits-all grocery cart, others are advocating the government provide incentives for people to purchase healthy food.
In South Carolina, 29 of 120 farmers markets accept SNAP and EBT money; none of them is in Columbia. Most recently in Orangeburg, an incentive program called Double Bucks has successfully become food-stamp friendly. When a person uses his or her SNAP benefits at the market, Double Bucks matches the amount spent, so $10 worth of lettuce would cost $5. Program proponents reported that four times more SNAP dollars came to the Orangeburg farmers market, making it worthwhile for low-income shoppers and local farmers alike. Typically the process involves the market getting a single license from the USDA, with SNAP recipients exchanging benefits for tokens or receipts.
At the first of four open forums to hear the public’s opinions on potential SNAP restrictions, most argued that telling one group of people what not to buy is unfair and that obesity is not just a problem among the poor.
Indeed, the diets of all Americans fall far short of dietary guidelines. The overall average score on a Healthy Eating Index was 58 out of a possible 100 in 2004, according to the Economic Research Service, the primary source of economic information and research for the USDA. SNAP participants scored slightly lower, with an overall score of 52. All groups had very low intakes of whole grains, dark green and orange vegetables, and legumes. All groups had high intakes of saturated fat, and too many calories from solid fats and added sugars.
In South Carolina, fewer than one in four adults consume at least five servings of fruits or vegetables daily as recommended for good health.
In Singleton’s household, she provides what fruits and vegetables she can for her family. But adding restrictions to SNAP, she said, would make her 5-year-old daughter, Neveah, very sad. Especially on Sundays – the one day of the week she is allowed to have ice cream.
“It’s not every day,” Singleton said. “It’s not unreasonable.”
***
The S.C. Department of Health and Environmental Control will conduct two more forums to let the public recommend which foods they think should be removed from or should remain on the state’s SNAP list of eligible foods.
April 18, 2013
5:30 to 7:30 p.m.
Greenville County Council Chambers (County Square)
301 University Ridge
Greenville, S.C. 29601
May 2, 2013
5:30 to 7:30 p.m.
Sterett Hall at the Navy Yard
1530 7th Street and Hobson Avenue
North Charleston, S.C. 29405
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