Across the nation, lower-income families rely on America’s largest agricultural and nutrition legislation, known as the “Farm Bill.” It defines commodity pricing for farmers, encourages environmental stewardship, and importantly, provides nutrition assistance for low-income households including through the Supplemental Nutrition Assistance Program (SNAP). As Congress drafts its next reauthorization, several members, including Rep. Andy Harris (R-1st), are hoping to include misguided policies into this essential bill.
Two proposals, the Healthy SNAP Act and a SNAP pilot program, would ultimately place more burdens on consumers and expand the reach of government further into individual decisions about nutrition, without evidence of better overall health outcomes for the American people. If tacked on to the Farm Bill, these ideas would empower the government to determine which foods poor and working-class families are allowed to eat.
The SNAP pilot program proposes a five-state experiment that would limit food stamp purchases to “nutrient-dense” items and mandate the U.S. Department of Agriculture (USDA) to categorize more than 600,000 products. There’s a catch: No one knows what “nutrient-dense” means. When left up to subjective sorting by regulators, products ranging from sparkling water to cheese could be on the chopping block.
As a physician, this is yet another example of well-meaning policymakers thinking they can regulate people into good health behaviors. I truly believe that lawmakers and regulators want to create better outcomes for people that amount to longer, healthier lives for patients and reduced financial strain on our health care system. But there’s little reason to believe that these kinds of policy overhauls that take an insultingly paternalistic approach to the American people will do anything to reduce obesity at the population level.
Of course, anyone paying attention would reasonably agree that the obesity epidemic is a major policy concern. But few have the courage to tell patients the truth about why they’re overweight, diabetic or otherwise unhealthy. There’s no single culprit – fat, sugar or otherwise – for the urgent situation we face. Restricting access to sodas, for instance, will do little to change this trajectory, especially since less than 6% of the American diet is made up of sweetened beverages. Banning peanut butter and jelly sandwiches, likewise, would accomplish nothing if consumers replace them with fried foods from the deli counter.
Courageous and effective policymaking should examine the entire American lifestyle that has put us on an unhealthy path. We’re more sedentary than we’ve historically ever been, yet we consume calories as though we all perform backbreaking work in the heat all day. We don’t eat enough varieties of freshly prepared wholesome foods, far too often choosing takeout or restaurants to feed us when we’re too tired to make our own meals. Here, portion sizes make it harder for people to listen to their bodies when they signal fullness, making moderation a difficult challenge for many.
In other words, our lifestyles lack the kind of balance that creates good health outcomes, and we wonder why, despite the marvels of modern medicine that have miraculously prolonged and enhanced our lives, we are still so unhealthy.
It’s not too late to do something about that. But it takes a lot of work on both the personal and population level to get into shape. It’s easier to soothe the public that the sources of their woes are single nutrients or foods that have unmercifully made us unhealthy. For politicians, it’s tough to tell voters what they don’t want to hear. One such hard truth is that good health requires mindfulness about what people do with and to their bodies. It may not be popular, but it’s true.
If politicians and bureaucrats restrict SNAP purchases to try to direct Americans’ behavior, they’re not just playing a cruel game of avoidance. They’re also signaling that they believe those whose misfortunes put them in need of temporary assistance somehow also lack the agency that other consumers possess to make healthy choices for themselves. That is deeply unjust.
For those truly committed to creating better health outcomes for those dependent on government programs for food, they should seek the input from medical professionals working with these groups to better understand how policymakers can educate and motivate individuals to make good choices that allow them to live full, healthy lives. For those who aren’t, growing the government to dictate to the people what they can and cannot eat is the easy way out. Americans deserve better.
The writer is an epidemiologist, the CEO of Connections for Health and the former CEO of Johns Hopkins All Children’s Hospital.
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