The role of public and private food assistance in supporting families’ food security and meal routines

https://doi.org/10.1016/j.childyouth.2023.106994Get rights and content

Highlights

  • Picking up a weekend food pack, or “Power Pack”, predicts lower food insecurity.

  • Program recipients who do not receive SNAP saw greater decreases in food insecurity.

  • Power Packs offers fresh foods, which promoted home cooking for non-SNAP families.

  • SNAP recipients were more likely to pick up packs at the end of their SNAP month.

  • Families who do and do not receive SNAP use local food assistance in different ways.

Abstract

“Backpack” food programs administered through public schools are a potentially powerful additional source of nutrition for low-income students and their families. Typically, backpack programs send non-perishable foods home with children to supplement school meals. Power Packs Project (PPP) is a unique backpack program, in that it provides fresh food alongside accompanying recipes, with the explicit goals of not only reducing food insecurity but also facilitating home cooking and improving nutrition for the whole family. Using daily, repeated surveys sent via text-message to program parents (N = 178), this study is the first to examine the effect of picking up a Power Pack in a given week on parent and child food insecurity and meal routines. Additionally, it explores whether effects differed for families who also received federal food assistance through the Supplemental Nutrition Assistance Program (SNAP). Results indicate that Power Packs is associated with lower parent and child food insecurity; this relationship is even stronger among families who did not also receive SNAP. Power Packs also promotes home cooking, but only among families who did not receive SNAP. Analyses of program usage revealed that SNAP recipients were far more likely to pick up their packs at the end of their SNAP month than they were just after SNAP benefit distribution, suggesting they use the program to smooth food consumption in tandem with SNAP. Implications of these findings for food assistance programs and policies are discussed.

Introduction

In 2015, the American Academy of Pediatrics declared food insecurity, defined as the inconsistent access to food of the quantity or quality needed to fuel a healthy life, a public health crisis (Council on Community Pediatrics et al., 2015). Indeed, in 2019, 14% of all children in the U.S. and 28% of low-income children lived in food insecure homes (Coleman-Jensen et al., 2020). These rates soared at the beginning of the COVID-19 pandemic to a staggering 40% of children overall, with rates even higher for children in low-income families and communities of color (Bauer et al., 2020). To reduce food insecurity, the federal government provides several programs, including the Supplemental Nutrition Assistance Program (SNAP; formerly Food Stamps).1 Although federal nutrition assistance reduces the severity of food insecurity (Gassman-Pines and Hill, 2013, Gibson-Davis and Foster, 2006; Gregory et al., 2016, Hoynes and Schanzenbach, 2015), many poor and near-poor children nonetheless continue to suffer from it. The consequences of these high rates of food insecurity are serious: food insecurity undermines children’s physical health, socioemotional wellbeing, and academic success (Alaimo et al., 2001, Ashiabi, 2005, Belsky et al., 2010, Cook et al., 2013, Eicher-Miller et al., 2009, Hines et al., 2021, Johnson and Markowitz, 2018a) and predicts higher levels of depression, harsh parenting, and spousal conflict among parents (Johnson & Markowitz, 2018b). With most recent national estimates indicating that there are approximately 13.5 million children living in food insecure households in the U.S. (Coleman-Jensen et al., 2022), these documented links call for research on ways to reduce food insecurity among our nation’s children.

One potentially powerful additional source of nutrition for school-aged children in particular are “backpack” food programs. Administered primarily by non-profit organizations, often in schools, backpack food programs typically send non-perishable foods home with children to provide food for the child (and family) during non-school hours (Fram & Frongillo, 2018). These programs offer a supplement to federal food assistance and as such could help alleviate the crisis of food insecurity in the U.S. To determine their potential effectiveness, however, we must first establish the extent to which backpack programs do alleviate food insecurity, for although a handful of studies have examined the effect of backpack programs on children’s academic outcomes (e.g., Kurtz et al., 2020), only one has systematically examined the effect of a backpack program on reducing family food insecurity and its results were equivocal (Burke et al., 2021).

Power Packs Project (PPP) is an ideal backpack program to study for insight into the question of how backpack programs might relate to food insecurity within families. PPP provides weekend food bags to children attending Title I schools in two Pennsylvania counties, in locations with numerous areas designated as food deserts (Economic Research Service, U.S. Department of Agriculture, 2021; Power Packs Project, 2022). Moreover, unlike typical backpack programs that provide only non-perishable foods for one child, which are typically higher in sodium, sugar, and fat than perishable items, PPP provides fresh food with accompanying recipes with the explicit goals of facilitating home cooking, encouraging family meals, and improving nutrition for the whole family (Smith et al., 2013, U.S. Department of Agriculture, U.S. Department of Health and Human Services., 2020). PPP thus provides not only more nutritious food than other backpack programs, but an opportunity to promote healthful food routines, including cooking from scratch and sharing family meals, that have been linked with better child and family wellbeing (Fiese et al., 2006, Hammons and Fiese, 2011). Specifically, family meals and cooking from scratch have been variously associated with improved self-esteem, language development, academic achievement, and physical health among children and enhanced family interactions (Fiese & Schwarz, 2008). Thus, by not only providing food, but also providing food that requires cooking and encourages shared meals, this program provides a unique opportunity to examine whether backpack programs can reduce household and child food insecurity as well as promote healthy eating.

An equally important question is whether backpack programs benefit families differently depending on families’ participation in federal food assistance programs. Private food assistance programs like PPP target the same families as federal food assistance, that is, low-income families with school-aged children who struggle sporadically or chronically with food insecurity. Indeed, our preliminary work with PPP indicates that the majority of PPP families also receive federal food assistance in the form of SNAP (Steimle et al., 2021). It is possible that families who receive SNAP use, and thus benefit from, private food assistance like PPP differently than families who use PPP as their main source of family-targeted food assistance (as distinct from school-provided breakfast and lunch, which only goes to school-aged children). Specifically, SNAP recipients may benefit less on average from PPP in terms of reduced food insecurity because they have another stable source of food assistance. Another possibility is that SNAP recipients benefit just as much as non-recipients but simply utilize the program differently than non-SNAP recipients: they may pick up backpacks more often at end of SNAP month, when their SNAP funds run low, than in weeks just after SNAP distribution. These differences in program effects for SNAP recipients and non-recipients could apply to PPP’s effect on meal routines, too. For example, SNAP recipients may use their federal benefits to purchase fresh foods for home cooking and family meals, and only rely on PPP for meal ingredients when their benefits are depleted and cannot cover fresh food.

To answer these questions, our research team partnered with PPP to gather longitudinal data on families’ food insecurity and meal routines at six participating schools. Specifically, using daily surveys, parents reported on their household food insecurity, child-specific food insecurity, and meal routines from January to March 2020. We leverage weekly variation in families’ program usage to identify the effects of the PPP on food insecurity and meal routines, as well as variation in those effects by SNAP receipt. Given well-documented links between food insecurity and negative parent and child wellbeing, answering these questions will illuminate whether PPP could serve as a model program for communities aiming to close gaps in food consumption that even federal food assistance leaves open.

It is well-documented that receiving SNAP significantly reduces food insecurity among school-aged children and their families (Gundersen et al., 2017, Hoynes and Schanzenbach, 2009, Kreider et al., 2012). Moreover, there is evidence that SNAP receipt, in turn, significantly improves low-income students’ test scores (Bond et al., 2021) and both healthcare utilization and health outcomes (Bronchetti et al., 2019). Although we know of no research linking SNAP to shared family meals or cooking, specifically, food insecurity itself limits the extent to which families have food to cook and share (Fiese & Schwartz, 2008). Indeed, one indicator of severe food insecurity is meal skipping, a hardship that obviates shared family meals and cooking from scratch. Food assistance programs like SNAP therefore serve not only to reduce food insecurity, but likely promote healthful meal routines.

Despite the program’s success, there is evidence that many SNAP recipients still experience food insecurity (Coleman-Jensen et al., 2022), particularly at the end of their monthly SNAP cycles, and that these periodic shortfalls meaningfully impact children’s wellbeing. For example, student standardized test scores fall (Gassman-Pines & Bellows, 2018) and behavior problems increase (Gennetian et al., 2016) at the end relative to the beginning of the SNAP month. These patterns likely emerge because food insecurity increases among SNAP recipients at the end of the SNAP month when families have used most or all of their SNAP benefits (Gassman‐Pines & Schenck‐Fontaine, 2019). These findings indicate that food insecurity varies meaningfully day-to-day and week-to-week in low-income families, even among those receiving federal food assistance, and that those daily fluctuations in food security can undermine child wellbeing. To the extent that patterns of meal routines follow patterns of food insecurity, these periodic effects likely extent to families’ experience of shared meals and cooking from scratch.

Local, school-based backpack programs are a potentially important source of additional food assistance for low-income families. After the Food for Kids backpack program was founded in Arkansas in 1995 to address student hunger over the weekend, backpack programs proliferated in the U.S. (Rodgers & Milewska, 2007). In 2006, thousands of the local backpack programs around the country were unified under the Feeding America Network, the umbrella organization for most food banks in the United States, such as the BackPack Program (Rodgers & Milewska, 2007). In 2014, the BackPack Program operated at more than 11,500 sites, serving 457,000 children and delivering more than 44 million meals (Feeding America, 2015). There are only a handful of studies on the effectiveness of these programs, and those that do exist are almost entirely small and descriptive (e.g., Fiese et al., 2020). The few well-controlled studies of backpack programs yield mixed results: one study examined effects on food insecurity and found a backpack program in Virginia reduced severe forms of child food insecurity, but increased less severe forms and had no effect on household food insecurity (Burke et al., 2021). Another study found expansion of a state backpack program boosted reading and math test scores among low-income children (Kurtz et al., 2020). Other studies have yielded mixed findings on the ability of backpack programs to increase school attendance (Fiese et al., 2020, Kurtz et al., 2020).

These mixed findings, particularly with regard to food insecurity, could stem from the approach standard backpack programs take to food provision, an approach that has been criticized on nutritional grounds. Backpack food programs typically send non-perishable foods home with children to provide food for the child during non-school hours (Fram & Frongillo, 2018). While these programs provide additional sustenance to children, the provision of shelf-stable, non-perishable items, which are typically higher in sodium, sugar, and fat than perishable items, contradicts standard public health recommendations to replace fats and sweets with fresh foods like vegetables and fruits (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2020). These provisions, while well-intended, may in turn reinforce unhealthful nutritional habits among families. Moreover, providing food for only one child could undermine family engagement in shared meals and meal preparation; at minimum, this approach does not encourage the provision of family meals. By contrast, perishable foods require food preparation, possibly as a family, and offer more nutritious meals. In this way, a backpack program that provides fresh foods should not only reduce food insecurity, but also support healthful meal routines.

To our knowledge, Power Packs Project is the only backpack program that provides perishable foods with the explicit goals of encouraging families to cook, supporting family meals, and improving nutrition, while also reducing food insecurity (Power Packs Project, 2022). Every Thursday in two counties in Pennsylvania across over 40 Title I schools, enrolled students or their parents pick up a pack of food for the weekend sized for the family and a recipe card for how to use the food to prepare meals. PPP’s uniquely healthful design suggests it could not only reduce household and child food insecurity, but also promote healthful meal routines. Given the well-documented links between meal routines, including sharing family meals and cooking from scratch, and better child and family socioemotional, cognitive, and physical wellbeing (Fiese & Schwartz, 2008), establishing both improved food security and enhanced meal routines as benefits of the program would indicate its potential as a model for the thousands of backpack programs nationwide.

Local backpack programs primarily target families who are also eligible for federal food assistance, that is, low-income families with school-aged children. Indeed, among families participating in Power Packs Project, nearly all receive free and reduced-price school meals and the majority receive SNAP (Steimle et al., 2021). An important potential moderator of the benefits of backpack programs, therefore, is the simultaneous receipt of SNAP. For families who do not receive SNAP, for instance, a program like PPP may serve as the families’ main source of food assistance, and picking up a pack may make the difference between a family being food secure or food insecure that week. For families who do receive SNAP, a weekly backpack would help the most in terms of food insecurity at the end of their SNAP month, when levels of food insecurity tend to increase (Gassman-Pines & Schenck-Fontaine, 2019), and help less just after SNAP distribution. If so, it is possible PPP families who receive SNAP pick up packs less at the beginning of their SNAP months and more often at end. Moreover, the average weekly effect of pack pickup on food insecurity and meal routines would be weaker among SNAP recipients than non-recipients, since SNAP families are theoretically using the packs to prevent food insecurity rather than diminish it. If so, identifying this moderation could not only clarify who benefits most on average from backpack programs, but also illuminate important heterogeneity in how low-income families use backpack programs, which could inform program practices and broader food assistance efforts.

Using program administrative and daily survey data gathered from January 2020 through March 2020, the present study examines the average effects of picking up a Power Pack each week on families’ food insecurity and meal routines, and how SNAP receipt moderates those effects. Specifically, families were surveyed every day for two weeks per month about their food insecurity and meal routines that day, and these data were merged with data on families’ weekly program usage. By using daily measures of food insecurity, we leverage naturally occurring variation in families’ program usage each week to precisely compare outcomes during weeks immediately after pack pickup to weeks after a non-pickup. In doing so, we contribute to the nascent literature on the effectiveness backpack programs at supporting children’s food security, but also illuminate how PPP, by providing fresh foods and accompanying recipes, may go beyond combating food insecurity by enhancing families’ healthy meal routines. If we detect variation in weekly pack effects on food insecurity or meal routines by SNAP receipt, we will go on to examine whether families who receive SNAP have a different pattern of pack pickup than families who do not. Specifically, we will examine whether SNAP families are more likely to pick up packs at the end of their SNAP month than just after SNAP distribution.

Section snippets

Data and sample

Our team has partnered with the PPP, and two partially rural school districts, for over three years to understand food insecurity among PPP families and the program’s ability to curtail it. PPP operates in over 40 schools across 16 school districts in Pennsylvania. All students who qualify for free and reduced-price lunch at participating schools are eligible to enroll in Power Packs, although participation is entirely voluntary and requires parents’ active enrollment. We selected a subset of

Program participation

Our team partnered with the PPP and the technology company Technuf, LLC, to design a tablet-based application school staff could use to track enrollment in the program, families’ demographic characteristics, and weekly, family-level pack pickup. These data were then stored securely in an encrypted database for program and research team use. Because school staff logged pack pickup each week for all enrolled families, full data are available from January through mid-March 2020 on families’

Descriptive statistics

The bottom portion of Table 1 displays descriptive statistics for all mean food insecurity and meal routines scores as well as pack pickup for the full sample and by SNAP receipt status. Notably, those who were and were not receiving SNAP did not differ on their average daily reports of food insecurity nor in their meal routines. Comparison of families’ frequency of picking up their Power Packs also indicates that approximately 65% of families picked up their packs in any given week, and that

Discussion

Food insecurity is a public health crisis in the U.S. that affects nearly one-third of low-income families and undermines parent wellbeing and child physical, socioemotional, and cognitive outcomes (Coleman-Jensen et al., 2022, Council on Community Pediatrics, Committee on Nutrition, Gitterman, B. A., Chilton, L. A., Cotton, W. H., Duffee, J. H., Flanagan, P., Keane, V. A., Krugman, S. D., Kuo, A. A., Linton, J. M., McKelvey, C. D., Paz-Soldan, G. J., Daniels, S. R., Abrams, S. A., Corkins, M.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

We thank Power Packs Project and their families for making this research possible.

Funding: This work was supported by Georgetown University and the Russell Sage Foundation (#2005-25249). The funders had no direct involvement in the study design nor this manuscript.

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