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. 2013 Sep 26:10:E163.
doi: 10.5888/pcd10.130113.

The impact of New York City's Health Bucks Program on electronic benefit transfer spending at farmers markets, 2006-2009

Sabrina Baronberg  1 , Lillian Dunn, Cathy Nonas, Rachel Dannefer, Rachel Sacks
Affiliations

The impact of New York City's Health Bucks Program on electronic benefit transfer spending at farmers markets, 2006-2009

Sabrina Baronberg et al. Prev Chronic Dis. .

Abstract

Introduction: Increasing the accessibility and affordability of fresh produce is an important strategy for municipalities combatting obesity and related health conditions. Farmers markets offer a promising venue for intervention in urban settings, and in recent years, an increasing number of programs have provided financial incentives to Supplemental Nutrition Assistance Program (SNAP) recipients. However, few studies have explored the impact of these programs on use of SNAP benefits at farmers markets.

Methods: New York City's Health Bucks Program provides SNAP recipients with a $2 coupon for every $5 spent using SNAP benefits at participating farmers markets. We analyzed approximately 4 years of electronic benefit transfer (EBT) sales data, from July 2006 through November 2009, to develop a preliminary assessment of the effect of the Health Bucks Program on EBT spending at participating markets.

Results: Farmers markets that offered Health Bucks coupons to SNAP recipients averaged higher daily EBT sales than markets without the incentive ($383.07, 95% confidence interval [CI], 333.1-433.1, vs $273.97, 95% CI, 243.4-304.5, P < 0.001) following the introduction of a direct point-of-purchase incentive. Multivariate analysis indicated this difference remained after adjusting for the year the market was held and the neighborhood poverty level.

Conclusion: When a $2 financial incentive was distributed with EBT, use of SNAP benefits increased at participating New York City farmers markets. We encourage other urban jurisdictions to consider adapting the Health Bucks Program to encourage low-income shoppers to purchase fresh produce as one potential strategy in a comprehensive approach to increasing healthful food access and affordability in low-income neighborhoods.

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Figures

Figure 1
Figure 1
Average daily EBT sales at New York City farmers markets with and without the Health Bucks incentive, from 2006 through 2009. From 2006 through 2007, Health Bucks coupons were distributed primarily through community-based organizations. From 2008 through 2009, they were distributed primarily as an incentive for using EBT at farmers markets. Values are in dollars (followed by number of market days) and represent average sales per market day. Abbreviation: EBT, electronic benefit transfer.
Figure 2
Figure 2
Average daily EBT sales at select New York City farmers markets before and after markets accepted Health Bucks, from 2006 through 2009. Analysis is limited to markets that accepted EBT both before and after accepting Health Bucks. Values are in dollars (followed by number of market days) and represent average sales per market day. Abbreviation: EBT, electronic benefit transfer.
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