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The Supplemental Nutrition Assistance Program (SNAP) is a highly effective program, vital to our nation’s health and well-being. SNAP’s entitlement funding structure allows it to provide benefits to anyone who meets the program’s eligibility requirements, and this structure also enables SNAP to respond quickly when need increases. Research shows that SNAP reduces poverty for millions, improves food security, and is linked with improved health. Despite SNAP’s successes, there is room to build on its considerable accomplishments. Evidence suggests that current benefit levels are not adequate for many households. Some vulnerable groups have limited SNAP eligibility, and some eligible individuals face barriers to SNAP participation. Policymakers should address these shortcomings by increasing SNAP benefits and expanding SNAP eligibility to underserved groups. The federal government and states should also continue improving policies and procedures to improve access for eligible individuals.

We present views of the Supplemental Nutrition Assistance Program (SNAP) from the perspective of participants. We are SNAP participants and academic researchers who have worked together for 11 years to understand, explain, and address food insecurity. SNAP is ensnared in much larger problems in US society related to the stigmatization of people who are poor and a lack of appreciation for the value and skills of their work. We encourage the public health community to think beyond SNAP, focus more assertively on wages and work supports, and replace our means-tested safety net with a new system of universal income that promotes equity, inclusion, and health for all. Although we offer recommendations to improve SNAP, the goal of most SNAP recipients has always been to move beyond the need for this program. The public health community can take the lead in finding more egalitarian, dignified, and effective ways to address poverty and food insecurity.

\"This volume presents research findings on the effects of early childhood propgrams and practices in the first decade of life and their implications for policy development and reform. The contributors are leading researchers in the multidisciplinary field of human development and in early childhood learning. Effects and cost-effectiveness of the most influential model, state, and federallly-funded programs, policies, and practices are described. These include Head Start, Early Head Start, the WIC Nutrition program, Nurse Family Partnership, and Perry Preschool as well as school reform strategies. The volume provides a unique multidisciplinary approach for understanding and improving interventions, practices, and policies to optimally foster human captial over the life course\"-- Provided by publisher.

This commentary introduces a special section of AJPH on the Supplemental Nutrition Assistance Program (SNAP), the US government’s largest antihunger program and third-largest antipoverty program. SNAP demonstrably lifts adults, children, and families out of poverty, thereby constituting a vital component of this nation’s public health safety net. Despite its well-documented benefits, SNAP is under political and budgetary siege, mainly from congressional representatives and lobbying groups opposed to a federal role in welfare. In part, SNAP is protected from total annihilation by its unusual authorizing legislation—the Farm Bill. This commentary provides a brief overview of the political history of SNAP and its Farm Bill location as background to the deeper analyses provided in this series of articles.

We develop a framework for welfare analysis of interventions designed to increase take-up of social safety net programs in the presence of potential behavioral biases. We calibrate the key parameters using a randomized field experiment in which 30,000 elderly individuals not enrolled in—but likely eligible for—the Supplemental Nutrition Assistance Program (SNAP) are either provided with information that they are likely eligible, provided with this information and offered assistance in applying, or are in a “status quo” control group. Only 6% of the control group enrolls in SNAP over the next nine months, compared to 11% of the Information Only group and 18% of the Information Plus Assistance group. The individuals who apply or enroll in response to either intervention have higher net income and are less sick than the average enrollee in the control group. We present evidence consistent with the existence of optimization frictions that are greater for needier individuals, which suggests that the poor targeting properties of the interventions reduce their welfare benefits.

Background: Food insecurity and poor diet quality disproportionately affect U.S. children from low-income households, with summer school closures exacerbating risks. Federally funded programs like the Summer Food Service Program (SFSP) and SUN Bucks (Summer EBT) aim to address these challenges, yet evidence of their post-pandemic dietary impact remains limited. Objectives: This study examines the relationship between policy innovations, summer meal participation, food insecurity, and diet quality among children from low-income households in Prince George’s County, Maryland. Methods: A cross-sectional design analyzed data from 158 households in Prince George’s County Public Schools across two waves (early fall 2022 and 2023). Validated tools (USDA’s Six-Item Short Form and Dietary Screener Questionnaire) assessed food security and diet quality. Sociodemographic factors, program participation, and dietary deviations from the 2020–2025 Dietary Guidelines were analyzed. Multivariate logistic regression identified determinants of poor diet quality (≥2 guideline deviations), adjusting for ethnicity, age, and housing stability. Results: Only 32.28% of eligible households participated in summer meal programs, with non-participation driven by lack of awareness (53.68%) and transportation barriers (11.58%). Significant dietary gaps included inadequate whole grain intake (0.8 vs. 3.0 servings/day) and excessive added sugars (14% of daily calories). Summer meal participation was associated with reduced odds of poor diet quality (OR = 0.23, p = 0.030), while older age (OR = 52.97, p < 0.001) and very low food security (OR = 8.42, p = 0.036) increased risk. Hispanic ethnicity had lower odds (OR = 0.17, p = 0.019) despite higher baseline food insecurity. Conclusions: Summer meal participation was associated with improved dietary outcomes but faced systemic participation barriers. Findings support policy reforms, such as multilingual outreach and mobile meal distribution, to address identified gaps.

School system is a promising platform for addressing all forms of malnutrition in adolescents. However, little is known about the impact of integrated school health and nutrition programmes on adolescent nutrition and educational outcomes in low‐ and middle‐income countries (LMICs). This systematic review sought to characterize school‐based health and nutrition interventions among adolescents in LMICs and analyze their effects on nutritional status and educational outcomes. Four databases were searched for studies evaluating school‐based health and nutrition interventions for adolescents in LMICs, reporting changes in either nutritional status or educational outcomes. A narrative synthesis was used to analyze and describe the evidence. Our review included 68 articles evaluating 58 interventions, of which a third had moderate to strong methodological quality. Forty‐two studies evaluated single‐domain interventions, while 26 evaluated multi‐component interventions. A third of all interventions were based on a theoretical framework. Three‐fourths of the interventions were shorter than 11 months, which may make identifying their effect difficult. The results of the effectiveness of these interventions were mixed and inconsistent across intervention types. Sixteen out of 21 studies evaluating multi‐component interventions and 12 out of 23 studies evaluating nutrition education reported improving nutritional or diet‐related outcomes. One out of six studies reported positive effects on educational outcomes. Our review has identified that research needs include: a greater inclusion of theory‐based approaches to guide the implementation of interventions; more studies of integrated interventions that involve parents and the wider community in LMICs; and extension of outcomes beyond nutritional status to include educational outcomes. Key messages Developing countries are experiencing nutritional and epidemiological transitions in their adolescent populations that result in widespread undernutrition and increasing overweight and obesity, creating a ‘double burden of malnutrition’. The school system offers a promising opportunity to address all forms of malnutrition in adolescents. It is still unclear, however, how school‐based health and nutrition interventions affect adolescents in low‐ and middle‐income countries (LMICs). Our review highlights the need for school‐based integrated multi‐component interventions that are contextually appropriate to address all forms of malnutrition and education outcomes in adolescents in LMICs.

Introduction. Brazil’s health system offers insights into addressing the double burden of malnutrition by proper population monitoring, coupled with local policies and national guidelines. Objective. To investigate the recent temporal trends in nutritional status indicators and its coverage of children aged two to five years from Campinas, a metropolis in the state of São Paulo, Brazil. Material and methods. The analysis of time series from 2018 to 2022 were conducted by accessing data from the Brazilian Food and Nutrition Surveillance System (SISVAN) due to regression analysis. Results. The number of children aged two to five in the SISVAN registry rose from 7,300 in 2018 to 11,171 in 2022, forming the study sample. In 2018, 700 were chronically undernourished, 306 underweight, and 977 overweight; by 2022, 530 showed stunting, 457 were underweight, and 1,084 overweight. Stunting prevalence declined from 9.6% (2018) to 4.7% (2022). Underweight dropped slightly from 4.2% to 4.1% over the years and overweight, consistently the highest indicator, ranged from 13.4% (2018) to 9.7% (2022). SISVAN’s coverage varied between 16.6% (2018) and 26.1% (2022), the lowest at 12.3% in 2020. The trend for stunting decreased significantly (APV: -15.01; CI95% -22.64; -6.62). Adding SISVAN’s coverage variable the model slightly reduced the declining stunting trend (APV: -12.12; CI95% -13.19; -11.04). Conclusions. Coordinated efforts to address nutritional challenges, from adequate population monitoring to the interaction between local policies and national guidelines, have shown positive health outcomes.