Understanding and comparing economic assistance models to improve food security and diet quality: A rapid review

Food insecurity and poor nutrition afflict millions of Americans with low incomes. Three policy approaches to address these challenges are widely debated: modifying existing cash-like food assistance programs (that is, increasing benefits with or without imposing nutrition restrictions) or introducing new cash-like food assistance; incentivizing fruit and vegetable purchases; and providing unconditional cash transfers. This rapid review synthesized experimental and quasi-experimental evidence of how these approaches affect food security, diet quality, and dietary intake. Included studies evaluated modifications to cash-like food assistance benefits, nutrition incentives, and cash transfers. Increasing benefits without imposing nutrition restrictions for cash-like food assistance programs has the strongest evidence for improving food security and has mixed evidence for dietary outcomes. Adding nutrition restrictions to such benefits inconsistently improves diet quality and may reduce program participation. Nutrition incentives prompt small increases in fruit and vegetable intake but inconsistent reductions in food insecurity. More research is needed on cash transfers. As the evidence base for the optimal design of economic assistance programs evolves, continued investment in existing food assistance and nutrition incentive programs with strong evidence for effectiveness is essential.