Cost-effectiveness of government nutrition assistance program policies in childhood obesity prevention

Background: Modifications to the federal government nutrition assistance programs have been considered as strategies to reducing childhood obesity. This study estimates the potential health impact and cost-effectiveness of providing financial incentives for fruit and vegetable purchases through the Supplemental Nutrition Assistance Program (SNAP), restricting purchases of sugar-sweetened beverages (SSBs) with SNAP benefits and the 2009 Women, Infants and Children (WIC) Program Food Package IV changes that target children ages 1-5.

Methods: The CHildhood Obesity Intervention Cost-Effectiveness Study (CHOICES) microsimulation model and systematic review process was used to estimate the impact and cost-effectiveness of three nutrition policies targeting SNAP and WIC. Healthcare costs averted and the cost-effectiveness of ten-year reductions in per capita body mass index (BMI), childhood obesity prevalence, and gains in quality-adjusted life years (QALYs) were estimated for the 2015 U.S. population.

Results:  Implementing these three policies would cost between $124 million and $528 million, and would reach 4.4 million to 20 million mostly low-income children in the first year. These interventions are estimated to reduce BMI by, on average, 0.042 – 0.1 units per person. Over a ten-year period these interventions are estimated to cost $91 to $497 per BMI unit reduced. Results on healthcare costs and cost-effectiveness to reduce childhood obesity and increase QALYs will be presented.

Conclusions: Changes to the federal nutrition assistance programs have varying results on BMI and reach, depending on program population and strategy. In comparison to clinical interventions, these policies can still be potentially cost-effective initiatives for reducing population BMI.