Today’s Problems, Yesterday’s Data

  • COVID-19 data dashboards: Particularly in the early days of the pandemic, tracking COVID case counts, hospitalizations, and deaths on a near real-time basis at the county and community levels was critical for estimating risk, making policy, and targeting limited resources. Publicly available, user-friendly dashboards — like this one from The New York Times — are especially helpful for communicable diseases, where individuals can play a role in protecting themselves and keeping others safe.
  • U.S. Census Bureau Household Surveys: Beginning in April 2020, the Pulse survey began asking people about pandemic-related challenges such as food scarcity, employment, delayed medical care, mental health, and so on. Questions were added and dropped as the landscape changed. Over time, the survey began asking about vaccination status and it has recently added a question about long COVID symptoms. The survey provides real-time, non-clinical data that can be easily viewed using an online interactive tool. Best of all, the data are very current; data are now available through October 17, 2022 — just two weeks ago.
  • Wastewater analysis: Wastewater surveillance has been invaluable to public health officials over the last few years, allowing them to detect everything from COVID-19 (which can show up in wastewater several days before it appears in positive tests or hospitalization) to opioids to polio. New York State has a dashboard showing where COVID-19 has been detected in wastewater across the State, and it’s updated weekly. With the reemergence of polio in New York (I still can’t believe I’m typing that sentence in 2022), officials are working to improve wastewater surveillance for it, and counties are exploring using it to detect flu, Hepatitis, and opioids.

By David Sandman, President and CEO, New York Health Foundation
Published in Medium on October 31, 2022

NYHealth Testimony on Food and Nutrition Benefit Programs

On October 26, 2022, the New York State Assembly Committee on Social Services held a hearing on public assistance benefits in New York State. NYHealth President and CEO David Sandman submitted the following testimony highlighting New Yorkers’ needs and perceptions related to food and nutrition benefit programs:

Thank you to Chairperson Rosenthal and distinguished members of the Committee for the opportunity to testify today. I am pleased to provide testimony on behalf of the New York Health Foundation (NYHealth), a private, independent, statewide foundation dedicated to improving the health of all New Yorkers, especially people of color and others who have been historically marginalized.

The Foundation’s Healthy Food, Healthy Lives program aims to connect New Yorkers with the food they need to thrive. Making it easier for people to enroll in and use nutrition benefit programs is a core strategy of this program.

Food and Nutrition Programs: A Critical but Underused Safety Net
Prior to the COVID-19 pandemic, 1 in 10 New Yorkers—nearly 2 million people—were food insecure, meaning they lacked consistent access to enough food for an active, healthy life.[1] With food prices now at their highest levels in decades, the prevalence and severity of food insecurity are likely to be even worse.

Food and nutrition programs—including the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and free school meals—provide a critical safety net that can help New Yorkers access the food they need to thrive. Yet many New Yorkers cannot or do not participate in these programs.

Compounding that challenge is the end of federal policies enacted early in the pandemic to expand access to healthy, affordable food. For example, a program that ensured every student in the nation had access to free school meals expired at the start of this school year. And, in mid-January, the expected end of the national public health emergency will mean the expiration of COVID-relief policies that expanded the social safety net: a continuous coverage provision that allowed individuals and families to stay covered on Medicaid without interruption, as well as increased funding for SNAP benefits that entitled participants to the maximum allowable benefit for their household size. The stakes are high, as millions of people who rely on these benefits will be affected when these policies change.

At this critical moment, it’s imperative to understand New Yorkers’ needs and preferences, and to develop policies and programs that are responsive to them. In my testimony today, I will focus on New Yorkers’ needs and perceptions related to food benefits.

NYHealth recently conducted research to capture the lived experiences of New Yorkers who are food insecure. This summer, we released the findings of a 1,507-person statewide Survey of Food and Health, which highlights the connections between food and health and contrasts the day-to-day struggles of food-insecure and food-secure New Yorkers.[2] Perhaps not surprisingly, it shows that food insecurity is highly associated with worse health: nearly half of all food-insecure New Yorkers rate their health as poor or fair; 69% report having at least one chronic illness; and more than half find it difficult to get the food they need. I encourage you to dig into the findings, which are available on our website,

The report also looks at New Yorkers’ experience with and perceptions of food and nutrition programs, examines their support for expanding and improving these programs, and makes recommendations for strengthening public benefits, emergency food, and meals programs. One of the most important takeaways related to this Committee’s work today: overwhelmingly, participants in public benefit programs suggest improving them by making permanent many of the temporary changes put in place during the COVID-19 pandemic.

The survey also surfaced participants’ perceptions about food and nutrition programs more broadly:

  • Nearly 90% of SNAP and WIC participants surveyed said they agree that the benefits are easy to use. And nearly 90% of families that participated in school meals in the last 12 months agree that the meals are helpful. Three-quarters (77%) of participating parents say their children like the school meals provided. And two-thirds (67%) agree that an adequate variety of meals is offered, reflecting cultural differences and religious dietary needs.
  • On the other hand, despite the crucial role that food and nutrition programs play, some food-insecure individuals are not eligible, and many of the programs available are under-enrolled. More than one-quarter (28%) of food-insecure New Yorkers don’t participate in any food or nutrition program.

We know that only 59% of eligible New Yorkers are enrolled in the WIC program.[3] At the same time, the population of eligible but unenrolled individuals in SNAP is low—89% of SNAP-eligible New Yorkers participate in the program.[4] Yet only 45% of survey respondents who identified as food-insecure had used SNAP in the last 12 months. This discrepancy suggests that the federal eligibility criteria prevent many food-insecure individuals in New York State, where the cost of living is high, from participating in SNAP.

We also know that participation in and perceptions of public programs vary substantially across demographic groups. For example: Food-insecure Asian New Yorkers are only half as likely to be enrolled in SNAP as their Hispanic peers (26% compared with 52%); and suburban New Yorkers experiencing food insecurity are less likely to find WIC easy to use (69%) compared with their rural (85%) and urban (94%) peers. Targeting outreach to different groups, understanding the reasons for low participation, and tailoring programs to the degree possible could help increase program participation and satisfaction

Barriers to Eligibility and Enrollment
The NYHealth survey found that food-insecure New Yorkers report substantial barriers to both eligibility and enrollment in food programs:

  • To apply or recertify, 63% of food-insecure individuals say that travel to the benefits offices is problematic.
  • A majority worry about the required paperwork.
  • Half are concerned that they earn too much to qualify.
  • Stigma is another major barrier: half of food-insecure New Yorkers worry that people will find out they participate in food benefits and do not want to rely on government programs.

Most New Yorkers Say Benefits Are Insufficient
Although participants say they like the program, only about half of SNAP participants report that the benefits are enough. One New Yorker who responded to the NYHealth survey put it this way:

“I get food stamps, but with inflation, I just don’t have enough to last all month. I only eat once a day, and try to stretch the food out. I can’t afford fresh vegetables and fruit.”

To improve the SNAP and WIC programs, survey respondents suggest:

  • increasing the benefit amount;
  • improving application and distribution methods (e.g., shorter approval timeline, multiple disbursements per month);
  • expanding the types of items individuals can buy with SNAP and WIC (e.g., hot foods, milk of a different fat content); and
  • expanding participant eligibility requirements (e.g., increase the income limit).

Overwhelming Support for Benefits Program Expansions
New York State can take a number of actions to improve participation in programs like SNAP, WIC, and school meals. And these measures are popular; large majorities of both food-insecure and food-secure New Yorkers support policies to reduce food insecurity and improve health. For example:

  • New Yorkers overwhelmingly agree that the State should make lunch free for all students. 93% of food-insecure respondents and 83% of food-secure respondents support universal free school meals.
  • 96% of families who used the Pandemic Electronic Benefit Transfer (P-EBT) program, a cash benefits program that acted as an alternative to traditional school meals, say the program should be available every summer.
  • 93% of the individuals who participated in WIC during this period want the services made available during the pandemic, such as remote benefit issuance and re-enrollment, to be made permanent.
  • New Yorkers agree that benefits applications should be simplified. Approximately 90% New Yorkers surveyed—both food-insecure and food-secure—say that people should be able to apply for SNAP, WIC, and Medicaid through a single, streamlined application.
  • New Yorkers also agree that it should be easier for families to use SNAP benefits to purchase groceries online (more than 90% of food-insecure New Yorkers and more than 80% of food-secure New Yorkers agree).

Opportunities for Action
Despite the end of some pandemic-related waivers and policies, policymakers in New York State can take actions to improve federal food security programs like SNAP, WIC, and school meals. Continued support for State programs like Nourish New York will also help hungry New Yorkers get the nutritious food they need to thrive.

Specifically, we recommend:

  • Make universal school meals permanent. New York State should continue to push the federal government to extend universal school meals permanently. In the absence of federal action, New York should consider covering the cost. Universal free school meals improve students’ physical health, mental wellbeing, and academic performance. A number of school districts—including Albany, Yonkers, Rochester, and New York City—already offer universal school meals, but approximately 2,000 schools serving more than 700,000 students in New York State are no longer able to provide free school meals. Universal school meal programs are very popular—with support from 93% of food-insecure New Yorkers and 83% of food-secure New Yorkers—and states including California, Maine, and Nevada have all recently implemented such programs.
  • Increase outreach for and tailor programs to increase participation. Public benefits and emergency food programs may not be serving all groups equally. For example, Asian individuals who are food insecure are less likely to participate in SNAP—only 26%, compared with approximately half of Hispanic, Black, and white individuals. They are also less likely to enjoy the food that pantries provide, less likely to approve of the variety in school meals, and less likely to enjoy school foods. Targeting outreach to different groups, understanding reasons for low participation, and tailoring programs to the degree possible could help increase participation.
  • Make application and recertification measures easier for SNAP and WIC participants. Nine out of ten New Yorkers agree that the State should create a single, streamlined application for SNAP, WIC, and Medicaid. There is also broad support to make measures enacted during the COVID-19 pandemic permanent. Some measures, like SNAP remote interviews and use of telephonic signatures, officials should choose to keep. For other measures, like WIC remote benefit recertification and benefit boosts for produce, New York officials should advocate to the U.S. Department of Agriculture for their continuation.
  • Explore ways to prevent food insecurity in the summer. Ninety-six percent of New York families that participated think the federal P-EBT program should be extended. The State should consider ways to provide cash benefits to students’ families over the summer in the absence of federal action.

Food-insecure New Yorkers rely upon nutrition and food programs that serve as a crucial safety net, but those programs could be improved. Even as the public health emergency may officially end, pandemic-era flexibility and creativity could and should be retained to ensure that all New Yorkers are connected with the healthy, nutritious food they need to thrive. My NYHealth colleagues and I look forward to being a resource to the Committee as you work to secure and strengthen food and nutrition benefit programs and support New Yorkers’ health.

[1] U.S. Department of Agriculture, Economic Research Center. Definition of food security. April 2022.

[2] New York Health Foundation, NYHealth Survey of Food and Health. August 16, 2022.

[3] U.S. Department of Agriculture, Food and Nutrition Service. WIC 2019 Eligibility and Coverage Rates.

[4] U.S. Department of Agriculture, Food and Nutrition Service. SNAP participation rates by state, all eligible people. 2020.