Millions of Americans could lose access to the Supplemental Nutrition Assistance Program (SNAP) as the federal government shutdown continues, raising concerns among health professionals about the impact on public health.
Bethany Doerfler, chief clinical research dietitian at Northwestern University Feinberg School of Medicine’s Digestive Health Institute, discussed potential consequences if SNAP benefits lapse. She emphasized that access to healthy food is a major factor in determining what people eat, especially for those managing chronic diseases.
“Access to healthy food is a major determinant of what people eat. Unhealthy food is cheaper and easier to get, and that’s a problem for people managing chronic diseases like diabetes, cancer and metabolic conditions. Food assistance programs shape what people eat at school, at home and beyond,” Doerfler said.
She added: “What we see is that people quiet their hunger with whatever food they can find, and that usually isn’t healthy foods. It completely undermines what we as healthcare providers are trying to do when we teach self-care or disease prevention. You can’t talk about self-care when people don’t have healthy choices.”
Doerfler also addressed the impact on children who make up a significant portion of SNAP recipients: “When children don’t have enough to eat, it hurts their school performance, and that impacts the economy. But it’s also a public health issue. For example, children in urban areas who lack iron and calcium are more vulnerable to lead poisoning because those nutrients compete with lead for absorption. Food insecurity doesn’t just mean hunger, it means exposure to environmental toxins, poorer learning and psychological stress for children.”
Discussing which families might be most affected by a loss of benefits, she said: “All families who receive food assistance need it. As a clinician, I can assure you it’s not easy to apply for or qualify for SNAP benefits — the people who get them truly need them. Every family that depends on that support will feel this impact. But it’s particularly hard for families where one or more people have a physical or cognitive disability. I have many patients with significant cognitive or developmental delays, which means a caregiver has to stay home and care for them. Those are the families that really struggle to find outside sources of financial support to make up the gap when these programs disappear.”
On chronic disease management without reliable access to nutritious foods such as fresh produce or lean proteins—often recommended in treating diabetes or preventing certain cancers—Doerfler explained: “Let’s take diabetes, for example. When a teen or an adult has type 2 diabetes, the preferred treatment is lifestyle intervention: eating whole foods that are high in fiber, low in saturated fat and low in refined carbohydrates. That means lean proteins like fish, poultry and beans, and plenty of fresh or frozen fruits and vegetables. But those are exactly the foods that become too expensive when people have less money to spend on food. So they gravitate toward bulk starchy meals like pasta or rice dishes... The same thing happens with certain cancers where lifestyle factors play a role... When people can’t afford fresh produce... those are exactly the foods that can help prevent cancer or reduce the risk of it coming back.”
Addressing misconceptions about SNAP use in America she stated: “I think there’s a media perception that people on food assistance can just buy junk food or soda. In reality there are guardrails on what people can purchase... These programs often combine nutrition education with food access and assistance... Most people who are receiving food assistance support are using it to buy healthy food.”