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The Real Cost of a Healthy Diet


November 2011


The economic crisis has taken a severe toll on the health and well-being of our nation’s most vulnerable citizens. In 2010, there were 48.8 million Americans who lived in households that were food insecure, including 16.2 million children. Food insecurity (limited access to sufficient nutritious food) is particularly detrimental to young children because they are in a phase of rapid brain development and growth, laying the foundation for future health and school success. Without adequate nutrition, the opportunity for optimal growth and development can be lost. Children’s HealthWatch research has shown that receipt of Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program) benefits is linked to better child health and development and improved food security.

As the only major U.S. city with two of the hungriest Congressional districts, there is no better place to examine issues of food insecurity than Philadelphia. Among households with children in 2010, approximately half in Philadelphia’s 1st Congressional District and nearly a third in the 2nd Congressional District did not have enough money to buy food that their family needed.

In these tough economic times, SNAP has never been more important in helping to buffer children from the negative health effects associated with living in poverty. Not only did SNAP help stimulate economic growth during the recent recession, it also pulled 1.7 million children out of poverty in 2010.

Nearly half of SNAP recipients are children

Since the beginning of the economic recession, SNAP participation has risen by 63 percent and now provides assistance to 44.5 million Americans. While this indicates that SNAP has responded as it was designed to – growing in times of increased need, shrinking as times improve – benefit levels remain too low. As evidence of this, many families who receive SNAP still report food insecurity.

Population Segment Percent of SNAP Recipients
Children 47%
Women 18 to 59 28%
Men 18 to 59 17%
Adults 60 and over 8%

Nearly half of SNAP recipients report food insecurity

Food Secure 52% 
Low Food Security 29%
Very Low Food Security 19%

The Thrifty Food Plan

Last updated in 2006, the U.S. Department of Agriculture’s Thrifty Food Plan (TFP) is used as the national standard for a “nutritious diet at a minimal cost”, in theory lifting families into food security. It is used to determine national poverty thresholds and serves as the basis for the maximum SNAP allotment. This is ironic, in that the TFP is based on the food spending patterns of low-income Americans who spend the least amount of money on food, many of whom are food insecure. In addition, almost 30% of SNAP recipients have relied on emergency food supplies. This supports our finding that the TFP market basket is not capable of meeting the needs of low-income families. 

The version of the TFP market basket used in this study is based on a household with 2 adults (19-50 years old) and 2 children (one 6-8 years old and another 9-11 years old). As Children’s HealthWatch reported in 2008, the shortcomings of the TFP have real consequences for families.

  • National average food price data do not capture regional variation. Food prices in urban areas are higher and SNAP benefits do not stretch as far.
  • Prepared foods are included in such small quantities that they are rendered meaningless. For example, only 0.48 ounces of “instant cup of soup” is allotted for a family of four for a week. This is equivalent to about a third of an entire cup of soup, which is 1.4 ounces.

Project Overview

Based at Drexel University’s School of Public Health, this project examined whether a healthy diet was within reach at neighborhood food stores for low-income families in Philadelphia receiving the maximum SNAP benefit allotment.

Project Objectives 

  • To determine the cost and availability of a healthy diet in different sized food stores in low-income neighborhoods in Philadelphia
  • To compare actual food costs and availability to the TFP market basket and the maximum SNAP allotment for a family of four

Project Methods

  • Selected four low-income neighborhoods in Philadelphia
  • Identified four stores (1 large store (supermarket), 1 medium store, and 2 small stores) in each neighborhood for a total of 16 stores
  • Used a shopping list that was a translation of the 2006 TFP food guidelines
  • Trained two graduate students at Drexel University’s School of Public Health in data collection procedures
  • Collected food availability and price data for the TFP shopping list over a 2-week period in summer 2011
  • Included estimated prices of missing items in the total cost
  • Calculated the average weekly and monthly cost of the TFP and the number of missing items at each store


Thrifty Food Plan remains unaffordable even with ARRA increase

  • Maximum SNAP benefit before ARRA: $588
    Maximum SNAP benefit after ARRA increase: $668 
  Average Price of Food
All Stores $864
Supermarket $772
Medium $805
Small $939

A family of four who receives the maximum SNAP benefit would need to spend an additional $2,352 per year on average to purchase the Thrifty Food Plan market basket items.

Data were collected in 16 food stores in Philadelphia. The affordability of the TFP was assessed by comparing the prices of the items on the TFP market basket shopping list to the maximum SNAP benefit for a family of four. Most SNAP recipients do not receive the maximum benefit, instead using SNAP to supplement their food budget. However, the maximum benefit is designed to cover the entire food budget of those families who have so little income or such high expenses that they cannot contribute to the family food budget.

In April 2009, SNAP benefits were raised across-the-board by an average of 13.6 percent under the American Recovery and Reinvestment Act (ARRA). As Children’s HealthWatch research and USDA studies have shown, the ARRA increase prevented food insecurity and protected the health and well-being of very young children living in poverty during the recession.

The overall average monthly cost of the items on the TFP shopping list in all stores surveyed was $864 (29% above the maximum SNAP benefit). This represents a $196 monthly shortfall for families who receive the maximum SNAP benefit. Without the ARRA increase, families would have experienced a $276 monthly shortfall. Together, these findings demonstrate that while the ARRA increase brought SNAP benefits closer to the true cost of the Thrifty Food Plan, improvement of current SNAP benefit levels is still needed.

Small stores remain the most convenient and prevalent type of store in many low-income neighborhoods; they are also the most expensive. Relative to large stores, the price of the TFP market basket was $167 more at small stores. Because so many families who receive SNAP rely on small stores as a primary place to purchase food, they are likely to experience the greatest shortfalls when trying to buy a healthy diet.

Still searching for fruit and other healthy options

The TFP food list used in this study is comprised of 104 items. On average, 35 percent of the items were unavailable in participating stores. Half of TFP items were missing at small stores, many of which were fresh fruits and vegetables and other healthy, nutrient-rich foods. With so much recent attention to the obesity rate in low-income communities, our research shows that not only are healthy foods out of reach financially for many SNAP recipients, they are often unavailable at small stores in many low-income neighborhoods. This may contribute to high rates of poor health and overweight. 

Half of Thrifty Food Plan items missing at small stores

  Percent of Missing Items
All Stores 35%
Supermarket 7%
Medium 33%
Small 50%

Policy Recommendations

  • Protect SNAP’s existing entitlement structure, allowing the program to expand with rising need and to shrink as the economy improves and families’ earnings increase. This structure has been crucial in protecting low-income households from hunger during natural disasters and economic recessions.
  • Maintain the ARRA benefit level improvements past their current expiration date of November 2013. This includes restoring the $2 billion cut to SNAP benefits that was included in the Healthy Hunger-Free Kids Act of 2010. By doing so, families will be better able to afford enough healthy food.
  • Consider replacing the USDA’s Thrifty Food Plan with the Low-Cost Food Plan as the basis for the maximum SNAP benefit. The Low-Cost Food Plan is a more accurate reflection of food pricing in struggling urban and rural communities.