Increases in Sugary Drink Marketing During Supplemental Nutrition Assistance Program Benefit Issuance in New York

Introduction: The Supplemental Nutrition Assistance Program (SNAP) is the largest federal food assistance program, providing $67 billion in benefits to 44 million Americans. Some states distribute SNAP benefits over one or a few days each month, which may create an incentive for retailers to heavily promote top-selling products, like sugar-sweetened beverages, when benefits are disbursed. Methods: A beverage environment scan assessing presence of displays, advertisements, and price promotions for sugar-sweetened, low-calorie, and unsweetened beverages was administered in a census of SNAP-authorized beverage retailers (n=630) in three cities in New York from September to November 2011. Multilevel regression models controlling for store type; county; and percentage SNAP enrollment, poverty, and non-Hispanic white population in the store's census tract were used to estimate the odds of in-store beverage marketing during the SNAP benefit issuance period compared to other days of the month. Data were analyzed in 2016. Results: There were higher odds of in-store sugar-sweetened beverage marketing during SNAP benefit issuance days (first to ninth days of the month) compared with other days of the month, particularly for sugar-sweetened beverage advertisements (OR=1.66, 95% CI=1.01, 2.72) and displays (OR=1.88, 95% CI=1.16, 3.03). In census tracts with high SNAP enrollment (>28%), the odds of a retailer having sugar-sweetened beverage displays were 4.35 times higher (95% CI=1.93, 9.98) during issuance compared with non-issuance days. There were no differences in marketing for low-calorie or unsweetened beverages. Conclusions: Increases in sugar-sweetened beverage marketing during issuance may exacerbate disparities in diet quality of households participating in SNAP. Policy changes, like extending SNAP benefit issuance, may mitigate these effects.