Changes – Multi-Sector

This indicator measures the number of individual jurisdictions (not settings) where governments (city, town, county, region, state, territory/commonwealth, Indian Tribal Organization, Alaska Native Corporation) enacted policies and practices to increase access to healthy food and/or opportunities for physical activity for areas where the residents are primarily low-income. PSE changes result from SNAP-Ed multi-sector partnerships and that are attributable in whole or in part to SNAP-Ed activity. In the case of MT7a and, potentially MT7e, it concurrently reduces access to less healthy food or sedentary behavior.

The indicator is significant because people who live in low-income neighborhoods have less access to healthy food and physical activity than others. Policies and standards that establish healthy choices in public settings where low-income residents receive services and nutrition education to guide best choices when they are available is a way to increase access and the probability that it will be used. The USDA Healthy Incentives Pilot demonstrated that when a financial incentive to purchase fruit and vegetables was added to SNAP benefits, it was used, particularly increasing vegetable consumption.¹ Improvement of a jurisdiction’s General Plan that specifically addresses or encompasses an area where residents are primarily low-income might include elements such as zoning, neighborhood plans that would make it more feasible to develop walkable communities, raise poultry, or establish community gardens on vacant lots.

MT7a.	Number or percentage of governmental jurisdictions that have healthy food procurement and/or vending policies and standards in place consistent with the Dietary Guidelines for Americans.
MT7b.	Number or percentage of governmental jurisdictions that provide nutrition education/nutrition resources at the point of enrollment for SNAP; e.g., 1) in offices [jurisdictional], 2) online [statewide], 3) by telephone [statewide]
MT7c.	Number or percentage of governmental jurisdictions that create public-private partnerships to provide incentives for the local production and distribution of food (i.e., food grown within a day’s driving distance of the place of sale)2
MT7d.	Number or percentage of governmental jurisdictions that have evidence-based policies and standards in place to support physical activity (e.g., establishment of bike-friendly transport facilities, use of point-of-decision prompts for stairwells)
MT7e.	Number or percentage of communities that have achieved a nutrition or health element in their General Plan to improve access and/or opportunities in areas where residents are primarily low-income3
MT7f.	Estimated number of people in the target population who have increased access to or are protected by the government policy or intervention: Total number of persons in the census-defined area(s) Number and proportion of persons who are SNAP-Ed eligible

1. Written procurement policies and standards
2. The routine mechanism through which nutrition education resources and/or referrals are made at each of the potential points of initial enrollment contact
3. The funding sources of financial incentive contribution to promotion of local production and distribution of food, e.g., Double Up Food Bucks or similar program in the jurisdiction(s) of interest
4. Written policies or built infrastructure supportive of physical activity
5. Review General Plans when they undergo an update

Low-income residents receiving services in cities, towns, and counties

Additional evaluation tools to measure MT7 can be found in the SNAP-Ed Library.

General plan
Healthy food procurement
Local food production
Nutrition assistance

¹ Bartlett S, Klerman J, Olsho L, et al. Evaluation of the Healthy Incentives Pilot (HIP): Final Report. Alexandria, VA: Prepared by Abt Associates for the U.S. Department of Agriculture, Food and Nutrition Service; September 2014. 552 p.

² Martinez S, Hand M, Da Pra M, et al. Local Food Systems: Concepts, Impacts, and Issues. U.S. Department of Agriculture, Economic Research Service; May 2010. 80 p. ERR 97.

³ “Low-income” area will depend on the scope of the element defined by the General Plan. For example, it could be a set of census tracts in which 50 percent or more of the households have income less than 185 percent of the federal poverty level or it could be a city or federally designated zone of economic need. The improvement does not have to only affect the low-income area, but the low-income area must be prioritized in the improvement.

Centers for Disease Control and Prevention. Improving the Food Environment Through Nutrition Standards: A Guide for Government Procurement. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention; February 2011. 24 p.