Simulating the impact of health behavior interventions in the SNAP-Ed population

In 2020, the US invested $441 million dollars in the Supplement Nutrition Assistance Program Education (SNAP-Ed), a program that encourages a healthy diet and promotes physical activity. Understanding the long-term health outcomes associated with promoting physical activity versus weight loss among the low-income population it serves could help guide the direction of future program efforts. We used the Future Americans Model (FAM), a microsimulation, to model over 10 years the impacts of changes in Body Mass Index (BMI) and exercise interventions on future health outcomes among adults aged 25 and older that could potentially accrue from SNAP-Ed interventions. We applied data from the Panel Study of Income Dynamics and data collected from 2,323 SNAP-Ed eligible adults in Los Angeles County in 2019. By 2029 interventions that increased vigorous physical activity by 20% would reduce the prevalence of difficulties with activities of daily living (ADL) by 4.72%. Interventions that would reduce BMI by 0.5 could decrease the prevalence of diabetes and heart disease by 5.34% and 0.66%, respectively. Helping people maintain weight loss, even as little as 3-4 lb, results in significant future health benefits. Given continued increases in weight at the population level, weight maintenance should be a focus of future interventions.