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Expanded Food and Nutrition Program Shows $10 Benefit for Each $1 Spent

A program to teach low-income adults about healthy food choices is a good bargain in terms of the health and economic benefits achieved, reports a cost-effectiveness study in the May/June issue of Journal of Nutrition Education and Behavior (

Led by Jamie Dollahite, Ph.D., R.D., of Cornell University, Ithaca, N.Y., the researchers performed economic evaluations to assess the costs versus benefits of the New York State Expanded Food and Nutrition Education Program (EFNEP). EFNEP aims to provide low-income adults with the knowledge, skills, attitudes, and behaviors they need to improve their family's diet and nutritional well-being. "The outcome data indicate that food and nutrition behavior changes resulting from EFNEP are likely to improve future health and reduce health care costs," Dr. Dollahite said.

The study included data on 5,730 low-income adults who "graduated" from the New York State EFNEP program in 2000. All attended at least six sessions and completed a pre- and post-course evaluation. The cost of the program was about $900 per graduate. A cost-benefit analysis was performed to assess the value of the benefits from a societal perspective, as used by the US Office of Management and Budget. "Cost-effectiveness was estimated to be as great as for many current health interventions," said Dr. Dollahite. The quality-of-life improvements produced by EFNEP were estimated to be worth more than $49 million. The benefit-to-cost ratio was therefore $9.59 per $1—each dollar spent on EFNEP resulted in about $10 in benefits.

EFNEP is delivered through Cooperative Extension throughout the United States with federal, state, and local funding. These new results suggest that EFNEP is a good investment from several perspectives. "The education provided by EFNEP directly supports current goals of both the U.S. Department of Agriculture and the U.S. Department of Health and Human Services, as indicated in the Dietary Guidelines for Americans and Healthy People 2010," Dr. Dollahite said. "Data showing that there are actual quality of life and monetary benefits to EFNEP provides an incentive to Congress to increase funding."

The study was supported by a USDA Research Development Grant from the Joint Center for Poverty Research (2000), the College of Human Ecology at Cornell University, and Cornell Cooperative Extension.

Megan Curran | alfa
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