Fruit & vegetable incentive programs
Fruit and vegetable incentive programs, often called bonus dollars, market bucks, produce coupons, or nutrition incentives, offer participants with low incomes matching funds to purchase healthy foods, especially fresh fruits and vegetables. Incentive amounts vary from dollar-to-dollar matches to matched spending increments (i.e., $1 for $5 spent); most programs set a daily benefit limit, often $10 or $20. Incentives are frequently redeemed at farmers markets, but can also be used at grocery stores, mobile markets, or through community supported agriculture (CSA) shares. Programs are typically funded and managed by non-profit organizations, private foundations, or local governments. Many programs match funds to Supplemental Nutrition Assistance Program (SNAP) benefit spending amounts. SNAP-based incentive programs must be registered and comply with the U.S. Department of Agriculture’s Food and Nutrition Service rules and regulations1, 2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased access to healthy food
Increased healthy food purchases
Increased fruit & vegetable consumption
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Improved dietary habits
Increased food security
Improved food environment
Improved weight outcomes
Reduced emissions
What does the research say about effectiveness?
There is strong evidence that fruit and vegetable incentive programs increase affordability, access, purchase, and consumption of fruits and vegetables3, 4, 5, 6. In general, subsidies and financial incentives for healthy foods have been shown to increase healthy food purchases, which enables increased healthy food consumption4, 7, 8, 9. However, additional evidence is needed to confirm long-term effects, especially after incentives are discontinued.
Fruit and vegetable incentive programs can significantly increase sales and the use of food assistance (e.g., SNAP or WIC) at farmers markets1, 10, 11. Fruit and vegetable incentive programs make fresh produce purchases more affordable for people with low incomes and are especially helpful as healthy food prices increase relative to unhealthy food prices6. In a Massachusetts-based study, produce incentives reduced the gap between baseline fruit and vegetable consumption and the recommended levels for a healthy diet by about 20% for participants using SNAP12. In a Philadelphia-based study, purchases with incentives increased by an average of 8 more servings of vegetables and 2.5 more servings of fruit per week than purchases without incentives13; however, other studies suggest more modest effects14. Price changes can alter consumption patterns, with data showing a 10% decrease in fruit and vegetable prices leading to a 14% increase in fruit and vegetable purchases and consumption4.
Fruit and vegetable incentive programs can increase the variety of fruits and vegetables purchased14 and can improve dietary intake for families with low incomes4, 5, 15. Participants with low levels of education and produce consumption before receiving incentives often have the greatest increases in fruit and vegetable consumption16. Fruit and vegetable incentives can also improve home food environments among older adults17 and may improve food security among families with low incomes4, 18, 19. Some studies suggest that participation improves diet quality, food security, and physical health outcomes such as self-reported health status among adults and children, reduced blood pressure, and improved weight status4, 5, 18.
In some circumstances, increased fruit and vegetable consumption continues for two to six months beyond participation in an incentive program20, 21, which suggests incentives may change food preferences and effects may be sustainable21. In other cases, effects do not last13, 14.
Combining healthy food incentive programs with restrictions on unhealthy food sales can reduce excess sugar consumption, increase fruit consumption, and improve healthy eating habits more than incentive programs or unhealthy food restrictions alone22, 23. Among older adults, for example, incentive programs increase vegetable consumption but do not replace unhealthy food choices or improve weight outcomes; incentive programs may need a longer duration and additional components to improve eating habits and weight outcomes17.
Successful incentive programs include an educational component24, 25, distribute incentives early in the farmers market season26, and use promotion efforts to raise awareness27. Partnerships with community-based organizations can help promote nutrition incentives, provide educational program components, and raise awareness about incentives. Fruit and vegetable incentive programs often rely on grants or short-term gifts for funding, which is a challenge for program sustainability and support of long-term benefits28.
Available evidence suggests fruit and vegetable incentive programs are both cost-effective and a low cost way to improve public health, especially when compared to the high costs of managing diet-related illnesses5. Experts suggest that wide implementation of these programs would result in long-term savings5. An analysis of the expansion of the Healthy Incentives Pilot (HIP) program, which offers households using SNAP a 30% rebate on produce purchases, suggests HIP is a cost effective way to modestly increase fruit and vegetable purchases and consumption for households using SNAP29.
Fruit and vegetable incentive programs may support local, seasonal eating among participants, which may reduce emissions from fossil fuels used to produce, process, and transport food30, 31. Participating in produce incentive programs may also reduce the energy intensity of an individual’s diet if more plant-based foods are consumed in place of animal products30, 32.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by expert opinion.
Fruit and vegetable incentive programs have the potential to decrease disparities in access to and consumption of healthy foods between people with higher incomes and people with lower incomes, according to experts and the program’s targeted design3, 6, 18. Disparities in access to food – especially affordable, healthy foods and fresh produce – and in food insecurity exist between communities in the U.S. by race and income3, 42, 43. Racial and economic disparities in healthy eating and diet-related health outcomes are persistent, if not increasing6, 18. Adults experiencing poverty face many barriers to consuming fresh fruit and vegetables, including high costs, poor food environments, and limited transportation options that further limit access to produce28. Food insecurity exacerbates disparities in healthy eating and is associated with higher health care costs, greater health care needs, and higher risk of many chronic diseases5, 18. As of 2023, approximately 13.5% of U.S. households experienced food insecurity, which is more than in 20223.
Incentive programs to help those with low incomes access fresh produce are not spread equally or equitably across the country. Many fruit and vegetable incentive programs are associated with farmers markets and are less available in rural areas than urban areas28. Some farmers markets are not accessible or inclusive for fruit and vegetable incentive recipients, creating barriers to redeeming vouchers. Overall, farmers markets can be exclusionary towards people of color and people with low incomes44, 45; many consumers and managers of farmers markets tend to be white, educated, and affluent46. Specific structural factors of farmers markets that limit access for fruit and vegetable incentive program participants include lack of public transportation, restricted hours, few vendors that accept incentive rewards, and limited produce variety47, 48.
Experts suggest that implementing multi-component interventions that include healthy food incentives, establishing farmers markets in neighborhoods that have been structurally disadvantaged and under-resourced, and accepting electronic benefit transfer (EBT) payments may increase farmers market use among populations using Supplemental Nutrition Assistance Program (SNAP) benefits49. A study among rural, Mexican heritage households suggests fruit and vegetable incentive programs may be more successful when designed with an awareness of participants’ cultural values and inclusion of culturally important produce50.
What is the relevant historical background?
Throughout U.S. history, discriminatory housing, lending, and exclusionary zoning policies entrenched racial residential segregation and concentrated poverty51, 52. This systemic disinvestment and exclusion by both government and private entities created and maintains community environments with limited resources, deteriorating infrastructure, hazardous industries and waste disposal sites, and many other factors that lead to poorer health outcomes for people of color and people with low incomes53, 54, 55, 56. Communities shaped by discriminatory policies are often areas that have limited access to healthy and affordable food, formerly known as food deserts42, 43. Individuals who live in these communities face higher food costs, fewer store options, and must travel further to purchase healthy food than those who live in well-resourced communities42. Residents also have increased exposure to high calorie foods that have little nutritional value, which often leads to worse health outcomes43.
Congress has created many policies that address food and nutrition in the U.S. based on both agriculture industry interests and anti-hunger efforts for people with low incomes. For example, the Supplemental Nutrition Assistance Program (SNAP) has its origin in temporary food stamp programs designed to alleviate hunger while also creating a market for food supplies deemed to be surplus by the Department of Agriculture. The Food Stamp Program (FSP) became a permanent program with the Food Stamp Act of 1964 and the program retained its dual purpose of improving nutrition for households with low incomes and supporting the agriculture industry57. The FSP evolved into SNAP with many variations in funding levels, priorities, and Congressional directives along the way57. In the 1970s, nutrition science began considering diet-related chronic diseases more holistically, including fresh fruit and vegetable consumption as part of a healthy diet58.
Fresh fruit and vegetable incentive and prescription programs evolved to increase the purchasing power of people dealing with food insecurity, including SNAP recipients3, 6. Authorized by the 2018 Farm Bill for fiscal years 2019 through 2023, the Gus Schumacher Nutrition Incentive Program (GusNIP) includes three grant programs that support stakeholders in the food and health care systems to implement projects that provide fruit and vegetable incentives or prescriptions for people with low incomes. GusNIP builds on the progress made by grant programs such as the Healthy Incentive Pilot and the Food Insecurity Nutrition Incentives59.
Most Americans do not meet the recommended daily servings of fruit and vegetables for a healthy diet; as of 2019, only 3% of U.S. adults consume the daily recommended servings of fruits and only 10% consume the daily recommended servings of vegetables4, 60. Low levels of fruit and vegetable consumption are associated with increased risk of chronic diseases and mortality6, 28, while adequate fresh fruit and vegetable consumption as part of a healthy diet reduces the risk of many chronic diseases5.
Equity Considerations
- What fruit and vegetable incentive programs are available to people in your community? What is the voucher redemption rate for existing fruit and vegetable incentive programs? What barriers do those who receive incentives face in redeeming their vouchers?
- Are there adequate spaces and organizations (e.g., farmers markets, grocery stores) that will partner with you to provide access to fresh produce? If farmers markets participate, how accessible are they in terms of location, public transportation options, and hours of operation?
- Who decides how and where to implement fruit and vegetable incentive programs? How is program funding determined and allocated?
- Which populations are you aiming to enroll in your fruit and vegetable incentive program? Have you adequately invested time in this community to build a culture of trust and an open line of communication? Have you considered cultural norms when choosing the food options or education you want to include in the program? How can your community improve outreach and welcoming efforts to increase participation?
Implementation Examples
The Nutrition Incentive Hub and Wholesome Wave’s National Nutrition Incentive Network support produce incentive programs at farmers markets, community supported agriculture (CSAs), and mobile markets across the country33, 34. The Nutrition Incentive Hub also features a map of farm direct, brick and mortar, and health care locations that host nutrition incentive and produce prescription programs35. A few examples include SNAP-EBT Match at the Gorge Grown Food Network’s markets in the Pacific Northwest36; Market Match at Crescent City Farmers Market in New Orleans, Louisiana37; Boston Double Up Food Bucks in Boston, Massachusetts38; Double Value Coupons available at 39 farmers markets in several cities and towns in Illinois39; and Market Bucks matching SNAP-EBT spending dollar-for-dollar (up to $10) at participating farmers markets across Minnesota40.
Double Up Food Bucks is a fruit and vegetable incentive program that matches SNAP-EBT dollars to purchase fruits and vegetables through the support of The Fair Food Network, a national nonprofit organization. As of 2025, Double Up Food Bucks is available in over 25 states41.
Implementation Resources
‡ Resources with a focus on equity.
WW-Running NIP toolkit - Wholesome Wave (WW). How to run a nutrition incentive program (NIP): A toolkit for Wholesome Wave’s National Nutrition Incentive Network.
NAFMNP-MarketLink - National Association of Farmers Market Nutrition Programs (NAFMNP). MarketLink.
Nutrition Incentive Hub - Nutrition Incentive Hub. Strengthening access to fruits and vegetables: A national resource for nutrition incentive programs.
NIH-GusNIP map - Nutrition Incentive Hub. (n.d.). GusNIP site map: Where nutrition incentive and produce prescription sites are located. Retrieved February 27, 2025.
CDC-Incentives - Centers for Disease Control and Prevention (CDC). (n.d.). Voucher Incentives and Produce Prescriptions. Retrieved February 11, 2025.
ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.
Footnotes
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1 USDA-King 2014 - King M, Dixit-Joshi S, MacAllum K, Steketee M, Leard S. Farmers market incentive provider study. Alexandria, VA: U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS), Office of Policy Support; 2014.
2 CDC-Incentives - Centers for Disease Control and Prevention (CDC). (n.d.). Voucher Incentives and Produce Prescriptions. Retrieved February 11, 2025.
3 Stein 2024 - Stein, R., Finnie, R. K. C., Harmon, S., Peng, Y., Pritchard, C., Vecsey, H., Emmons, K. M., Hargarten, S., Simon, M. A., Blanck, H. M., Harris, D. M., Bellows, L., Coleman-Jensen, A., Fleischhacker, S., Koenings, M. M., Odoms-Young, A., Seligman, H. K., Grant, C., & Powell, A. (2024). Impact of fruit and vegetable incentive programs on food insecurity, fruit and vegetable consumption, and health outcomes: A Community Guide systematic review. American Journal of Preventive Medicine, S0749379724004112.
4 Brooks 2023 - Greatorex Brooks, E., & McInerney, M. (2023). Community-based fruit and vegetable prescription programs: A scoping review. Journal of Nutritional Science, 12, e99.
5 Haslam 2022 - Haslam, A., Gill, J., Taniguchi, T., Love, C., & Jernigan, V. B. (2022). The effect of food prescription programs on chronic disease management in primarily low-income populations: A systematic review and meta-analysis. Nutrition and Health, 28(3), 389–400.
6 Karpyn 2022 - Karpyn, A., Pon, J., Grajeda, S. B., Wang, R., Merritt, K. E., Tracy, T., May, H., Sawyer-Morris, G., Halverson, M. M., & Hunt, A. (2022). Understanding impacts of SNAP fruit and vegetable incentive program at farmers’ markets: Findings from a 13 state RCT. International Journal of Environmental Research and Public Health, 19(12), 7443.
7 Gittelsohn 2017 - Gittelsohn J, Trude ACB, Kim H. Pricing strategies to encourage availability, purchase, and consumption of healthy foods and beverages: A systematic review. Preventing Chronic Disease. 2017;14(E107):170213.
8 Grech 2015 - Grech A, Allman-Farinelli M. A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices. Obesity Reviews. 2015;16(12):1030-1041.
9 An 2013 - An, R. (2013). Effectiveness of subsidies in promoting healthy food purchases and consumption: A review of field experiments. Public Health Nutrition, 16(7), 1215-1228.
10 Freedman 2014 - Freedman DA, Mattison-Faye A, Alia K, Guest MA, Hébert JR. Comparing farmers’ market revenue trends before and after the implementation of a monetary incentive for recipients of food assistance. Preventing Chronic Disease. 2014;11:130347.
11 Young 2013a - Young CR, Aquilante JL, Solomon S, et al. Improving fruit and vegetable consumption among low-income customers at farmers markets: Philly Food Bucks, Philadelphia, Pennsylvania, 2011. Preventing Chronic Disease. 2013;10:120356.
12 Olsho 2016 - Olsho LEW, Klerman JA, Wilde PE, Bartlett S. Financial incentives increase fruit and vegetable intake among Supplemental Nutrition Assistance Program participants: A randomized controlled trial of the USDA Healthy Incentives Pilot. The American Journal of Clinical Nutrition. 2016;104(2):423-435.
13 Phipps 2015 - Phipps EJ, Braitman LE, Stites SD, et al. Impact of a rewards-based incentive program on promoting fruit and vegetable purchases. American Journal of Public Health. 2015;105(1):166-172.
14 Steele-Adjognon 2017 - Steele-Adjognon M, Weatherspoon D. Double Up Food Bucks program effects on SNAP recipients’ fruit and vegetable purchases. BMC Public Health. 2017;17:946.
15 Polacsek 2018 - Polacsek M, Moran A, Thorndike AN, et al. A supermarket double-dollar incentive program increases purchases of fresh fruits and vegetables among low-income families with children: The healthy double study. Journal of Nutrition Education and Behavior. 2018;50(3):217-228.e1.
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22 French 2017 - French SA, Rydell SA, Mitchell NR, et al. Financial incentives and purchase restrictions in a food benefit program affect the types of foods and beverages purchased: Results from a randomized trial. International Journal of Behavioral Nutrition and Physical Activity. 2017;14:127.
23 Harnack 2016 - Harnack L, Oakes JM, Elbel B, et al. Effects of subsidies and prohibitions on nutrition in a food benefit program: A randomized clinical trial. JAMA Internal Medicine. 2016;176(11):1610-1619.
24 Wetherill 2017 - Wetherill MS, Williams MB, Gray KA. SNAP-based incentive programs at farmers’ markets: Adaptation considerations for Temporary Assistance for Needy Families (TANF) recipients. Journal of Nutrition Education and Behavior. 2017;49(9):743-751.e1.
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27 USDA-Karakus 2014 - Karakus M, Milfort R, MacAllum K, Hao H. Nutrition assistance in farmers markets: Understanding the shopping patterns of SNAP participants. Alexandria, VA: U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS), Office of Policy Support; 2014.
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29 An 2015 - An R. Nationwide expansion of a financial incentive program on fruit and vegetable purchases among Supplemental Nutrition Assistance Program participants: A cost-effectiveness analysis. Social Science & Medicine. 2015;147:80-88.
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32 Project Drawdown-Diet - Project Drawdown. Climate solutions: Plant-rich diets.
33 Nutrition Incentive Hub - Nutrition Incentive Hub. Strengthening access to fruits and vegetables: A national resource for nutrition incentive programs.
34 Wholesome Wave - Wholesome Wave. Bridging America's nutrition gap.
35 NIH-GusNIP map - Nutrition Incentive Hub. (n.d.). GusNIP site map: Where nutrition incentive and produce prescription sites are located. Retrieved February 27, 2025.
36 GGFN-Food assistance - Gorge Grown Food Network (GGFN). Food assistance: Discounts and vouchers at local farmers markets/farm stands.
37 CCFM-Special programs - Crescent City Farmers Market (CCFM). Token policy & special programs: Market match.
38 Boston-BDUFB - City of Boston. (n.d.) Boston Double Up Food Bucks: Have EBT? Get more fresh fruits and veggies with Boston Double Up Food Bucks. Retrieved February 27, 2025.
39 IDHS-Farmers markets - Illinois Department of Human Services (IDHS). Farmers markets that accept the Illinois Link Card.
40 HSM-Market Bucks - Hunger Solutions Minnesota (HSM). Market Bucks: Market Bucks match SNAP-EBT spending dollar-for-dollar (up to $10) at participating farmers markets across Minnesota.
41 FFN-Double Up - Fair Food Network. (n.d.). Double Up Food Bucks: Get double the fruits & veggies. Retrieved February 27, 2025.
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47 Blumberg 2022 - Blumberg R, Fowler E, Bai Y, et al. An investigation of social ecological barriers to and facilitators of WIC Farmers Market Nutrition Program voucher redemption. Nutrients. 2022;14(9):1871.
48 Di Noia 2017 - Di Noia J, Monica D, Cullen KW, Thompson D. Perceived influences on farmers’ market use among urban, WIC-enrolled women. American Journal of Health Behavior. 2017;41(5):618-629.
49 Freedman 2017 - Freedman DA, Flocke S, Shon EJ, et al. Farmers’ market use patterns among Supplemental Nutrition Assistance Program recipients with high access to farmers’ markets. Journal of Nutrition Education and Behavior. 2017;49(5):397-404.e1.
50 Hanbury 2017 - Hanbury MM, Gomez-Camacho R, Kaiser L, Sadeghi B, de la Torre A. Purchases made with a fruit and vegetable voucher in a rural Mexican-heritage community. Journal of Community Health. 2017;42(5):942-948.
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57 SNAP-History - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). A short history of SNAP.
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59 USDA-GusNIP - U.S. Department of Agriculture, National Institute of Food and Agriculture. (n.d.). Gus Schumacher Nutrition Incentive Program (GusNIP). Retrieved February 27, 2025.
60 CDC MMWR-Lee 2022 - Lee, S.H., Moore, L.V., Park, S., Harris, D.M., & Blanck, H.M. (2022). Adults meeting fruit and vegetable intake recommendations — United States, 2019. Morbidity and Mortality Weekly Report (MMWR), 71, 1–9.
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