On Tuesday, the RAND Corporation published the results of a preliminary study on South Africa’s HealthyFood initiative, a benefit program sponsored through the nation’s largest private insurance company. The program provides some 260,000 South African households with up to a 25 percent rebate on healthy food purchases — “cash for carrots,” if you will — and the encouraging numbers suggest that similar initiatives could work right here in America.

While the study does suffer from some methodological snags — the biggest being that households’ eating habits were self-reported rather than observed — its authors conclude that the right level of rebates can be a strong catalyst for healthier eating habits. For instance, the survey of 350,000 HealthyFood participants and nonparticipants found that “a 10% and 25% discount on healthy food purchases is associated with an increase in daily fruits and vegetables consumption by 0.38 (95% CI: 0.37 – 0.39) and 0.64 (95% CI: 0.62 – 0.65) servings, respectively,” and that rebate participants were more likely to eat three or more servings of wholegrain foods daily while being less likely to eat foods high in sugar, salt, fried foods, processed meats, and fast food.

Admittedly, the report does not find that the healthier eating habits significantly reduced overweight rates or participants’ average BMIs. However, it does see a statistically significant correlation between higher discount rates and lower obesity, suggesting that the right amount of financial motivation can spur enough eating habit changes to make a dent in obesity rates on the macro level.

So could a similar program work in the U.S. — particularly for low-income Americans who struggle with food insecurity, and often have to resort to high-fat and high-calorie diets to get more nutritional “bang-for-the-buck”? There’s not a whole lot of data on the matter yet. But that will soon change, as a 2011 pilot program under the Supplemental Nutrition Assistance Program (SNAP) — the “Healthy Incentives Pilot” — mimics the HealthyFood initiative, offering inflated discounts of up to 30 percent cash back on healthy food purchases, and its results will be published later this year. If the findings track South Africa’s, then it could be a game changer for low-income communities often beset by unhealthy food habits and high obesity rates. And incentivizing healthy eating with rebates could be a more effective policy than more blunt and restrictive initiatives, like South Carolina Gov. Nikki Haley’s (R) controversial push to limit food stamp purchases to healthy items.

Still, the funding element is key, as the study found that higher rebate levels were required to change the eating habits of people who were entrenched in subpar diets. The South African program offers monthly discounts of up to $500 for a family and $250 for individuals — significantly higher than the average monthly SNAP allotment, which is supposed to be a supplemental benefit (although it doesn’t actually work that way in reality). But South Africa’s example suggests that, given sufficient financial backing, cash for carrots could be a worthwhile undertaking throughout America.

On Tuesday, the South Carolina House rejected extra Obamacare funding for the state’s Medicaid program. One Republican legislator offered a novel reason for the Republican majority’s decision: the President’s race.

State Rep. Kris Crawford’s comments came during the early stages of the state Medicaid debate in late January. Crawford suggested that it was politically beneficial for Republicans (who run a Statehouse that flew the Confederate flag in front of it as recently as December 2011) to oppose any political initiatives spearheaded by a black man:

Rep. Kris Crawford, a Republican from Florence and also an emergency room doctor, supports the expansion but expects the Republican caucus to vote as a block against the Medicaid expansion.

“The politics are going to overwhelm the policy. It is good politics to oppose the black guy in the White House right now, especially for the Republican Party,” Crawford said.

South Carolina’s voter ID law was blocked last year by the Department of Justice on grounds that it violated the Voting Rights Act. The author of the law admitted to receiving, and responding positively to, racist emails in support of the law.

Governor Nikki Haley’s (R) steadfast opposition to the Medicaid expansion is becoming increasingly lonely; a wave of Republican governors have recently accepted federal assistance in providing health care for their poor citizens. South Carolina hospitals, who strongly support the expansion, have gone so far as to ask that their taxes be raised to pay for it.

(HT: David Graham.)

Gov. Nikki Haley’s (R-SC) state has a serious weight problem — and she knows it. That’s why last week, flanked by public health officials, Haley announced that she will push for a controversial overhaul of South Carolina’s nutritional assistance program that would limit food stamp purchases to “healthy” items. It’s a well-meaning idea meant to tackle the state’s rampant obesity epidemic and its resulting health care costs — unfortunately, the proposal isn’t the most effective way to tackle obesity, and implementing it could end up preventing low-income Americans from receiving adequate nutrition.

Any changes to a state’s food stamp program require a waiver from the federal government, and no state has successfully received one to date. The Charlotte Observer reports that Haley will hold group meetings with food stamp recipients, public health advocates, food makers, and various other officials to determine which foods should be purchasable with food stamps — and which shouldn’t — before requesting the waiver, in an effort to sway the federal government by putting up a unified front. That means that the specifics of Haley’s plan have yet to be fleshed out, and her office did not respond to ThinkProgress’ request for more details.

Still, Haley’s statements on the matter suggest that she wants to discourage South Carolina residents from using food stamps to purchase high-fat, high-calorie, and high-sodium products. “That $1 billion [in federal nutritional assistance] no longer will go to candy and chocolate and sodas and chips — it’ll be going to apples and oranges and things that are healthy,” she said.

That’s certainly an admirable goal considering South Carolina’s abysmal public health statistics: a full third of the state’s 4.7 million resident are obese, making it the eighth most obese state in America; another third are overweight; and the state ranks second in the country for obesity-related diabetes risk. Furthermore, the cost of treating obesity-related illnesses for low-income Americans accounts for almost 12 percent of national Medicaid spending — and likely an even higher percentage in South Carolina, where 18 percent of residents are on the federal Supplemental Nutrition Assistance Program (SNAP).

But the efficacy — and the practical logistics — of Haley’s approach remains an open question. Proposals to limit food stamp purchases are a source of fierce debate among both public health and poverty advocates — not to mention supermarkets and food makers who argue that the transaction costs of separating SNAP from non-SNAP products would be too high or hurt product sales.

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January marks Cervical Cancer Awareness Month, and one South Carolina lawmaker is taking the opportunity to revive his cervical cancer prevention efforts after Republican Gov. Nikki Haley (R-SC) shot him down last year. State Rep. Bakari Sellers (D-SC) is reintroducing a bill to encourage HPV vaccination among middle schoolers — the same legislation that Haley vetoed last June even though it passed both chambers of the state legislature with broad bipartisan support.

Sellers’ bill would simply require state health officials to offer the HPV vaccine and educational material to seventh graders, and it wouldn’t make it mandatory for parents to vaccinate their children. At a press conference to announce the legislation’s reintroduction, Sellers explained that he is most concerned about expanding access to the vaccine to the families that otherwise may not have heard about it or may not have been able to afford it. “There are sisters, there are daughters, there are mothers who die every day from cervical cancer,” Sellers said. “And if we can save one life, I think it’s worth fighting for.”

Seller’s announcement is particularly timely. Just last week, a joint report released by the Centers for Disease Control and the National Cancer Institute found that HPV-related cancers have been on the rise over the last two years, even as other types of cancer have declined.

Medical experts partly attribute the rising cancer rates to the fact that not enough teenagers are taking the HPV vaccine, and aim to get at least 80 percent of all pre-teens vaccinated by next decade. Even though the CDC approved the Gardasil vaccine for children above 9 years old back in 2009 — and federal guidelines urge all young women to receive Gardasil starting at the age of 11 to help mitigate their risk of developing cervical cancer — less than half of girls ages 13 to 17 got at least one dose of the three-part vaccine over the past two years.

Conservative scaremongering over the vaccine — suggesting it could somehow lead to “sexual promiscuity,” even though doctors simply consider it a preventative measure like any other type of vaccination — has successfully transformed cancer prevention into a politicized issue. South Carolina itself has one of the highest rates of cervical cancer in the nation, and Sellers wants to give the governor yet another chance to decide what she wants to do about it.

Last week, South Carolina Gov. Nikki Haley (R) — who made headlines when she claimed that “women don’t care about contraception” — vetoed a bill that would have allowed free HPV vaccinations for girls. The bill passed overwhelmingly with bipartisan support, but Haley blocked it, despite sponsoring a bill to mandate HPV vaccinations for seventh grade girls as a state senator. After her veto, Haley said that her 2007 sponsorship was a “mistake.”

Following Haley’s opposition to the HPV vaccine bill, MSNBC host Rachel Maddow said on her show that “being against cancer in the Republican Party is a scandal now”:

This week, the aversion to preventing cervical cancer — the idea that trying to prevent it is a scandal — that idea seems to be spreading…It is 2012 now, and so Governor Haley vetoed that bill. Because being against cancer in the Republic Party is a scandal now. At least being against cervical cancer is a scandal now. What, because it is a lady cancer, maybe? There is a vaccine for preventing this kind of cancer.

Watch Maddow’s comments:

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The use of HPV vaccinations as a method to prevent cancer has scientific support. According to the Centers for Disease Control and Prevention, “every year about 12,000 women are diagnosed with cervical cancer and 4,000 women die from this disease in the U.S.” By stopping the transmission of the disease, the HPV vaccine is a way of preventing cervical cancer.

Haley is not the only republican to backtrack from earlier support for the vaccine. In 2007, Texas Gov. Rick Perry (R) mandated the vaccine for young girls through an executive order. But when he was running for president, his GOP competitors blasted Perry for supporting the mandate. Perry eventually rescinded his position, and, like Haley, said that his support for the mandate was a mistake.

– Nina Liss-Schultz