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When Cassandra J. Perry was 13, a physical disability prevented her from going to school.

She had a genetic connective tissue disorder called Ehlers-Danlos syndrome, which means that her joints are unstable, her connective tissue is weak, she’s more prone to injuries, and she has chronic pain.

When she began living alone as an adult after splitting up with her spouse, she worried about how she’d be able to grocery shop.


Her physical disabilities — Ehlers-Danlos syndrome, osteoarthritis, and pudendal neuralgia — had become more severe over time, making physical activity harder for her.

“Grocery shopping and food prep have become impossible on my own,” says Perry. “I can't always get to a store, and when I can, I can't carry my own groceries due to limitations on how much weight I'm allowed to hold and carry.”

Cassandra J. Perry. Photo by Louis Shackleton, used with permission.

Perry had to rely on the generosity of friends to get enough to eat.

With Supplemental Security Income (SSI) being her only source of financial support, she crowdfunded six times to have enough money to buy groceries.

She had a Patreon account for eight months. Two of her friends regularly helped her cook meals, and others invited her over for meals.

“To survive, I kept a strict budget, which I would share publicly each time I needed to crowdfund,” Perry explains. “I had to get over my pride and my fear of asking for help.”

She supplemented the crowdfunding and SSI income with money she made selling her belongings, such as clothing and books.

Perry knew this method of survival wasn’t sustainable, so she joined the Supplemental Nutrition Assistance Program in the spring of 2015.

Often known as "food stamps," this benefit gives her $192 each month, which covers half of her overall food costs.

“Without [it], I would only be able to meet my food needs by relying on the generosity of my social network, food pantries, and food kitchens," she says.

“Most days, I can't physically walk around a store, even if someone is doing the carrying for me,” she says. Her friends and family help by going to the store with her, and they do the shopping while she waits in the car. She then joins them in the checkout line to pay using her benefits.

Perry paying for groceries with her EBT card. Photo by Louis Shackleton, used with permission.

And thanks to local farmers markets,  that $192 a month extends even farther.

These local markets match up to an extra $30 for healthy items, allowing her to bring home more fresh produce.

Because she’s on food stamps, Perry also qualifies for community support agriculture, where subscribers receive a regular supply of produce and other farm goods, such as in-season fruits and vegetables, eggs, meat and milk.

Since unprocessed, fresh foods tend to be more costly, her benefits and the additional incentives to buy fruits and vegetables make a significant difference.

Perry says that food pantries and kitchens tend not to have the specific kinds of healthy foods her doctor recommends as part of her treatment. This makes the fact that her food stamps give her access to more fresh produce particularly invaluable. Perry can also use her benefits to buy prepackaged and prepared (cut, chopped, diced, or peeled) produce, which she can't get at food pantries and is easier for her since she has limited use of her hands.

Perry is grateful that she never has to make the choice between eating or paying rent.

Photo courtesy of Cassandra Perry.

“This provides me with a guarantee that I'll have food to eat because I won't have to choose between eating and paying bills,” she says. “Every last dollar I can muster is put to very good use.”

Because she is physically unable to work and lives on a limited budget, her benefits are a lifeline.

According to the 2015 National Health Interview Survey, 1 in 4 participants on food stamps have a disability that prevents them from working — just like Perry. That’s more than 11 million people. These benefits ensure they never have to make an impossible decision between going hungry or having a roof over their heads.

You can’t put a price on that kind of support.

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Robert Wood Johnson Foundation

Unlimited fruits and veggies, breakfast, and after-school supper. These Vermont schools serve it all — for free.

No matter what, all students in Burlington, Vermont, get breakfast, even in the hallway if they’re running late to class. They can load up on as many fresh, locally sourced fruits and vegetables as they want.

In other words, these kids don’t have to worry about being hungry during the school day: The Burlington School Food Project runs a free meals program for every child to make sure of that.


Such programs exist in schools throughout the country for one simple but critical reason: Kids need to eat to function. When kids are well-fed, their focus and performance in the classroom improves.

They can also bring healthy eating habits home to their families. Many kids who qualify for free meals in the U.S. have families that depend on programs like the Supplemental Nutrition Assistance Program, or SNAP, to ensure they get enough to eat outside of school.

Places like Burlington that prioritize and support food and nutrition assistance are wonderful examples of addressing hunger from multiple angles and can be a real game changer.

Students eating a meal in Burlington. Image via ​Ben Hudson/Burlington School Food Project​.

The impact is particularly noticeable for students from low-income and other struggling families.

"When the kids get to school, regardless of their income — if they don't have breakfast, they are hungry," says Doug Davis, food service director of Burlington School Food Project.

"Kids don't want to be hungry," Davis says, "but they also don't want to be embarrassed or humiliated in front of their friends. We really need to create a model that meets all of our kids where they are."

Such a model is vital for children because we know that "where they are" could change in an instant — which is why SNAP is also vital for children.

When a family goes through a natural disaster or a parent gets laid off or there’s a major medical emergency, it becomes all the more difficult to get kids fed at all, let alone fed fresh, nutritious food.

That’s why experts say that school meal programs, in tandem with SNAP benefits, can make all the difference for kids who would otherwise go hungry.

As it is, far too many children in the United States are hungry today. The U.S. Department of Agriculture reports that 6.5 million children live in food-insecure households, which means they don’t always have enough food. SNAP plays a critical role in resolving that problem, as nearly half of all SNAP participants are children.

Image via iStock.

We all know what it’s like to have such a busy day that we don't get a chance to eat; we all know how that can affect our productivity and our mood for the whole day. According to economist Diane Schanzenbach, kids similarly suffer when they're hungry during the school day.

"Your brain doesn't function as well when you're hungry," she says. Kids have a hard time concentrating if all they can think about is the emptiness in their bellies.

Research has shown, Schanzenbach explains, that kids with early access to SNAP benefits can be 18% more likely to graduate from high school — a crucial factor in preparing them for an economically stable and healthy future.

In other words, everything can change when kids have enough to eat.

Back in Burlington, there’s no question food access makes for a better school day.

Davis paints a picture of happy, healthy kids when he describes a typical school day in Burlington.

For one thing, students get to make the most of what he calls a "painfully short" 22-minute lunch period. Kids spend more of those precious minutes in their seats with their friends and food without having to wait in line at a cash register.

They also get to choose food that looks good to them, and they learn to serve themselves, making them more likely to eat than if they had food already placed on their tray for them.

A child selects food at school in Burlington. ​Ben Hudson/Burlington School Food Project​.

That’s right — these kids are actually excited to eat their veggies.

Based on research like Schanzenbach's, it’s easy to figure out why these differences are so crucial. A cafeteria full of students eating nutritious food is a cafeteria full of kids getting a great start in life.

SNAP's impact on food assistance is clear — but the effects goes even further than you might imagine.

Schanzenbach and her colleagues tracked families across decades andfound thatSNAP benefits lead to more economic self-sufficiency for women. For those who are mothers, their children then grow up to be healthier and more economically self-sufficient.

Plus local economies get a boost: Every $5 spent in new SNAP benefits generates up to $9 in economic activity.

School meal programs can also give the economy a boost: For instance, Burlington School Food Project sources their food from local farmers, and their "farm to school" approach gets the whole community engaged.

Research also shows that low-income families can use their SNAP benefits to make healthier choices.

Image via iStock.

"The truth is, when people have more resources to spend, they're more likely to buy healthier food," Schanzenbach says. Some slack in the budget means more room for foods like vegetables, poultry, and milk.

Thanks to SNAP benefits and school meals, every family can be empowered to lead happy, healthy lives.

Cafeterias in Burlington light up with students’ smiles as they load their trays with food plucked fresh from nearby farms. Kids have more focus in classrooms and higher attendance rates.

A child at school in Burlington. Image via Ben Hudson/Burlington School Food Project​.

Any family can fall on hard times. Making sure they have enough to eat helps them get back on their feet faster.

If the lessons in Burlington can be applied across the country, millions of kids will have a shot at a bright, healthy future.

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Robert Wood Johnson Foundation

Almost 10 years ago, Stephanie Land and her baby daughter Mia had no choice but to check into a homeless shelter.

Stephanie was fleeing an abusive relationship. She had no family to turn to, and she couldn't afford a place of her own. For the next three months, she and Mia lived in the Port Townsend homeless shelter in Washington.

Stephanie knew she needed help — and that's why one of the places she turned to was the Supplemental Nutrition Assistance Program(SNAP).


Applying for SNAP benefits can be an an ordeal under the best circumstances, but it was even more challenging for Stephanie because she lacked internet access. Thankfully, her persistence paid off and she soon began receiving benefits to help her pay for food.

Photo via iStock.

Her SNAP benefits were usually $200 to $300 a month — a mere $7 to $10 a day — and it was often all she had to pay for food.

But the SNAP benefits went a long way for her family. Mia was a picky eater, so Stephanie had to get creative to make sure she was getting as much nutritious food as she could afford. Sometimes that meant adding vegetables and a homemade sauce to packages of instant ramen to get Mia to eat them.

It was a process, but ultimately, SNAP, along with other welfare benefits like health care and child care, helped them stay afloat while Stephanie looked for work.

Photo via iStock.

Unfortunately, looking for work was easier said than done during the 2008 recession.

"All the jobs that were available during normal child care hours were more professional jobs," Stephanie recalls.

The only jobs she could get were entry-level, minimum-wage jobs that usually involved her working late hours, when affordable child care services are rarely available.

This balancing act of working low-paying jobs, caring for her daughter, and living on welfare wore on Stephanie. But she knew that college could be her ticket out of it.

The Land family in their studio apartment in low-income housing. Photo via Stephanie Land.

Stephanie applied for and received the Pell Grant and the Women's Independence Scholarship, which helps survivors of domestic violence pay tuition. She also took out student loans.  

While these helped significantly, she had to keep working because the federal benefits she needed to survive — like food stamps — would only continue if she was working at least 20 hours a week.

As a full-time student and single mom, working that much proved near impossible. But Stephanie kept pushing forward, relying on her resourcefulness and persistence to make it to each next day.

"I learned the only person I really had to depend on is myself," she says.

[rebelmouse-image 19345897 dam="1" original_size="400x400" caption="Stephanie Land. Image via Stephanie Land/Stepville." expand=1]Stephanie Land. Image via Stephanie Land/Stepville.

Stephanie didn't feel comfortable turning to friends for support during this time because she knew some of them believed that people who rely on federal benefits are lazy, entitled, and refuse to work hard.

It's a hurtful stigma and, unfortunately, one that many believe about people who have no choice but to rely on programs like SNAP.

"Being on food stamps and on Facebook at the same time, you learn what your friends really think of people on welfare," Stephanie explains. "You learn pretty quickly not to offer that information readily."

While Stephanie is proof positive that this stigma's message is false, she still felt embarrassed about needing federal assistance. In fact, it was that discomfort that made her all the more determined to change her situation.

After six years of hard work,she graduated with a bachelor's degree in English and started making a living wage writing.

Stephanie and Mia. Photo via Stephanie Land.

She wrote about various aspects of her day-to-day life, like working as a house cleaner and being a single mom living on $6 a day.

"I found a niche that not too many people can write about from a first-person perspective," Stephanie says.

She can  provide a window into a world that's often just speculated over rather than clearly seen. Many people push away the idea of poverty because they want to believe it could never happen to them. Through her insightful writing, though, Stephanie has proven no one is immune.  

"While it’s terrifying to come out and openly admit those things, it was also something people needed to read about," Stephanie says. "Especially from someone who doesn’t fit the stereotypical image of what people connect with someone living in poverty."

When an article Stephanie wrote for Vox about cleaning houses went viral, she got a call from a well-known literary agent the same day asking to sign her. A year later, she was offered a book deal.  

Today, Stephanie lives in her first real house with her two daughters.

"It was quite a moment finally watching my girls play in a backyard," she recalls.

But, she says, she'll never forget those years she lived in poverty.  

Stephanie with her daughters Coraline (left) and Mia (right). Photo via Stephanie Land.

She's written about her experience for a number of publications, including The New York Times and The Washington Post. She's also a regular writer for the Center for Community Change, whose mission is to help improve low-income families' lives. And she's received a number of emails from people who were, or currently are, dealing with the issues she's faced, thanking her for giving them a voice.

As a result, she looks at the world through a different filter — one of compassion for everyone she comes across.

"I try not to make any assumptions about other people’s lives because it’s so easy to suddenly be in that place where you have nowhere to go," Stephanie explains. "And you never know who’s going through something like that."

If you or someone you know is living in poverty or with food insecurity, a good first step for them to take is to call 211 or check out 211.org online. There, you can find information about the Supplemental Nutrition Assistance Program (SNAP) as well as many other federal assistance programs.

No one should have to choose between food and medicine. For many low-income people with chronic illnesses, however, it's a decision far too familiar.

Seth Berkowitz, a doctor at Massachusetts General Hospital, recalls a woman — a mother — who ended up in the hospital with dangerously high blood pressure. The woman had a prescription for a medication to keep her blood pressure down, but she hadn't filled it because it was nearing the end of the school year and her kids' final tests were coming up. Faced with the option of paying for a prescription she needed or making sure her kids weren’t going into their tests hungry, she chose to feed her kids.

This is not an uncommon dilemma. When Berkowitz conducted a study on the subject back in 2014, he discovered that a third of the chronically ill patients he saw couldn't afford both food and medication.


By skipping medications in favor of paying for food, people and families often end up spending more on health care in the long run. Medical emergencies are expensive — even just a ride in an ambulance can cost several thousands of dollars — and skipping regular checkups or other preventive care can lead to more costly problems further down the line.

Seeing firsthand how food insecurity forces people to make tough decisions, Berkowitz began work on a follow-up study.

Does helping people afford food lower their overall medical bills?

According to a new study published in JAMA Internal Medicine by Berkowitz and colleagues, food assistance through the American government’s Supplemental Nutrition Assistance Program could help low-income individuals and families save on their medical bills.

SNAP — formerly known as food stamps — is a federal program that gives low-income individuals money to spend on food. The exact implementation varies state by state, but overall about 1 in 7 Americans get help through the program.

Though the program may have started with stamps and paper bills, today funds are distributed through government issued EBT cards like this one. Photo by Justin Sullivan/Getty Images.

Berkowitz’s study looked at roughly 4,400 low-income adults, about 40% of whom were on SNAP. When Berkowitz’s team compared how much the average person in each group was spending on health care, they found the SNAP group spent about $1,400 less per year.

For comparison, the average single adult on SNAP receives about $1,500 a year in benefits.

What can we do with this knowledge?

Berkowitz’s study wasn’t able to pinpoint why these savings happen, but they have some ideas. People with SNAP benefits — now better able to feed their families — may be more likely to get their necessary prescriptions and checkups. Being able to afford healthier food might also be a factor.

This market in New York City both accepts SNAP funds and rewards the purchase of fresh fruit and vegetables with vouchers. Photo by Andrew Burton/Getty Images.

This research is especially timely as America is searching for a way to decrease its massive health care bill.

By understanding how social programs help keep people out of the hospital in the first place, studies like this one can help us understand how to keep spending down.

Not to mention how to make sure moms like Berkowitz’s patient can both feed their kids and fill their prescriptions too.