Health Aff (Millwood)
August 2023
The Supplemental Nutrition Assistance Program (SNAP) reduces food insecurity but is underused among many households. To increase SNAP participation, twenty-one states have adopted the standard medical deduction (SMD), which simplifies administrative requirements for eligible households (those with older adults or people with disabilities). However, to offset the costs of the SMD, states have reduced SNAP benefits elsewhere, raising concerns of negative spillover effects.
View Article and Find Full Text PDFBackground: Black people are more likely to be diagnosed with hypertension and to experience food insecurity and antihypertensive medication non-adherence compared to White people in the U.S. The Supplemental Nutrition Assistance Program (SNAP)-a means-tested program that targets food insecurity has been shown to affect health outcomes.
View Article and Find Full Text PDFUsing administrative records from Missouri, we investigate the characteristics of Supplemental Nutrition Assistance Program (SNAP) participants aged 60 and older who experience administrative churn. Among these adults, 1 in 4 experienced administrative churn, and 1 in 5 experienced more than one spell of churn. Risk of churn, frequency, duration of churn spells, and the value of foregone SNAP benefits varied with individual, household, and geographic characteristics, and was more common among non-whites, members of larger households, and those living in urban areas.
View Article and Find Full Text PDFBackground: Food insecurity has been associated with medication non-adherence among individuals living with chronic diseases like hypertension. The relationship between Supplemental Nutrition Assistance Program (SNAP)-a public program that addresses food insecurity-and Medication adherence among older Medicaid-insured adults living with hypertension is not clear.
Objective: To analyze the association between patterns of SNAP participation and adherence to antihypertensive medications among older Medicaid-insured individuals.
J Gerontol B Psychol Sci Soc Sci
January 2023
Objectives: Participation in the Supplemental Nutrition Assistance Program (SNAP) among eligible adults aged 60 and older is much lower than among the younger population, and rates continue to decline throughout the life course while at the same time the risk of cognitive impairment increases. Due to the high administrative burden associated with SNAP application processes, cognitive impairment may be associated with low uptake of SNAP among the low-income older adult population, particularly among more socially disadvantaged groups (females, Blacks, and those living alone). We provide new evidence that changes in cognitive functioning are associated with reductions in the probability of SNAP take-up among eligible older adults.
View Article and Find Full Text PDFThis study investigates the extent to which the household living arrangements of older adults influences their experiences of material hardship. Using data from the 2014 Panel of the Survey of Income and Program Participation, we run linear probability models with individual fixed effects to estimate the likelihood that a change in living arrangements predicts a change in food insecurity, housing hardship and utility hardship. Although household living arrangements are associated with reports of material hardship for older adults, individual fixed effect models point to a reduced role for the change in living arrangements on the change in the probability of experiencing material hardship.
View Article and Find Full Text PDFWell-child visits are protective for child health but underutilized in the United States. The Supplemental Nutrition Assistance Program (SNAP), the largest federal food assistance program in the United States, has been shown to reduce food insecurity and may also promote child health by supporting preventative health care utilization. We examined the relationship between SNAP participation and infant well-child visits using state administrative data from Missouri's Department of Social Services for the period January 2006 to July 2014 for more than 50,000 infant-mother dyads.
View Article and Find Full Text PDFJ Racial Ethn Health Disparities
October 2022
The Covid-19 pandemic, which began in early 2020, has eroded the previous decade's reductions in food insecurity. Pandemic-related food insufficiency has been concentrated among Black and Hispanic households and those who have experienced a recent work loss. Households with children are particularly vulnerable.
View Article and Find Full Text PDFThe burdens of chronic diseases such as hypertension and diabetes for older Americans are profound. Yet, data on the population-level prevalence of hypertension and diabetes among the older adult Supplemental Nutritional Assistance Program (SNAP) population and the associated level of medication adherence is lacking despite evidence of the "treat or eat" trade-off in the general population. We used linked administrative data from SNAP and Medicaid between 2006 and 2014 in the state of Missouri to document rates of hypertension or diabetes diagnoses and medication adherence.
View Article and Find Full Text PDFUnlabelled: In the United States, the SNAP and TANF programs provide financial support to low-income households with children. Yet, little is known about the extent of this support over the early childhood period or how program participation varies by race (or ethnicity) and metropolitan county residence. We use administrative data from Virginia to document participation in SNAP and TANF among children born between 2007 and 2010 during their early childhood period, which we define here as birth to age six.
View Article and Find Full Text PDFBackground: Currently in the United States, childhood injuries are the leading cause of mortality and morbidity, resulting in an estimated 9.2 million emergency department visits and $17 billion annually in medical costs. For preschoolers, it is also the leading cause of disability.
View Article and Find Full Text PDFPrior research examines the prevalence of either disability food insecurity among immigrants. We examine whether the presence of a disability operates as a stronger predictor of food insecurity among prime-aged immigrants relative to the US-born. Probit models estimate the relationship of disability with food insecurity among immigrants and distinguish by duration of US residence and citizenship status using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2014.
View Article and Find Full Text PDFBackground: Administrative churn occurs when a household exits the Supplemental Nutrition Assistance Program (SNAP) and then returns to the program within 4 months. Although a number of studies have examined health care utilization patterns related to Medicaid administrative churn less is known about health care utilization patterns among Medicaid-insured SNAP enrollees.
Objectives: To investigate the characteristics and health care utilization patterns of Medicaid insured SNAP participants who experience SNAP administrative churn.
Health Aff (Millwood)
November 2019
The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Although participation in it has been shown to reduce food insecurity, there is comparatively less clear causal evidence of positive health effects of participation, particularly among adults. We examined the relationship between SNAP participation and premature mortality using data for 1997-2009 from the National Health Interview Survey, linked to data for 1999-2011 from the National Death Index.
View Article and Find Full Text PDFAnecdotal and descriptive evidence has led to the claim that some low-income households may face a "eat or breathe" tradeoff, but quantitative evidence is scarce. We link Medicaid claims data to monthly Supplemental Nutritional Assistance Program (SNAP) participation data from the state of Missouri from 2010 to 2013 to explore monthly patterns in children's emergency room (ER) claims for asthma and to examine whether these patterns are sensitive to the timing and amount of SNAP benefits. This allows us to empirically test whether SNAP households with Medicaid insurance face trade-offs between food and medicine that increases the likelihood that a child in a SNAP and Medicaid household will go to the ER for asthma at the end of the month.
View Article and Find Full Text PDFThe Supplemental Nutrition Assistance Program (SNAP) is a public policy program that aims to reduce food insecurity-a social determinant of health that has been associated with suboptimal blood pressure control in the United States. The aim of the article was to explore the association between SNAP benefit timing and size and probability of hypertension-related emergency department (ED) claims. This study used the SNAP data from the Missouri's Department of Social Services for January 2010 to December 2013 linked to Medicaid ED claims data.
View Article and Find Full Text PDFBackground: Households with a disabled adult are disproportionately food insecure, yet the mechanisms linking food insecurity to disability are under-specified.
Objective: To develop and empirically examine a model of the potential pathways connecting specific types of disability with food insecurity.
Methods: With pooled, repeated cross-sectional National Health and Nutrition Examination Survey data (1999-2014) including 38,354 participants, we ran probit models to estimate the probability of being food insecure as a function of different sets of disability measures and our control variables.
Objective: The present study examines the connection between the timing and size of Supplemental Nutrition Assistance Program (SNAP) benefits and the occurrence of emergency room (ER) visits for hypoglycaemia, a condition that is highly sensitive to short-term changes in nutritional intake.
Design: We used administrative data from Missouri SNAP and Medicaid to identify the timing of issuance and the benefit size of SNAP and the timing of ER claims for hypoglycaemia. We estimated the probability of submitting an ER claim for hypoglycaemia as a function of the calendar week, SNAP benefit week and the size of the SNAP benefit in models that controlled for individual demographic characteristics.
Background: Although there is substantial disability among veterans, relatively little is known about working-aged veterans' uptake of Department of Veterans Affairs (VA) Disability Compensation and Social Security Disability Insurance (DI).
Objectives: This study identifies levels of veteran participation in VA disability and/or DI benefit programs, examines transitions into and out of VA and DI programs among veterans, and estimates the size and composition of the veteran population receiving VA and/or DI benefits over time.
Methods: Data from the 1992, 1993, 1996, 2001, 2004, and 2008 Survey of Income and Program Participation (SIPP) are used to describe VA and DI program participation among veterans under the age of 65.
J Gerontol Soc Work
October 2016
This analysis uses data from the Survey of Income and Program Participation (SIPP) to examine whether veteran and disability statuses are jointly associated with poverty and material hardship among households that include an older adult. Compared to households that do not include a person with a disability or veteran, disabled nonveteran households are more likely to be in poverty and to experience home hardship, medical hardship, and bill-paying hardship. Disabled veteran households are not significantly different in terms of poverty, but exhibit the highest odds of home hardship, medical hardship, bill-paying hardship, and food insufficiency.
View Article and Find Full Text PDFEval Program Plann
October 2014
Given the increased necessity for local program administrators to operate evidenced-based programs developed for different target populations and community settings, we present evidence about the effectiveness of a specific adolescent health intervention, Making Proud Choices (MPC). MPC was originally designed for inner city, African-American youth in high HIV communities, but implemented recently in diverse settings shown to be at high risk of teen-pregnancy in Missouri. In light of the pressures for local adaptation of the comprehensive sexual education curriculum, we created a three-pronged fidelity assessment tool.
View Article and Find Full Text PDFOver the past decade, there has been much attention focused on community readiness for catastrophic emergency events, such as major natural disasters or terrorist attacks. However, though the economic costs associated with experiencing such an event are high, the probability of such events occurring is quite low. At the same time, less catastrophic events that temporarily disrupt essential services to local areas, such as water and electricity, are quite common.
View Article and Find Full Text PDFObjective: Mental health disorders are of great social, economic, and policy concern. A higher incidence of major depressive disorder has been reported among those living in or near poverty. Our study examines the extent to which the relationship between income and depression is mediated by measures of material hardship.
View Article and Find Full Text PDFHousehold food insufficiency is a significant problem in the United States, and has been associated with poor outcomes on mental health indicators among low-income women. However, it is difficult to disentangle the mental health consequences of household food insufficiency from poverty and other shared risk factors. Drawing on theories of the social production of health and disease, research evidence linking food insufficiency with poor mental health, and high rates of food insufficiency among welfare recipients, we examined whether a change in household food insufficiency is associated with a change in women's self-reported mental health in a sample of current and recent welfare recipients over a 3-year period of time, controlling for common risk factors.
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