Childhood injuries and food stamp benefits: an examination of administrative data in one US state

SNAP participation and the health and health care utilisation of low-income adults and children

OBJECTIVE

This article examined whether participation in the Supplemental Nutrition Assistance Program (SNAP) produced changes to adult and child health and health care utilisation during a period of economic recession.

DESIGN

Instrumental variables analysis relying on variation in state SNAP policies to isolate exogenous variation in household SNAP participation.

SETTING

Nationally representative data on child and adult health from the 2008 to 2013 National Health Interview Survey.

PARTICIPANTS

Participants were 92 237 adults and 45 469 children who were either eligible for SNAP based on household income and state eligibility rules or were low income but not eligible for SNAP benefits.

RESULTS

For adults, SNAP participation increased the probability of reporting very good or excellent health, and for both adults and children, reduced needing but having to go without dental care or eyeglasses. The size of these benefits was especially pronounced for children. However, SNAP participation increased the probability of needing but not being able to afford prescription medicine, and increased psychological distress for adults and behavioural problems for children under age 10.

CONCLUSIONS

SNAP's benefits for adult health and improved access to dental and vision care for adults and children suggest benefits from the program's expansions during the current COVID-induced crisis. Predicted negative effects of SNAP participation suggest the need for attention to program and benefit structure to avoid harm and the need for continued research to explore the causal effects of program participation.

Proximity to SNAP-authorized retailers and child maltreatment reports

The Supplemental Nutrition Assistance Program (SNAP) has been shown to have positive benefits for children. Families may face fewer barriers to accessing food they can purchase with their benefits if more stores in their neighborhoods accept SNAP benefits. We examine whether proximity to stores accepting SNAP benefits is related to child maltreatment (abuse and neglect) reports, particularly those potentially related to food insecurity. We combine geographically identified child maltreatment report data from the state of Connecticut from 2011 through 2015 with state SNAP-authorized retailer data. Using within-Census block group changes in the presence of a SNAP-authorized store, we find that in large, rural areas, one additional SNAP store is associated with a 4.4 percent decrease in the child maltreatment report rate (p < 0.05), and an 11.3 percent decrease in substantiated cases of maltreatment (p < 0.10), even net of changing zip code level factors and time-invariant neighborhood characteristics. The relationship between a neighborhood SNAP store and child maltreatment reports in these rural areas is largely driven by neglect, concentrated among young and school-aged children (ages 0-9), and primarily due to fewer reports by medical personnel. We find no effects of a neighborhood SNAP store on child maltreatment reports in smaller, more densely populated neighborhoods. Sensitivity checks affirm these results. Results indicate the benefits of access to SNAP retailers on the child welfare system and child well-being more broadly, especially in rural areas.