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Abstract

Background: 2007-2013 spanned an economic downturn with rising food costs. While Supplemental Nutrition Assistance Program (SNAP) benefits increased during those years by 13.6% from the 2009 American Recovery Reinvestment Act (ARRA), the impact of these competing conditions on household food insecurity (HFI, household food insecure but child food secure) and child food insecurity (CFI, household and child food insecure) in households with infants and toddlers has not been investigated.

Objective: To describe HFI and CFI in households participating in SNAP vs. households likely eligible but not participating (No SNAP).

Design: Repeat cross-sectional

Participants/Setting: 19,999 caregivers of childrenChildren’s HealthWatch survey in emergency and primary care departments in 5 US cities.

Main Outcome Measures: The 18-item U.S. Household Food Security Survey (HFSS) measured HFI (≥3 affirmative responses on non-child-specific questions) and CFI (≥2 affirmative responses to eight child-specific questions).

Statistical analyses performed: The sample was stratified by SNAP/ No SNAP. Multinomial logistic regression analyses examined the association between SNAP receipt and HFI and CFI.

Results: Across the study period, controlling for confounders including year, households with SNAP were 17% less likely to experience HFI (AOR 0.83; 95% CI,0 .75, 0.91; p

Conclusions: Receipt of SNAP vs. No SNAP was associated with decreased prevalence of HFI and CFI during much of the economic downturn; this impact waned as the buying power of the boost in benefit amounts during the ARRA period eroded.

Key Take Away Points

  • Across the study period 2007-2013, controlling for confounders including year, households with SNAP were 17% less likely to experience household but not child food insecurity (HFI) and children in households with SNAP were 33% less likely to experience household and child food insecurity (CFI) than households who were likely eligible, but not participating in SNAP.
  • The prevalence of HFI and CFI in the SNAP group fluctuated from 2007 to 2013, but the trend overall increased across the 7-year period.
  • Receipt of SNAP vs. No SNAP was associated with decreased prevalence of HFI and CFI during the study period; this impact waned as the buying power of the boost in benefit amounts following the boost to SNAP benefits under the American Recovery Reinvestment Act (ARRA).

Author Biography

Allison Bovell, MDiv - Research, Policy, and Communications Coordinator, Children's HealthWatch, Department of Pediatrics, Boston Medical Center, Boston, MA

Stephanie Ettinger de Cuba, MPH - Research and Policy Director, Children's HealthWatch, Boston University School of Public Health, Data Coordinating Center, Boston, MA

Patrick Casey, MD - Principal Investigator, Children's HealthWatch, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR; Sharon Coleman, MS, MPH - Statistical Analyst, Boston University School of Public Health, Data Coordinating Center, Boston, MA

John Cook, PhD - Principal Investigator, Children's HealthWatch, Department of Pediatrics, Boston University School of Medicine, Boston, MA

Diana Cutts - Principal Investigator, Children's HealthWatch, Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN

Timothy C. Heeren, PhD - Biostatistician, Boston University School of Public Health, Data Coordinating Center, Boston, MA

Alan Meyers, MD, MPH - Principal Investigator, Children's HealthWatch, Department of Pediatrics, Boston University School of Medicine, Boston, MA

Megan Sandel, MD, MPH - Principal Investigator, Children's HealthWatch, Department of Pediatrics, Boston University School of Medicine, Boston, MA

Maureen M. Black, PhD - Principal Investigator, Children's HealthWatch, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD

Mariana Chilton, PhD - Principal Investigator, Children's HealthWatch, Drexel University School of Public Health, Philadelphia, PA

Deborah A. Frank, MD - Principal Investigator, Children's HealthWatch, Department of Pediatrics, Boston University School of Medicine, Boston, MA

Acknowledgements

The authors acknowledge Justin Pasquariello and Richard Sheward for their invaluable assistance in preparation of this manuscript, as well as the Children’s HealthWatch interviewers, administrative staff, and participants. The work of Children’s HealthWatch is funded by foundations and generous donors. A full list of funders is available at http://www.childrenshealthwatch.org/giving/supporters/.

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