Project:
Giving Kids a Boost: The Positive Relationship between Frequency of SNAP Participation and Child’s Preventative Health Care Utilization in the First Year

Year: 2019

Investigator: Arteaga, Irma, Leslie Hodges, and Colleen Heflin

Institution: University of Missouri

Project Contact:
Irma Arteaga
University of Missouri
241 Middlebush Hall
Columbia, MO 65211
Phone: 573-882-2718
Email: arteagai@missouri.edu

Recently, levels of food insufficiency in households with children have risen; while levels of well-visits and immunizations for young children have fallen. Primary care, especially pediatric well-visits, is important for establishing good health practices at an early age and ensuring that children receive vaccines against infectious diseases. A growing body of evidence supports a strong negative linkage between food insecurity and child health and food insecurity and health care use, including primary care. At the same time, it is observed that many children who participate in SNAP are at higher risk for poor health including African American and Hispanic children, who have poorer health outcomes than white children on a number of measures. Moreover, African American children are less likely than white children to receive recommended doses of vaccines against preventable diseases, while Hispanic children are less likely than white children to have had a well-child visit in the past year.

Although SNAP reduces food insecurity, improvements in child health due to SNAP participation are not as large as one might expect. One explanation is that prior literature has not examined interruptions in monthly SNAP receipts for households with children due to data limitations. Thus, little is known about how SNAP dynamics impact child health care use and, by extension health, and whether this relationship differs by race/ethnicity and geography. This study examines the relationship between SNAP participation and well-visits and immunizations in the first year of life, using administrative data for more than 50,000 children-mother dyads, and logistic regression models. This study used SNAP benefit receipts linked to Medicaid claims data from Missouri’s Department of Social Services (Family Support Division) for the period January 2006 to July 2014.

This study finds that compared to always receiving SNAP, leaving SNAP or receiving SNAP inconsistently which may be a consequence of administrative churn, reduces the likelihood that an infant receives all recommended well-child visits in the first year. These discrepancies are larger for children living in urban areas, and children whose mothers are African American and Hispanic. Models that used patterns of SNAP participation suggest that one obstacle for infant care among low-income households with diagnosed maternal depression may be the stability of SNAP receipt. The study revealed that stable SNAP participation primarily influences vaccination rates through well visits, which is when most infants receive their immunizations.

Given major public health concerns about recent declines in well-visits and immunizations, it is possible that procedures like waiver extensions and remote interviews for application and recertification, could help to address the instability in SNAP participation among new mothers and, by extension, could reduce the public health burden associated with unstable participation.