Hispanic children are more likely to live in food-insecure households than their White peers. Food insecurity is associated with multiple poor health outcomes and, thus, has wide-ranging implications for children’s well-being and productivity as adults. Research suggests that nonmetropolitan new destinations (places with historically small or nonexistent Hispanic populations with recent high rates of Hispanic population growth) experience substantial socioeconomic disadvantages, potentially placing Hispanic children who live in them at greater risk of food insecurity and poor health outcomes. The projection that Hispanics will compose 24.4 percent of the population by 2050 suggests the need to better understand how associations between food insecurity and Hispanic children’s health vary across diverse spatial contexts and how current strategies to reduce food insecurity vary in their effectiveness across these spatial contexts.
A primary goal of the Supplemental Nutrition Assistance Program (SNAP) is to reduce food insecurity, and numerous studies have found SNAP to be effective in achieving this goal. However, it unclear whether SNAP’s ability to reduce food insecurity and related negative health outcomes among children is spatially heterogeneous. Accordingly, this project aimed to (1) identify and describe differences in Hispanic children’s food insecurity, health outcomes, and health care access between metropolitan and nonmetropolitan counties and between established Hispanic destinations and new Hispanic destinations; (2) determine whether SNAP participation is associated with food security and health outcomes among Hispanic children in families with incomes below 200 percent of the Federal poverty level (FPL), and (3) determine whether associations between SNAP participation, food insecurity, and Hispanic child health vary by metropolitan status and between new and established Hispanic destinations.
The study sample included 14,928 Hispanic children (ages 0-17) from the 2011-14 restricted files of the National Health Interview Survey (NHIS). These data were merged with county- and State-level data from the U.S. Census American Community Survey and U.S. Department of Agriculture SNAP Policy Database. Using statistical methods to adjust for biases related to selection into SNAP, the study examined low-income Hispanic children in metropolitan and nonmetropolitan counties and in established and new Hispanic destinations to determine whether there were associations between family SNAP participation and: food insecurity, fair/poor health, overweight/obesity, receipt of a routine health checkup in the past 12 months, and whether the child has a usual place for medical care.
Metropolitan Status and Destination Type Differences in Food Insecurity, SNAP Participation, and Children Health Outcomes: About 28 percent of low-income (income-to-poverty ratio below 200 percent of FPL) Hispanic children are in food-insecure families, and 47 percent are in families that receive SNAP benefits. Nonmetropolitan Hispanic children are more likely than their metropolitan peers to be in SNAP-participating families. Despite the fact that nonmetropolitan Hispanic children are socioeconomically disadvantaged relative to their metropolitan counterparts, there are very few metropolitan status or destination-type differences in health outcomes among Hispanic children. Compared to children in metropolitan counties, those in nonmetropolitan counties have slightly higher prevalence of fair/poor health (but the rates are very low for both groups), lower prevalence of overweight/obesity, and lower prevalence of having a usual place for medical care, but those differences are not statistically significant. The only significant difference is that children in nonmetropolitan counties are less likely than their metropolitan peers to have received a routine health checkup in the past 12 months.
Associations Between SNAP Participation and Food Insecurity and Health Outcomes for Hispanic Children: After accounting for differences in likelihood of SNAP participation, the study found that SNAP was associated with greater odds of food insecurity among low-income Hispanic children. SNAP participation was also associated with greater odds of fair/poor health among Hispanic children of immigrants and with greater odds of obesity/overweight among children in food-secure (but not food-insecure) households, among children in nonmetropolitan counties (but not metropolitan counties), and among children in new destinations (but not established destinations). SNAP does appear to be beneficial for health care access among some groups of Hispanic children. Specifically, SNAP receipt is associated with greater odds of receiving a routine health checkup in the past 12 months for Hispanic children of U.S.-born parents, children in both food-secure and food-insecure families, children in metropolitan counties, and children in established destinations. However, the protective effects of SNAP on receipt of a routine checkup are not evident for children of immigrants, children in nonmetropolitan counties, or children in new destinations. Finally, SNAP was associated with greater odds of having a usual place for medical care only among children in food-secure households.