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Supplemental Nutrition Assistance Program participation and health care expenditures in children
Stephen Rogers1,2, Arvin Garg3, Yorghos Tripodis4
1Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, 801 Albany St 2nd Floor, Boston, MA, 02119, USA. rogerssr@chop.edu.
Insights
The Supplemental Nutrition Assistance Program (SNAP) benefits children's health, but this study found no short-term healthcare cost savings for children enrolled in SNAP. Unlike adults, SNAP enrollment did not significantly reduce healthcare expenditures in children.
Area of Science:
- Public Health
- Health Economics
- Pediatric Health
Background:
- The Supplemental Nutrition Assistance Program (SNAP) is known to improve child health outcomes, such as birth weight and nutritional status.
- While studies indicate SNAP reduces healthcare costs in adults, its impact on healthcare expenditures in children is less understood.
Purpose of the Study:
- To investigate the association between continuous Supplemental Nutrition Assistance Program (SNAP) enrollment and healthcare expenditures in U.S. children.
- To determine if SNAP enrollment influences short-term health care costs in children from low-income households.
Main Methods:
- Retrospective analysis of the Medical Expenditure Panel Survey (2013-2017) for U.S. children under 18 in households below 200% of the federal poverty level.
- Multivariable regression was used to model the effect of continuous SNAP enrollment on health expenditures at 12 and 24 months, adjusting for sociodemographic and clinical factors.
Main Results:
- A total of 5,626 children were analyzed; 49.2% had consistent SNAP enrollment over two years.
- Unadjusted healthcare expenditures were initially lower for SNAP recipients, but adjusted analyses revealed no statistically significant differences in total health care expenditures, including ED, inpatient, outpatient, and prescription costs.
- SNAP-recipient households were more likely to have incomes below 100% FPL and children were more often publicly insured compared to non-recipients.
Conclusions:
- Sustained SNAP enrollment over two years did not lead to significant short-term healthcare cost reductions in children.
- Findings suggest that, unlike in adults, SNAP may not reduce healthcare costs among children, despite its established benefits for child health and well-being.
- Children in SNAP programs face significant social hardships, highlighting the need for comprehensive support beyond nutritional assistance.
Background:
The Supplemental Nutrition Assistance Program (SNAP) has well-established positive impacts on child health outcomes, including increased birth weight and decreased likelihood of underweight status. Studies in adult populations suggest that SNAP is associated with lower health care costs, although less is known in children.
Methods:
Retrospective analysis of U.S. children (age <18 years) living in low-income households (< 200% of the federal poverty level) in the 2013-2017 Medical Expenditure Panel Survey. We used multivariable regression, adjusting for sociodemographic and clinical covariates, to model the effect of continuous SNAP enrollment on health expenditures as compared to non-enrollees at 12 and 24 months.
Results:
The sample included 5,626 children, of whom 49.2% consistently received SNAP for the entire two-year survey period. Compared with SNAP non-recipients, SNAP-recipient households more often had incomes below 100% FPL (78.3% vs 37.9%), and children in SNAP-recipient households were more often publicly insured (94.9% vs 64.5%). Unadjusted expenditures were lower for children in SNAP-recipient households at 12 ($1222 vs $1603) and 24 months ($2447 vs $3009). However, when adjusting for sociodemographic and clinical differences, no statistically significant differences in health care expenditures, including emergency department, inpatient, outpatient, and prescription costs, were identified.
Conclusion:
SNAP participant children experience heightened social hardships across multiple domains. There were no differences in short term health care costs based on SNAP enrollment when accounting for differences in sociodemographic and clinical factors. Despite demonstrated child health benefits, we found that sustained enrollment in SNAP over a two-year period did not generate significant short- term health care cost reductions. Our findings suggest that although SNAP is intended to act as a benefit towards the health and well-being of its recipients, unlike among adults, it may not reduce health care costs among children.
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