补充营养援助计划的工作要求和安全网计划参与
Chima D Ndumele1, Hannah Factor2, Matthew Lavallee1
1Yale School of Public Health, New Haven, Connecticut.
JAMA internal medicine
|November 4, 2024
概括
补充营养援助计划 (SNAP) 的工作要求显著减少了SNAP覆盖范围,特别影响了弱势群体. 医疗补助计划的覆盖率基本上没有受到影响,这表明就业增长有限.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
背景情况:
- 工作要求在美国安全网计划中越来越多地得到实施,但它们对弱势群体的影响尚未得到充分理解.
- 对于那些最有可能受到这些政策负面影响的个体的人口,临床和社会经济特征,人们知之甚少.
研究的目的:
- 检查工作要求与参加安全网计划,特别是补充营养援助计划 (SNAP) 和医疗补助之间的联系.
- 识别受SNAP工作要求不成比例地影响的个人的特征.
主要方法:
- 康涅狄格州的一项队列研究分析了在2016年重新引入SNAP工作要求之前和之后的SNAP和Medicaid入学趋势.
- 一个三重差异的研究设计比较了针对目标的有能力的成年人没有家属的结果与受影响和不受影响的城镇的豁免父母/照顾者.
- 从2015年8月到2018年4月的数据分析了从2022年8月到2024年9月的数据.
主要成果:
- 在工作需求实施后,SNAP覆盖率下降了25% (5.9个百分点).
- 医疗补助覆盖率没有显示出统计学上显著的变化.
- 工作需求不成比例地影响了慢性病患者,老年受益者和收入较低的人,增加了他们退出SNAP的可能性.
结论:
- SNAP的工作要求导致SNAP覆盖率大幅下降,特别是在临床和社会经济上最脆弱的人群中.
- 对医疗补助覆盖的最小影响表明,工作要求并没有显著增加从更广泛的安全网中过渡受益者的就业.
- 调查结果强调,在设计和实施社会援助计划的工作要求时,需要考虑特定人群的脆弱性.
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