Editor’s Note: Elizabeth Zeichner is a former high school teacher and third-year medical student at Emory University School of Medicine.
-Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics
There have been numerous studies associating food hardship with poor health outcomes. A consistent lack of access to food, let alone fresh, healthy food, can have significant effects on a child’s health and development. There is now more research exploring the association between the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program, and health outcomes.
This week, an article with an accompanying video abstract, entitled, “SNAP participation and emergency department use,” by Rajan Sonik, PhD from Altamed and colleagues at the US Department of Agriculture and Cambridge Health Alliance, is being early released in Pediatrics (10.1542/peds.2022-058247). The article looks at the association between receiving SNAP benefits and emergency health care use among children with and without special health care needs (SHCN).
The study analyzed data from pooled cross-sectional samples of approximately 25,000 children ages 0-17 in low-income households from the 2016-2019 iterations of the National Survey of Children’s Health. Household food hardship was identified with a single-item food insufficiency question that asked about household ability to afford food. The authors also looked at SNAP participation, health status, emergency healthcare use, and SHCN status, among other comparisons. You can review the methods section of the paper for more details about their analysis.
Overall, Sonik and colleagues found that household SNAP participation is “associated with reduced food hardship, improved health status and reduced emergency healthcare use.” They found that these effects are even larger for children with SHCN.
This thought-provoking study highlights the multi-factorial implications of social determinants on healthcare outcomes. It is extremely encouraging that SNAP is associated with appreciable health gains. However, addressing food insecurity through SNAP is just one small, albeit tangible and impactful, solution in a large system of structural inequities. The authors write that “the flow from racism to disparities in housing, health care, education, and other facets of life – and the resulting long-term patterns of embodied stressors that increase risks for chronic disease development – are unlikely to be unwound by SNAP alone.”
My main takeaway from this article is that we need to ask our patients, especially those with SHCN, about food access and if they are signed up for SNAP benefits. Although we cannot forget that there are other social determinants that likely have an important impact on our patients’ health, this somewhat immediate solution can improve health outcomes for our patients and their families.