Arteaga Irma, Hodges Leslie, Heflin Colleen
University of Missouri, United States.
Economic Research Service, USDA, United States.
SSM Popul Health. 2021 Sep 2;15:100910. doi: 10.1016/j.ssmph.2021.100910. eCollection 2021 Sep.
Well-child visits are protective for child health but underutilized in the United States. The Supplemental Nutrition Assistance Program (SNAP), the largest federal food assistance program in the United States, has been shown to reduce food insecurity and may also promote child health by supporting preventative health care utilization. We examined the relationship between SNAP participation and infant well-child visits using state administrative data from Missouri's Department of Social Services for the period January 2006 to July 2014 for more than 50,000 infant-mother dyads. We find that compared to always receiving SNAP, leaving SNAP or receiving SNAP unstably reduces the likelihood that an infant receives all recommended well-child visits in the first year. These patterns are more pronounced for infants living in urban areas, infants with Black or Hispanic mothers, and infants whose mothers are diagnosed with depression. We also find that stable SNAP participation primarily influences vaccination rates through well-child visits, which is when most infants receive their immunizations. Given the increased public health risk of foregone care, these results may inform policy makers as they consider making permanent policy waivers to reduce the administrative burden of the recertification process and increase the stability of SNAP participation.
健康儿童体检对儿童健康具有保护作用，但在美国却未得到充分利用。补充营养援助计划（SNAP）是美国最大的联邦食品援助计划，已被证明可以减少粮食不安全状况，还可能通过支持预防性医疗保健的利用来促进儿童健康。我们使用密苏里州社会服务部2006年1月至2014年7月期间的州行政数据，对50000多个母婴二元组进行了研究，以考察SNAP参与情况与婴儿健康儿童体检之间的关系。我们发现，与一直领取SNAP相比，停止领取或不稳定领取SNAP会降低婴儿在第一年接受所有推荐的健康儿童体检的可能性。这些模式在城市地区的婴儿、母亲为黑人或西班牙裔的婴儿以及母亲被诊断患有抑郁症的婴儿中更为明显。我们还发现，稳定参与SNAP主要通过健康儿童体检影响疫苗接种率，而大多数婴儿是在健康儿童体检时接种疫苗的。鉴于放弃医疗保健会增加公共卫生风险，这些结果可能会为政策制定者提供参考，因为他们在考虑做出永久性政策豁免，以减轻重新认证过程的行政负担，并提高SNAP参与的稳定性。
