Harvard T.H. Chan School of Public Health.
Bailit Health Purchasing, Needham, Massachusetts, USA.
Curr Opin Pediatr. 2023 Feb 1;35(1):33-38. doi: 10.1097/MOP.0000000000001192. Epub 2022 Nov 11.
In 2020, obesity prevalence among US children reached 19.7%, impacting about 14.7 million children and adolescents. Food insecurity among children is also a public health concern but has largely decreased or remained stable over the past decade, reaching 6.2% of US households with children in 2021. Given food insecurity and obesity's interconnected nature and their negative consequences on children's health, it is of interest to assess the Supplemental Nutrition Assistance Program's (SNAP's) impact on childhood food security, dietary quality, disease risk, and health outcomes.
Evidence suggests that SNAP participants, including children, struggle to meet key dietary guidelines and perform poorly on key health indicators when compared with income-eligible and higher income nonparticipants. Children participating in SNAP were more likely to have elevated disease risk and consume more sugar-sweetened beverages (SSBs), more high-fat dairy, and more processed meats than income-eligible nonparticipants. However, research suggests that federal food assistance programs with more stringent nutrition standards - the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the National School Lunch Program (NSLP) and School Breakfast Program (SBP) - improve dietary quality, increase birth weight and gestation periods, and reduce childhood obesity, infant mortality and healthcare costs.
After reviewing the evidence on SNAP's impacts on food insecurity, dietary quality, and health as well as research on the health impacts of other more successful federal food assistance programs, we provide three policy recommendations to strengthen SNAP's effectiveness as a health intervention for children and families.
2020 年,美国儿童肥胖患病率达到 19.7%,影响约 1470 万名儿童和青少年。儿童食品不安全也是一个公共卫生问题,但在过去十年中,这一问题在很大程度上有所减少或保持稳定,2021 年有 6.2%的美国家庭有儿童面临食品不安全问题。鉴于食品不安全和肥胖之间的相互关联性质及其对儿童健康的负面影响,评估补充营养援助计划(SNAP)对儿童食品安全、饮食质量、疾病风险和健康结果的影响是很有意义的。
有证据表明,与符合收入条件和收入较高的非参与者相比,包括儿童在内的 SNAP 参与者在满足关键饮食指南方面存在困难,在关键健康指标上表现不佳。参与 SNAP 的儿童更有可能面临更高的疾病风险,并且比符合收入条件的非参与者消费更多的含糖饮料(SSB)、更多高脂肪乳制品和更多加工肉类。然而,研究表明,具有更严格营养标准的联邦食品援助计划——妇女、婴儿和儿童特别补充营养计划(WIC)以及国家学校午餐计划(NSLP)和学校早餐计划(SBP)——可以改善饮食质量,增加出生体重和妊娠期,并降低儿童肥胖、婴儿死亡率和医疗保健成本。
在审查了 SNAP 对食品安全、饮食质量和健康的影响的证据以及其他更成功的联邦食品援助计划对健康影响的研究后,我们提出了三项政策建议,以加强 SNAP 作为儿童和家庭健康干预措施的有效性。