扩大补充营养援助计划资格背景下的青少年心理健康和自杀行为。

Adolescent Mental Health and Suicidal Behaviors in the Context of Expanded Supplemental Nutrition Assistance Program Eligibility.

机构信息

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

出版信息

J Adolesc Health. 2024 Sep;75(3):435-441. doi: 10.1016/j.jadohealth.2024.05.028. Epub 2024 Jul 11.

DOI:10.1016/j.jadohealth.2024.05.028

PMID:39001749

Abstract

PURPOSE

Food insecurity is a risk factor for poor mental health and suicidal behaviors among adolescents. Prior research shows that states with policies that expand Supplemental Nutrition Assistance Program (SNAP) eligibility have a lower prevalence of food insecurity. The primary aim of this study was to compare the prevalence of feelings of sadness or hopelessness, suicidal ideation, and suicide attempts among adolescents in states that had the asset test eliminated and the income limit increased for SNAP eligibility to adolescents in states that did not have either policy.

METHODS

Using 2013-2021 data from state Youth Risk Behavior Surveys (N = 855,119) and the SNAP Policy Database, we conducted log-binomial regression with generalized estimating equations and adjusted for confounders.

RESULTS

The prevalence of persistent feelings of sadness or hopelessness was similar among adolescents in states that had the asset test eliminated only and among adolescents in states that had both the asset test eliminated and the income limit increased (i.e., both policies) compared to adolescents in states that did not have either policy. While the prevalence of suicidal thoughts was similar among adolescents in states that had the asset test eliminated only compared to adolescents in states that did not have either policy, the prevalence of suicidal thoughts (prevalence ratio = 0.91, 95% CI 0.88, 0.94) and suicide attempts (prevalence ratio = 0.82, 95% CI 0.78, 0.86) was lower among adolescents in states that had both policies compared to adolescents in states that did not have either policy.

DISCUSSION

States with policies that expand SNAP eligibility have a lower prevalence of suicidal behaviors among adolescents.

摘要

目的

食品不安全是青少年心理健康状况不佳和自杀行为的一个风险因素。先前的研究表明，扩大补充营养援助计划（SNAP）资格的州，食品不安全的发生率较低。本研究的主要目的是比较取消资产测试并提高 SNAP 资格中青少年收入限制的州与未实施这两项政策的州的青少年中感到悲伤或绝望、有自杀意念和尝试自杀的发生率。

方法

使用 2013 年至 2021 年来自各州青少年风险行为调查（N=855119）和 SNAP 政策数据库的数据，我们采用广义估计方程对数二项式回归，并对混杂因素进行了调整。

结果

与未实施任何一项政策的州的青少年相比，仅取消资产测试的州的青少年和同时取消资产测试和提高收入限制的州的青少年（即两项政策）中持续感到悲伤或绝望的发生率相似。虽然仅取消资产测试的州的青少年中自杀念头的发生率与未实施任何一项政策的州的青少年相似，但有两项政策的州的青少年中自杀念头（流行率比=0.91，95%置信区间 0.88，0.94）和自杀企图（流行率比=0.82，95%置信区间 0.78，0.86）的发生率低于未实施任何一项政策的州。