Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
Injury Prevention Research Center, University of North Carolina at Chapel Hill.
JAMA Netw Open. 2024 Aug 1;7(8):e2428680. doi: 10.1001/jamanetworkopen.2024.28680.
Households with children and minoritized racial and ethnic groups experience a disproportionate burden of food hardship. During the COVID-19 pandemic, the US federal government implemented emergency allotments in the Supplemental Nutrition Assistance Program (SNAP), increasing the amount of food purchasing assistance received by many participating households.
To examine the association of implementing emergency allotments in SNAP with food hardship among households with children overall and for households with Black, Hispanic, and White children by comparing income-eligible households that did and did not participate in SNAP.
DESIGN, SETTING, AND PARTICIPANTS: This ecologic cross-sectional study used 2016-2022 National Survey of Children's Health data and a difference-in-differences approach to compare changes in the risk of food hardship from before implementation of emergency allotments in SNAP (2016-2019) to during implementation (2020-2022). Households with children younger than 18 years and incomes 130% or less of the federal poverty level (FPL) in all 50 states and Washington, DC, were included.
Implementation of emergency allotments in SNAP.
The primary outcome was caregiver report of household food hardship during the past 12 months.
Of 44 753 households with incomes 130% or less of the FPL, a weighted 23.4% had Black children, 56.7% had White children, and 19.9% had children of other races. More than one-third of households (37.8%) had Hispanic children, and 31.8% had young children aged 0 to 5 years. The percentage of households that experienced food hardship decreased from 2016 to 2021 (from 62.9% to 48.2% among SNAP-participating households and from 44.3% to 38.9% among income-eligible nonparticipating households) but increased in 2022 (to 58.0% among SNAP-participating households and to 47.5% among nonparticipating households). Adjusting for confounders, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating compared with nonparticipating households (risk ratio [RR], 0.88; 95% CI, 0.81-0.96). Implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating households with Hispanic (RR, 0.86; 95% CI, 0.72-1.02) and White (RR, 0.85; 95% CI, 0.76-0.94) children compared with nonparticipating households but not among households with Black children (RR, 1.04; 95% CI, 0.87-1.23).
In this ecologic cross-sectional study, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among households with children. Efforts are needed to ensure that all populations benefit from economic policies.
有儿童和少数族裔群体的家庭承受着不成比例的粮食困难负担。在 COVID-19 大流行期间，美国联邦政府在补充营养援助计划（SNAP）中实施了紧急拨款，增加了许多参与家庭获得的食品购买援助。
通过比较参与和不参与 SNAP 的符合条件的收入家庭，来研究 SNAP 中实施紧急拨款与所有有儿童的家庭以及有黑种人、西班牙裔和白种人儿童的家庭的粮食困难之间的关联。
设计、设置和参与者：本生态交叉研究使用了 2016 年至 2022 年全国儿童健康调查数据，并采用差异中的差异方法，比较了 SNAP 实施紧急拨款之前（2016-2019 年）和实施期间（2020-2022 年）的粮食困难风险变化。研究对象为所有 50 个州和华盛顿特区的年龄在 18 岁以下且收入在联邦贫困线（FPL）的 130%以下的有儿童的家庭。
SNAP 中实施紧急拨款。
主要结果是看护人报告过去 12 个月家庭的粮食困难情况。
在收入低于 FPL 的 130%的 44753 户家庭中，加权后有 23.4%的家庭有黑人孩子，56.7%的家庭有白人孩子，19.9%的家庭有其他种族的孩子。超过三分之一的家庭（37.8%）有西班牙裔孩子，31.8%的家庭有 0 至 5 岁的幼儿。有粮食困难的家庭比例从 2016 年到 2021 年下降（参与 SNAP 的家庭从 62.9%下降到 48.2%，不参与 SNAP 的符合条件的家庭从 44.3%下降到 38.9%），但在 2022 年有所上升（参与 SNAP 的家庭上升到 58.0%，不参与的家庭上升到 47.5%）。调整混杂因素后，与不参与的家庭相比，SNAP 中实施紧急拨款与参与家庭的粮食困难风险降低有关（风险比 [RR]，0.88；95%置信区间，0.81-0.96）。与不参与的家庭相比，SNAP 中实施紧急拨款与参与家庭的西班牙裔（RR，0.86；95%置信区间，0.72-1.02）和白人（RR，0.85；95%置信区间，0.76-0.94）儿童的粮食困难风险降低有关，但与黑人儿童的家庭（RR，1.04；95%置信区间，0.87-1.23）无关。
在这项生态交叉研究中，SNAP 中实施紧急拨款与儿童家庭的粮食困难风险降低有关。需要努力确保所有人群都能从经济政策中受益。
