1. Participation in the Supplemental Nutrition Assistance Program (SNAP) is associated with lower utilization of pediatric emergency departments. This association is mediated both by reduced food insecurity and improved child health at the family level.
2. The benefit of participating in SNAP for reduced emergency department use is greatest for children with special health care needs.
Evidence Rating Level: 2 (good)
Research overview: Family-level food insecurity is a known risk factor for pediatric emergency department use. The purpose of this study was to assess whether the Supplemental Nutrition Assistance Program (SNAP), a federally funded food relief program in the United States, is associated with health benefits in children. A secondary analysis of data from the National Survey of Children’s Health found that participation in SNAP was associated with fewer pediatric emergency department visits, with the greatest benefits seen for children with special medical needs. I was. This association was mediated by both reduced family-level food insecurity and improved child health. This analysis benefits from a large nationally representative sample and rigorous epidemiological methods. Leveraging a probit model incorporating instrumental variables, the authors were able to account for differences in her SNAP performance across states. However, limitations center on the potential for residual confounding by unmeasured variables to persist despite these modeling efforts. In addition, participation in SNAP, although not considered in the analysis, may be correlated with use of other benefit programs that may affect children’s health.
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Related reading: Social risk factors influence pediatric emergency department utilization and hospitalization
detail [cross-sectional study]: Using data from the National Child Health Survey from 2016 to 2019, this study aimed to assess whether family participation in SNAP is associated with reduced use of pediatric emergency rooms. I was doing it. In total, a sample of her 24,990 children aged 0 to her 17 years living in households with an income below her 150% of the federal poverty level was considered. Structural equation modeling was used to assess the association between her SNAP participation in this group and pediatric emergency use, accounting for two instrumental variables (SNAP category eligibility and requalification duration). Confounders measured (family level: child’s age, sex, race/ethnicity, parent/caregiver employment, parent/caregiver education, household income, presence of smokers in the household; state level: unemployment, GDP, and per capita income); and latent variables representing unmeasured confounders. We then ran a probit model to estimate the overall pediatric emergency department utilization rate and the probability of children with and without special care needs (SHCN) separately. Participation in SNAP was associated with a decrease in the odds of family feeding difficulties (-18.3%), an increase in the odds of children being well (+8.1%), and a decrease in pediatric emergency department utilization (-5.2%). ) was associated with Levels at p < 0.01. These relationships were stronger across the board in children with SHCN than in children without SHCN.
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