Panel Paper: Nutrition and Health among Low-income Children: Estimating the Association with SNAP using a Quasi-Experimental Approach

Saturday, November 4, 2017
Field (Hyatt Regency Chicago)

*Names in bold indicate Presenter

Katelin M Hudak, Elizabeth F Racine, Lisa Schulkind and Arthur Zillante, University of North Carolina, Charlotte

The Supplemental Nutrition Assistance Program (SNAP) is the nation’s largest federal food assistance program. The goal of the program is to help low-income families afford a healthy diet. However, several studies have found that participation in SNAP is associated with poorer diet quality and an increased probability of being overweight among adults. Poor diet quality and being overweight contribute to the metabolic syndrome, which is a cluster or risk factors that increase the risk of heart disease, diabetes, and stroke. The few studies that have examined these outcomes in children, a particularly vulnerable group, have inconsistent findings. A potential reason for mixed findings is the issue of selection bias. Unobserved differences between participants and nonparticipants pose a challenge in identifying the association between SNAP participation and child health outcomes. This project uses two research designs that mitigate selection bias, and thus can better identify the relationship between SNAP participation and child health: differences-in-differences and regression discontinuity. The objective of this study is to analyze the association of SNAP with three groups of diet-related health outcomes in children: diet quality, weight status, and risk factors for metabolic syndrome. The analysis uses the 2007-2014 waves of the National Health and Nutrition Examination Survey (NHANES). The difference-in-difference design uses the increase in SNAP benefit amounts from the American Recovery and Reinvestment Act in a quasi-natural experiment. The regression discontinuity design uses the SNAP income-eligibility criteria to distinguish those eligible for the program from those just over the eligibility threshold. This study fits well into the conference theme because it shows how alternative research designs can shed light on policy issues by using existing data. Developing a better understanding of the relationship between SNAP participation and diet-related health outcomes in children can lead to refined federal nutrition policy. This is a critical policy question that has far-reaching implications for the health and well-being of the low-income children and families that rely on SNAP to help meet basic needs.