scholarly journals 974. The Effects of Changes in State-Level Policies Affecting Eligibility for the Supplemental Nutrition Assistance Program (SNAP) on Annual HIV Diagnoses in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S516-S516
Author(s):  
Aaron Richterman ◽  
Louise Ivers ◽  
Alexander Tsai ◽  
Jason Block

Abstract Background The connection between food insecurity and HIV outcomes is well-established. The Supplementary Nutrition Assistance Program (SNAP), the primary program in the United States that addresses food insecurity, may have collateral impacts on HIV incidence, but the extent to which it does is unknown. “Broad-based categorical eligibility” for SNAP is a federal policy that provides a mechanism for states to increase the income or asset limits for SNAP eligibility. The Department of Agriculture under the Trump Administration has proposed eliminating this policy. Methods We estimated the association between the number of new HIV diagnoses from 2010 to 2014 for each state and (1) state income limits for SNAP eligibility as a percentage of the federal poverty level and (2) state asset limits for SNAP eligibility (increased/eliminated vs. unchanged). We fitted multivariable negative binomial regression models with annual incidence of HIV diagnoses specified as the outcome; SNAP policies as the primary explanatory variable of interest; state and year fixed effects; and time-varying covariates related to the costs of food, health care, housing, employment, SNAP outreach, and total spending on Temporary Assistance for Needy Families (TANF) programs. Results From 2010 to 2014, 204,034 new HIV diagnoses occurred in the United States. HIV diagnoses within states had a statistically significant inverse association with state income limits for SNAP eligibility (IRR 0.94 per increase in the income limit by 35% of federal poverty level, 95% CI 0.91-0.98), but no statistically significant association with state asset limits (increased asset limit vs. no change, IRR 1.02, 95% CI 0.94-1.10; eliminated asset limit vs. no change, IRR 1.04, 95% CI 0.99-1.10) (Table). Table Conclusion State income limits for SNAP eligibility were inversely associated with the number of new HIV diagnoses for states between 2010-2014. Proposals to eliminate the use of broad-based categorical eligibility to increase the income limit for SNAP may undercut efforts to end the HIV epidemic in the United States. Disclosures All Authors: No reported disclosures

Author(s):  
Jason M Nagata ◽  
Hilary K Seligman ◽  
Sheri D Weiser

ABSTRACT During the coronavirus disease 2019 (COVID-19) pandemic, food insecurity has doubled overall and tripled among households with children in the United States. Food insecurity and COVID-19 may exacerbate one another through bidirectional links, leading to a syndemic, or sequential disease clusters, which exacerbate one another. Experiencing food insecurity may be associated with macronutrient and micronutrient deficiencies, which can weaken host defenses, thus increasing susceptibility to COVID-19. Food insecurity is associated with chronic medical conditions, which may afford a higher risk of severe COVID-19 illness. People experiencing food insecurity may have increased exposure to COVID-19 while procuring food. People with COVID-19 may be unable to work, generate income, and procure food while quarantined, which may exacerbate food insecurity. Clinicians should screen for food insecurity during the COVID-19 pandemic and provide referrals to food-assistance programs when appropriate. Policymakers should expand benefits for the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to address increases in the depth and breadth of food insecurity during the COVID-19 pandemic.


Author(s):  
Craig Gundersen

Food insecurity is a leading public-health challenge in the United States today. This is primarily due to the magnitude of the problem—about 50 million persons are food insecure—and the serious negative health and other outcomes associated with being food insecure. This chapter first defines the measure used to delineate whether a household is food insecure. The measure, the Core Food Security Module (CFSM), is based on 18 questions about a household’s food situation. From the responses, a household is defined as food secure, low food secure, or very low food secure, with the latter two categories defined as “food insecure.” I next discuss the extent of food insecurity in the United States across various dimensions, the key determinants of food insecurity, and the multiple negative consequences associated with food insecurity. Two of the key policy tools used to address food insecurity are the Supplemental Nutrition Assistance Program (formerly known as the Food Stamp Program) and the National School Lunch Program. A brief overview and definition of the eligibility criteria for each program is provided along with a discussion of their respective impacts on food insecurity. This chapter concludes with four major current challenges pertaining to food insecurity and food assistance programs.


Author(s):  
Molly Knowles ◽  
Joanna Simmons ◽  
Mariana Chilton

Food insecurity—lack of access to enough food for an active and healthy life—is a major public health issue, affecting the health and well-being of one in seven people in the United States. Food insecurity is related to economic, social, and political conditions, and is beyond the control of a single household. Structural inequalities and discrimination against people of color, LGBTQ people, immigrants, people with disabilities, and women drives disparities in food insecurity. Major policy interventions include raising wages, improving the Supplemental Nutrition Assistance Program, various programs of the Child Nutrition Reauthorization, and the Elder Nutrition Program, but these programs are not sufficient to address food insecurity fully. A human rights approach, which recognizes the right to food and promotes increasing civic participation among people from all sectors, offers new possibilities in addressing food insecurity in the United States.


Author(s):  
Aaron Richterman ◽  
Jason P Block ◽  
Alexander C Tsai ◽  
Louise C Ivers

Abstract Introduction The connection between food insecurity and HIV outcomes is well-established. The Supplemental Nutrition Assistance Program (SNAP), the primary food safety net program in the US, may have collateral impacts on HIV incidence. “Broad-based categorical eligibility” for SNAP is a policy that provides a mechanism for states to increase the income or asset limits for SNAP eligibility. Methods We estimated the association between the number of new HIV diagnoses 2010-2014 for each state and (1) state income limits and (2) state asset limits for SNAP eligibility. We fitted multivariable negative binomial regression models with number of HIV diagnoses specified as the outcome; SNAP policies as the primary explanatory variable of interest; state and year fixed effects; and time-varying covariates related to the costs of food, health care, housing, employment, other SNAP policies, and Temporary Assistance for Needy Families spending. Results HIV diagnoses within states had a statistically significant association with state income limits for SNAP eligibility (IRR 0.94 per increase in the income limit by 35% of federal poverty level, 95% CI 0.91-0.98), but no association with state asset limits (increased asset limit vs. no change, IRR 1.02, 95% CI 0.94-1.10; eliminated asset limit vs. no change, IRR 1.04, 95% CI 0.99-1.10). Conclusions State income limits for SNAP eligibility were inversely associated with the number of new HIV diagnoses for states between 2010-2014. Proposals to eliminate the use of broad-based categorical eligibility to increase the income limit for SNAP may undercut efforts to end the HIV epidemic in the US


2019 ◽  
Vol 48 (3) ◽  
pp. 433-447 ◽  
Author(s):  
Craig Gundersen ◽  
Elaine Waxman ◽  
Amy S. Crumbaugh

The Supplemental Nutrition Assistance Program (SNAP) serves as the primary tool to alleviate food insecurity in the United States. Its effectiveness has been demonstrated in numerous studies, but the majority of SNAP recipients are still food insecure. One factor behind this is the difference in food prices across the country—SNAP benefits are not adjusted to reflect these differences. Using information from Feeding America's Map the Meal Gap (MMG) project, we compare the cost of a meal by county based on the Thrifty Food Plan (TFP)—which is used to set the maximum SNAP benefit—with the cost of the average meal for low-income food-secure households. We find that the cost of the latter meal is higher than the TFP meal for over 99 percent of the counties. We next consider the reduction in food insecurity if, by county, the maximum SNAP benefit level was set to the cost of the average meal for low-income food-secure households. We find that if this approach were implemented, there would be a decline of 50.9 percent in food insecurity among SNAP recipients at a cost of $23 billion.


Author(s):  
Denise Holston ◽  
Jessica Stroope ◽  
Matthew Greene ◽  
Bailey Houghtaling

Food insecurity in rural settings is complex and not fully understood, especially from the perspective of low-income and Black residents. The goal of this study was to use qualitative methods to better understand experiences with food access and perceptions of the food environment among low-income, predominately Black rural Louisiana residents in the United States. Data were collected from focus group discussions (FGD) and focus group intake forms. Study participants were all rural residents eligible to receive at least one nutrition assistance program. FGD questions focused on perceptions of the food environment, with an emphasis on food access. Participants (n = 44) were predominately Black and female. Over half (n = 25) reported running out of food before the end of the month. Major themes included: store choice, outshopping, methods of acquiring foods other than the grocery store, and food insecurity. Concerns around price, quality, and transportation emerged as factors negatively impacting food security. Understanding residents’ perceptions and experiences is necessary to inform contextually appropriate and feasible policy and practice interventions that address the physical environment and social conditions that shape the broader physical food environment in order to achieve equitable food access and food security.


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