The Role of Government-Funded Assistance Programs on HIV Testing Among Poor U.S. Adults

Government-funded assistance program enrollment may play an important role in the overall increase of HIV testing among low-income U.S. adults. We pooled data from the 2016–2018 National Health Interview Survey and limited analyses to respondents aged 18 to 64 years with incomes less than 100% of the U.S. poverty threshold ( N = 9,497). The outcome of interest was ever testing for HIV. Prevalence ratios were used to assess the likelihood of ever testing for HIV and were adjusted for sociodemographic covariates including whether the respondent was a beneficiary of any government-funded assistance programs (e.g., Medicaid; job-placement/training/human services; or Temporary Assistance for Needy Families). After adjusting for significant sociodemographic covariates, government-funded assistance beneficiaries were significantly more likely to ever test for HIV (adjusted prevalence ratio = 1.3; 95% CI = [1.2, 1.4], p < .0001) than adults with incomes less than 100% of the U.S. poverty threshold who did not receive government assistance. Beneficiaries of government-funded assistance programs are more likely to test for HIV.

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Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape

JMIR Mental Health ◽

10.2196/mental.5843 ◽

2016 ◽

Vol 3 (2) ◽

pp. e26 ◽

Cited By ~ 10

Author(s):

Dror Ben-Zeev

Keyword(s):

Mental Health ◽

Mental Illness ◽

Severe Mental Illness ◽

Mobile Phone ◽

Mobile Phones ◽

Mobile Technology ◽

Low Income ◽

Mental Health Problems ◽

Assistance Program ◽

The U.S

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.

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Understanding Participation in Social Programs: Why Don't Households Pick up the Lifeline?

The B E Journal of Economic Analysis & Policy ◽

10.2202/1935-1682.1583 ◽

2007 ◽

Vol 7 (1) ◽

Cited By ~ 14

Author(s):

Mark Burton ◽

Jeffrey Macher ◽

John W Mayo

Keyword(s):

Low Income ◽

Information Dissemination ◽

State Level ◽

Social Programs ◽

Participation Rates ◽

Public Programs ◽

Assistance Program ◽

Assistance Programs ◽

Program Characteristics ◽

The Individual

Abstract In this study, we draw upon data from the low-income Lifeline Assistance Program (Lifeline) for telephone service to examine the participation of eligible households in social programs designed to alleviate financial hardship. Utilizing panel data on participation levels in 1997 and 2003 and the associated variation in state-level policies, we are able to identify program characteristics that significantly affect participation rates. In particular, we find that participation rates are significantly negatively influenced by limitations that some states place on the ability of Lifeline subscribers to utilize optional calling features such as three-way calling or call forwarding. We also find that program participation is positively influenced by the longevity of the individual state's Lifeline program. While no direct test of state-level advertising is feasible, this result is suggestive of an inter-temporal pattern of information dissemination that grows with program longevity. Because eligibility for the Lifeline service is conditional upon participation in other low-income public programs, we also find that: (1) the larger the number of "portals" (i.e., low income public programs that states identify as creating Lifeline eligibility), the higher is participation; and (2) higher financial benefits of these portal programs attract greater participation in Lifeline programs. These results suggest important linkages that may be exploited through coordination of low-income assistance programs. Finally, we test for, and find that variations in Lifeline benefits significantly influence participation rates.

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Ensuring Access to Fruits and Vegetables for the Nation’s Most Vulnerable – Contributions of WIC and SNAP

The Economists Voice ◽

10.1515/ev-2017-0005 ◽

2017 ◽

Vol 14 (1) ◽

Author(s):

Dena R. Herman

Keyword(s):

Low Income ◽

Fruits And Vegetables ◽

Eating Habits ◽

Food Choices ◽

Safety Net ◽

Supplemental Nutrition ◽

Assistance Program ◽

Supplemental Nutrition Program ◽

Nutrition Assistance ◽

The U.S

AbstractThe Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) are critical programs in the U.S. because they form the basis of the nation’s nutrition and hunger safety net. SNAP has large effect nationwide offering nutrition assistance to 1 in 7 low-income Americans, while WIC serves more than half of all infants in the U.S. and a quarter of all children ages 1-5 years. Despite the reach of these programs, there is still room for improvement, especially when it comes to increasing access to healthy food items and improving eating habits. The objective of this paper is to make recommendations for how WIC and SNAP can work better together to continue to incentivize purchases and support low-income population’s knowledge and access to healthier food choices, particularly those foods that have traditionally been most expensive – fruits and vegetables.

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Comparison of Emergency Preparedness Practices between Food Assistance Program Participants and Non-Participants in the United States

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182412937 ◽

2021 ◽

Vol 18 (24) ◽

pp. 12937

Author(s):

Gina J. Fung ◽

Laura K. Jefferies ◽

Michelle A. Lloyd Call ◽

Dennis L. Eggett ◽

Rickelle Richards

Keyword(s):

United States ◽

Low Income ◽

Emergency Preparedness ◽

The United States ◽

Food Assistance ◽

Food Assistance Programs ◽

Assistance Program ◽

Convenience Sample ◽

Assistance Programs ◽

The Impact

Background: Previous research has suggested many households are meeting the Federal Emergency Management Agency’s 3-day emergency food and water storage recommendations. The impact of limited economic household resources on emergency preparedness practices related to food and water is uncertain. The purpose of this study was to compare emergency preparedness practices in households participating in United States’ food assistance programs with households not participating in these programs. Methods: A convenience sample of adults (n = 572) completed an online Qualtrics survey. Descriptive statistics, chi-square statistics, and independent t-tests were used to measure differences between households participating in food assistance programs vs. non-participating households. Results: Most households participating in food assistance programs felt prepared to provide household members with food and water during an emergency, which did not significantly differ from non-participating households. Households using food assistance programs had less accessible cash but had similar foods on-hand for an emergency compared to non-participating households. However, they more frequently reported having baby formula/food and less frequently reported having vitamin/mineral supplements compared to non-participating households. Conclusions: Food assistance programs may be effective in providing enough food and water to help low-income families be prepared for an emergency.

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Assessing the Likely Impacts of Proposed Food Boxes on SNAP Recipients

Policy Perspectives ◽

10.4079/pp.v26i0.19279 ◽

2019 ◽

pp. 1-9

Author(s):

Ahoefa Ananouko

Keyword(s):

Food Insecurity ◽

Low Income ◽

Negative Impact ◽

Assistance Program ◽

Assistance Programs ◽

Budget Request ◽

Before And After ◽

The Government ◽

Nutrition Assistance ◽

Nutrition Assistance Programs

The Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp Program, is the largest of the federal food and nutrition assistance programs. Studies show that SNAP is vital in increasing recipients’ food budgets, as reflected in recipients’ food spending before and after the 2009 Stimulus Package. SNAP has also been shown to reduce food insecurity for U.S. households. Proposed changes to SNAP by the Trump administration in its initial 2019 budget request could have major impacts on households that depend on the program to lessen the setbacks caused by poverty. Based on economic theory and results from previous studies examining expenditure responses to changes in SNAP, this article explores possible impacts of allocating half of SNAP benefits in the form of food boxes. It argues that these changes would have a negative impact on low-income households—especially children. These changes could create further food insecurity among some of the most vulnerable, while also increasing costs to the government.

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Usual Nutrient Intake of Older Adults in the U.S. Is Lower Among SNAP Participants Compared to Income-Eligible Non-Participants

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_077 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1084-1084

Author(s):

Yue Qin ◽

Alexandra Cowan ◽

Regan Bailey ◽

Shinyoung Jun ◽

Heather Eicher-Miller

Keyword(s):

Older Adults ◽

Low Income ◽

Nutrient Intake ◽

Dietary Reference Intake ◽

Cross Sectional ◽

Assistance Program ◽

Nutrition Service ◽

Usual Intake ◽

Nutrition Assistance ◽

The U.S

Abstract Objectives Policy proposals to limit use of the Supplemental Nutrition Assistance Program (SNAP) and to allow dietary supplement (DS) purchase with SNAP benefits draw attention to knowledge gap of usual nutrient intake and adherence to the Dietary Reference Intake recommendations from foods alone and with DS (total intake) among low-income older adults. To address this gap, the estimated distributions of usual nutrient intake (from foods alone and total) and risk of inadequate intake among U.S. older adults participating in SNAP were compared with income-eligible non-participants. Methods Data from 4,791 older adults (≥60 years) from the 2007–2016 National Health and Nutrition Examination Survey were used in this cross-sectional secondary analysis. DS data from an in-home inventory and dietary data from up to two 24-hour recalls were used to estimate usual nutrient intake distributions (total and from foods alone) and the proportion of the population below the Estimated Average Requirement (EAR) using an adapted National Cancer Institute method. Pairwise t-tests compared SNAP participants and eligible non-participants with significance set at P < 0.05. Results SNAP participants had lower usual intake from foods alone compared to eligible non-participants for vitamins B6 (P = 0.046) and E (P = 0.027); the risk of inadequate intake was higher among SNAP participants compared to eligible non-participants for vitamin E (P = 0.0004). Similarly, total usual nutrient intake was lower among SNAP participants compared to eligible non-participants for magnesium (P = 0.019), zinc (P = 0.0003), vitamin C (P = 0.02) and vitamin D (P = 0.0002) and the proportion not meeting the EAR was higher among SNAP participants compared to eligible non-participants for magnesium (P = 0.044). Conclusions Older adults participating SNAP had lower usual intake and meet the EAR less compared to eligible non-participants for certain nutrients. The proportion at risk of inadequate intake was lower when all nutrients sources were examined compared to foods alone. Future policies should focus on improving nutrient intake among food assistance participants and their food security. Funding Sources Supported by University of Kentucky Center for Poverty Research through funding by the U.S. Department of Agriculture, Food and Nutrition Service, Contract Number 12319819C0006.

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Accelerating Evaluation of Financial Incentives for Fruits and Vegetables: A Case for Shared Measures

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182212140 ◽

2021 ◽

Vol 18 (22) ◽

pp. 12140

Author(s):

Nadine Budd Nugent ◽

Carmen Byker Shanks ◽

Hilary K. Seligman ◽

Hollyanne Fricke ◽

Courtney A. Parks ◽

...

Keyword(s):

Low Income ◽

Financial Incentives ◽

Fruits And Vegetables ◽

Financial Incentive ◽

Evaluation Model ◽

Health Impact ◽

Dietary Quality ◽

Assistance Program ◽

Nutrition Assistance ◽

The U.S

Food insecurity, or lack of consistent access to enough food, is associated with low intakes of fruits and vegetables (FVs) and higher risk of chronic diseases and disproportionately affects populations with low income. Financial incentives for FVs are supported by the 2018 Farm Bill and United States (U.S.) Department of Agriculture’s Gus Schumacher Nutrition Incentive Program (GusNIP) and aim to increase dietary quality and food security among households participating in the Supplemental Nutrition Assistance Program (SNAP) and with low income. Currently, there is no shared evaluation model for the hundreds of financial incentive projects across the U.S. Despite the fact that a majority of these projects are federally funded and united as a cohort of grantees through GusNIP, it is unclear which models and attributes have the greatest public health impact. We explore the evaluation of financial incentives in the U.S. to demonstrate the need for shared measurement in the future. We describe the process of the GusNIP NTAE, a federally supported initiative, to identify and develop shared measurement to be able to determine the potential impact of financial incentives in the U.S. This commentary discusses the rationale, considerations, and next steps for establishing shared evaluation measures for financial incentives for FVs, to accelerate our understanding of impact, and support evidence-based policymaking.

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Race/Ethnicity and Self-Reported Diabetes among Adults in the National Health Interview Survey: 2000–2003

Public Health Reports ◽

10.1177/003335490712200509 ◽

2007 ◽

Vol 122 (5) ◽

pp. 616-625 ◽

Cited By ~ 10

Author(s):

Luisa N. Borrell ◽

Natalie D. Crawford ◽

Florence J. Dallo

Keyword(s):

National Health ◽

Low Income ◽

National Health Interview Survey ◽

Health Interview Survey ◽

Health Interview ◽

Hispanic People ◽

Interview Survey ◽

Race Ethnicity ◽

Hispanic White ◽

The U.S

Objective. We investigated the effect of race among Hispanic and non-Hispanic people on self-reported diabetes after adjusting for selected individual characteristics and known risk factors. Methods. Using the National Health Interview Survey 2000–2003, these analyses were limited to Hispanic and non-Hispanic people who self-identified as white or black/African American for a final sample of 117,825 adults, including 17,327 Hispanic people (with 356 black and 16,971 white respondents). Results. The overall prevalence of diabetes was 7.2%. After adjusting for selected covariates, Hispanic white and black respondents were 1.56 (95% confidence interval [CI] 1.32, 1.83) and 2.64 (95% CI 1.10, 6.35) times more likely to report having diabetes than non-Hispanic white respondents. The estimate for non-Hispanic black respondents was 1.45 (95% CI 1.29, 1.64). When compared to low-income non-Hispanic white respondents, low-income Hispanic white respondents (odds ratio [OR] 1.64; 95% CI 1.26, 2.19) and non-Hispanic black respondents (OR 1.71; 95% CI 1.38, 2.11) were more likely to report having diabetes. Hispanic black people born in the U.S. were 3.54 (95% CI 1.27, 9.82) times more likely to report having diabetes when compared to Hispanic white people born in the U.S. In comparison to non-Hispanic white respondents, the odds of reporting diabetes decreased for non-Hispanic black respondents, while the odds remained constant for Hispanic white respondents ( p-value for interaction between survey year and race/ethnicity = 0.03). Conclusions. This study suggests that race may be a proxy for unmeasured exposures among non-Hispanic and Hispanic people. Thus, given the importance of race on health and the racial heterogeneity among Hispanic people, race among Hispanic people should be investigated whenever the data allow it.

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