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Families with young children who experienced a reduction or cutoff in Supplemental Nutrition Assistance Program (SNAP) benefits because of increased income were more likely to experience food insecurity and report poor health following the benefit change, according to new research from Children’s HealthWatch, based out of Boston Medical Center (BMC), and published in the May issue of Health Affairs.

Children’s HealthWatch surveyed over 8,500 families in five U.S. cities from 2007-2015 who participated in SNAP in the previous year. Twenty percent reported a reduction in SNAP benefits because of income increase, while 16 percent reported benefits being cut off because of income increase. Compared to families with consistent SNAP benefit levels, those whose benefits were reduced or cutoff were more likely to experience food insecurity, energy insecurity, and were more likely to forgo health care for family members because they could not afford it. Families whose benefits were reduced experienced more negative outcomes than those who were cut off, including greater odds of housing instability, children and caregivers being in fair or poor health, and maternal depressive symptoms. Researchers say this seemingly counterintuitive finding could be explained by the possibility that income increases large enough to result in a cutoff may help buffer families from some hardships.

“These findings raise serious concerns about abrupt SNAP reductions and cutoffs for families whose income fluctuates,” says Stephanie Ettinger de Cuba, MPH, Executive Director of Children’s HealthWatch at BMC and researcher at Boston University School of Medicine (BUSM). “The economic hardships these families face can take a serious toll on child and caregiver health, including through high levels of stress, inadequate nutrition, and compromised immune systems, leading to increased strain on the health care system.”

SNAP serves as a buffer against food insecurity for millions of low-income Americans. Food insecurity and other economic hardships have been associated with negative health, developmental, behavioral, and educational issues for children and their caregivers. The majority of SNAP participants with children have earned income. However many low-wage workers have unstable working hours, work seasonal jobs, or have sporadic overtime hours that can result in unpredictable income fluctuations. When family income increases, it can trigger rapid reductions or termination of SNAP benefits.

The research team argues policymakers should consider ways to make SNAP reductions less abrupt for working families, and smooth the transition out of receiving benefits so that families have a chance to stabilize financially.

“Policymakers could take into account the timing and amount of income increases over a longer period to provide a more realistic picture of family employment and income stability,” says Deborah A. Frank, MD, founder of Children’s HealthWatch at BMC and professor of Child Health and Well-Being at BUSM. “The unintended impacts on child health of benefit loss immediately following potentially short-lived income increases are too great for us to continue with the status quo.”
 

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