COVID-19 SNAP Boost Improved Food Security for Low-Income Families

Children and their families greatly benefited from Supplemental Nutrition Assistance Program (SNAP) emergency assistance provided during the height of the COVID-19 pandemic. There was a marked decrease in food hardship when comparing the postimplementation period of 2020 to 2022 and the pre-implementation period of 2016 to 2019, according to a new public health analysis published in JAMA Network Open.¹

This analysis encompassed households with children younger than 18 years that had incomes at 130% or less of the federal poverty level and lived in the 50 states and Washington, DC. Overall, 44,753 households were included in the present study: 56.7% of these households had White children; 37.8%, Hispanic children; 23.4%, Black children; and 19.9%, children of another race. Close to a third (31.8%) had children aged 0 to 5 years.

On January 21, 2020, the first US case of SARS-CoV-2 infection was confirmed by the CDC. Less than 2 weeks later, the US declared a public health emergency—a move that came 3 days after a declaration from the World Health Organization that there was a global public health emergency.²

Food insecurity has hit critical levels in the US, the study authors noted. There are many causes: elevated living expenses, steep housing costs, unemployment, low-wage jobs, limited or uncertain access to adequate food, and lack of money or resources.^1,3,4 The effects are especially acute for families who have children, of whom 17% of households have experienced food insecurity, and minoritized populations; there is a 22% rate of food insecurity among Black families and 21% among Hispanic families compared with 9% of White families. Both physical and mental health are affected.¹

At present, SNAP enrollment comes in at 20 million low-income families.

The authors of this study note how their findings indicate emergency SNAP benefits were note equally realized after implementation of the Families First Coronavirus Response Act. | Image Credit: jetcityimage-stock.adobe.com

Less than 6 weeks after the US declared the public health emergency, the Families First Coronavirus Response Act provided a pathway for families with children to request supplemental SNAP benefits. It was signed into law by President Trump on March 18, 2020, with the benefits starting April 1 of that year and continuing through the month after the month in which the public health emergency ended.⁵

For their ecologic cross-sectional analysis, the present study authors utilized 2016-2022 National Survey of Children’s Health (NSCH) data. Some states ended these additional benefits in 2021 or 2022, but the federal government continued with the program through March 2023. The NSCH uses just the question, “Which of these statements best describes your household’s ability to afford the food you needed during the past 12 months?” to gauge food hardship, and respondents can choose from a range of 4 answers that range from “We could always afford enough to eat” to “Often we could not afford to eat.”

Before food insecurity jumped back up in 2022 among both households receiving SNAP benefits and those not participating in the program—to 58.0% and 47.5%, respectively—there was a nearly 15 percentage point drop, equating to 23.4%, from 62.9% to 48.2% between 2016 and 2021. Households that were eligible to participate in SNAP based on income but did not also experienced a decrease in food hardship in this same period, but to a lesser extent: 44.3% to 38.9% (12.2% overall).

These data equate to a 12% reduced risk overall of food hardship among SNAP-participating households (risk ratio [RR], 0.88; 95% CI, 0.81-0.95) vs nonparticipating households and an 11% reduced risk in participating households among the 17 states that ended the additional SNAP benefits early (RR, 0.89; 95% CI, 0.78-0.98). Even among households that had an income of 200% or less of the FPL, there was an 8% reduced risk of experiencing food insecurity (RR, 0.92; 95% CI, 0.86-0.98).

An adjusted model took this a step further, considering household receipt of cash assistance, household adult employment status, household income against the FPL, caregiver-reported child race/ethnicity, state-level economic policies (eg, minimum wage, Earned Income Tax Credit rate, Medicaid expansion, and maximum Temporary Assistance for Needy Families benefits for a family of 3). There were also several sensitivity analyses.

Compared with households not participating in SNAP, more households that participated in SNAP received government program cash assistance (18.1% vs 3.1%) and had an unemployed adult (30.8% vs 14.0%), Black children (30.3% vs 15.1%), and an income between 0% and 65% of the FPL (53.5% vs 38.5%). Data also show that SNAP participating households that had either White or Hispanic children had reduced risk of food hardship compared with households with Black children: 15% and 14% reduced risks, respectively, compared with a 4% greater risk.

The authors underscore that the emergency SNAP benefits likely were not realized on equal footing, due to the decreased risk only among Hispanic and White households with children compared with Black households with children, and that this could have been the result of segregated food environments and gaps in SNAP need vs benefits actually received. They highlight, too, that their findings echo previous studies showing drops in food difficulty following earlier iterations of emergency SNAP benefits.^6,7

“Collectively, these results reinforce the critical role of SNAP in mitigating food hardship, particularly during economic crises,” they note, and that population-level health can benefit as a result.

“Future research is needed to examine the implications of the end of emergency allotments in SNAP on child and family food hardship,” the authors concluded, “and to understand strategies to ensure that the potential benefits of such economic support policies are realized for all populations.”

References

1. Austin AE, Sokol RL. Emergency allotments in SNAP and food hardship among households with children. JAMA Netw Open. 2024;7(8):e2428680. doi:10.1001/jamanetworkopen.2024.28680

2. AJMC® staff. A timeline of COVID-19 developments in 2020. The American Journal of Managed Care®. January 1, 2021. Accessed August 19, 2024. https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020

3. Hunger and food insecurity. Feeding America. Accessed August 19, 2024. https://www.feedingamerica.org/hunger-in-america/food-insecurity - :~:text=Causes of food insecurity,-Food insecurity is&text=According to our Elevating Voices,, and low-wage jobs

4. Food insecurity. Health People 2030. Accessed August 19, 2024. https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/food-insecurity#:~:text=Food%20insecurity%20is%20defined%20as,possible%20outcome%20of%20food%20insecurity

5. SNAP – Families First Coronavirus Response Act and impact on time limit for able-bodied adults without dependents (ABAWDs). USDA Food and Nutrition Service. March 20, 2020. Accessed August 19, 2024. https://www.fns.usda.gov/snap/ffcra-impact-time-limit-abawds

6. Restrepo BJ. The protective effect of SNAP during economic downturns: evidence from the COVID-19 pandemic. Appl Econ Perspect Policy. 2023;45(4):2141-2160. doi:10.1002/aepp.13345

7. Sanjeevi N, Monsivais P. Association of emergency allotment discontinuation with household food insufficiency in Supplemental Nutrition Assistance Program participants: a quasi-experimental study. Prev Med. 2023;177:107784. doi:10.1016/j.ypmed.2023.107784