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- Title
Association of State Expansion of Supplemental Nutrition Assistance Program Eligibility With Rates of Child Protective Services–Investigated Reports.
- Authors
Austin, Anna E.; Shanahan, Meghan E.; Frank, Madeline; Naumann, Rebecca B.; McNaughton Reyes, H. Luz; Corbie, Giselle; Ammerman, Alice S.
- Abstract
This cross-sectional study examines the association of expansion of Supplemental Nutrition Assistance Program (SNAP) eligibility by US states with changes in the rates of child protective services–investigated reports for suspected neglect and physical abuse of children. Key Points: Question: Is state adoption of policies that expand Supplemental Nutrition Assistance Program (SNAP) eligibility by eliminating the asset test or increasing the income limit associated with changes in the rates of child protective services (CPS)–investigated reports for suspected abuse and neglect? Findings: In this cross-sectional ecologic study of 29 213 245 CPS-investigated reports, state elimination of the asset test for SNAP eligibility, increase in the income limit for SNAP eligibility, or adoption of both policies were associated with decreases in rates of CPS-investigated reports overall and CPS-investigated reports for neglect. State increases in the income limit or adoption of both policies were associated with decreases in rates of CPS-investigated reports for physical abuse. Meaning: Results from this study suggest that state adoption of policies that increase the number of families eligible to receive food-purchasing assistance through SNAP may contribute to reductions in CPS-investigated reports. Importance: States in the US have the option to eliminate the asset test and/or increase the income limit for Supplemental Nutrition Assistance Program (SNAP) eligibility under a policy called broad-based categorical eligibility (BBCE). Given associations of economic hardships, including food insecurity, with child protective services (CPS) involvement, state adoption of these policies may be associated with changes in rates of CPS-investigated reports. Objective: To examine the association of state elimination of the asset test and increases in the income limit for SNAP eligibility under BBCE with rates of CPS-investigated reports. Design, Setting, and Participants: This cross-sectional ecologic study used data from 2006 to 2019 obtained from the SNAP Policy Database and the National Child Abuse and Neglect Data System Child Files and difference-in-differences analyses. The data were analyzed from March to September 2022. The study used CPS-investigated reports for suspected child abuse and neglect from 37 US states to examine elimination of the asset test, from 36 states to examine increases in the income limit, and from 26 states to examine adoption of both policies. Exposures: State elimination of the asset test, increases in the income limit, and adoption of both policies to expand SNAP eligibility. Main Outcomes and Measures: Number of CPS-investigated reports, overall and specifically for neglect and physical abuse, per 1000 child population. Results: From 2006 to 2019 for all 50 states and the District of Columbia, there were a total of 29 213 245 CPS-investigated reports. By race and ethnicity, 19.8% of CPS-investigated reports were among non-Hispanic Black children and 45.7% among non-Hispanic White children (hereafter referred to as Black and White children). On average, there were 8.2 fewer CPS-investigated reports (95% CI, −12.6 to −4.0) per 1000 child population per year in states that eliminated the asset test, 5.0 fewer CPS-investigated reports (95% CI, −10.8 to 0.7) per 1000 child population per year in states that increased the income limit, and 9.3 fewer CPS-investigated reports (95% CI, −15.6 to −3.1) per 1000 child population per year in states that adopted both SNAP policies than there would have been if these states had not adopted these policies. There were decreases in CPS-investigated reports for neglect in states that adopted either or both policies, and small decreases in CPS-investigated reports for physical abuse in states that increased the income limit or adopted both policies. There were decreases in CPS-investigated reports among both Black and White children. For example, there were 6.5 fewer CPS-investigated reports among Black children (95% CI, −14.6 to 1.6) and 8.7 fewer CPS-investigated reports among White children (95% CI, −15.8 to −1.6) in states that adopted both SNAP policies than there would have been if these states had not adopted these policies. Conclusions and Relevance: Results from this cross-sectional study suggest that state expansion of SNAP eligibility through elimination of the asset test and increases in the income limit may contribute to decreases in rates of CPS-investigated reports. These results can inform ongoing debates regarding SNAP policy options, specifically BBCE, and prevention efforts for child abuse and neglect.
- Subjects
FOOD relief; CONFIDENCE intervals; FOOD security; CROSS-sectional method; ECOLOGICAL research; SOCIOECONOMIC factors; ELIGIBILITY (Social aspects); CHILD welfare; DESCRIPTIVE statistics; RESEARCH funding
- Publication
JAMA Pediatrics, 2023, Vol 177, Issue 3, p294
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2022.5348