Can food assistance influence diabetes trends in the U.S.?

The government-funded Supplemental Nutrition Assistance Program (SNAP) provides food assistance to low-income individuals in the U.S. As the pandemic unfolded, SNAP was crucial in combating food insecurity, the economic and social condition of inadequate access to high quality food on a consistent basis. In 2020, around 40 million low-income individuals received SNAP benefits, up from 35 million in 2019.

Senior citizen wearing a mask holding a shopping basket in a grocery store aisle.

SNAP is an important tool in addressing poverty during times of economic need, but does it affect health as well? Previous studies have suggested that SNAP participants have improvements in self-reported health. Food insecurity has been tied to a number of medical conditions, notably cardiovascular risk factors such as diabetes. Changes in food insecurity levels are even associated with improvements in population-level cardiovascular mortality rates. In a study in Diabetes Care, researchers investigate the relationship between the prevalence of diabetes at the county-level and state SNAP policies, and the findings suggest that SNAP could play a key role in the health of communities.

Understanding the association of food insecurity and food assistance with diabetes is particularly important given the continued rise of diabetes in the U.S. and disproportionate burden that falls upon low-income individuals. As of 2020, more than 1 in 10 adults have diabetes, with the prevalence twice as high among people living in poverty compared to high-income individuals.

Teasing apart the relationship between SNAP participation and diabetes is complicated by the fact that low-income individuals are both more likely to be SNAP participants and have a higher risk of developing diabetes. However, as SNAP is administered by states, each state has some leeway in factors such as determining eligibility, how often participants have to show proof of income, and others related to ease of access. Each of these state-level policies may affect SNAP participation, independent of factors such as income. The researchers took advantage of these state-to-state variations in the number of people participating in SNAP to study the relationship between SNAP and the prevalence of diabetes in a given area. One key takeaway of the study is that states should lower barriers to SNAP participation for eligible people—greater participation in such programs can have important downstream effects on population-level health outcomes.

This story is by Sameed Khatana. Read more at Penn LDI.