MedicalResearch.com Interview with:
Allison Bovell-Ammon, M.Div.
Deputy Director of Policy Strategy
MedicalResearch.com: What is the background for this study?
Response: Children’s HealthWatch was founded in 1998 by pediatric providers treating children with failure to thrive in six US cities across the country. They began their research on the health impacts of economic hardships like food insecurity in response to the 1996 welfare reform legislation after witnessing deteriorating health among young children in their clinics as a result of welfare sanctions on families.
Over the years, the scope of the research has expanded to include research on food insecurity, housing instability, energy insecurity, health care hardships, and child care constraints. Through our current network of pediatricians and public health researchers in five US cities (Boston, Baltimore, Little Rock, Minneapolis, and Philadelphia), we seek to improve the health and well-being of children under age 4 and their families by informing policies that address and alleviate economic hardships. Our ongoing data collection in emergency departments and primary care clinics enables us to rapidly respond to emerging public health issues as policies and economic conditions change. While we have produced other papers and analyses specifically addressing health and economic disparities relevant to immigrant families, we were specifically interested in exploring this topic because the clinicians in our group as well as national media began anecdotally reporting that immigrants were forgoing accessing critical public health programs like SNAP out of fear.
MedicalResearch.com: What are the main findings?
Response: Federal policy proposals continue to seek to discourage immigrants, including those with qualified documentation statuses, from participating in the Supplemental Nutrition Assistance Program (SNAP). SNAP is our country’s premier federal program for addressing food insecurity and has been associated with reductions in food insecurity and improvements in health across the life course.
While SNAP eligibility rules remained unchanged during the study period, the preliminary findings demonstrate a drop in participation in SNAP in 2018. The data also highlight disparities between families with immigrant mothers versus those with US born mothers. Since the Great Recession, food insecurity among families with immigrant mothers in the sample had greater increases in food insecurity than families with US born mothers. During the same time period, however, SNAP participation increased at a greater rate among families with US born mothers compared to families with immigrant mothers – more than 90% of whom had US born children who are eligible for SNAP.
MedicalResearch.com: What should readers take away from your report?
Response: Today, given national debates about immigration and actions taken by the federal government it is possible that we are seeing a potential “chilling effect” among low-income immigrant families in the preliminary 2018 data. These families may be proactively dis-enrolling or choosing not to participate in nutrition assistance programs out of fear of deportation or future effects on their immigration status. Previous anecdotal reports from across the country document this chilling effect.
The findings of this study provide preliminary evidence that immigrant mothers of young children in five US cities are participating in SNAP at a lower rate than previous years. This has important implications because it demonstrates that rhetoric and the threat of policy changes, even before changes are enacted, may create fear among immigrant communities. This fear may force them to make agonizing choices between continued enrollment in critical nutrition programs and future immigration status. These trade-offs will likely have a negative effect on health outcomes for children and their families.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This preliminary research underscored the need to look into the trends of utilization for other critical programs including housing subsidies, health insurance, and energy assistance. Additionally, more research is needed to understand the health impacts of what appear to be reductions in program participation among immigrant families, particularly among those most recently arrived.
I have no disclosures to report.
APHA 2018 abstract publication:
Trends in food insecurity and SNAP participation among immigrant families of US born young children Allison Bovell-Ammon, M.Div, Boston Medical Center, Boston, MA, Stephanie Ettinger de Cuba, MPH, Boston University School of Medicine, Boston, MA, Diana Cutts, MD, Hennepin County Medical Center, Minneapolis, MN and Sharon M. Coleman, MS, MPH, Boston University School of Public Health, Boston, MA
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