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The Supplemental Nutrition Assistance 
Program (SNAP) and Child Health 
 
By Shivani Kuckreja, Ally Pyers, and Carolyn Chelius  
____________________________________________________________________________ 
 
Introduction to SNAP and Child Health  
 
In this paper, we investigate the effects of the Supplemental Nutrition Assistance Program 
(SNAP) on the health of children up to 18 years of age, using data from the Integrated Health Interview 
Series (IHIS). Our research is relevant, for SNAP is the U.S’s largest nutrition assistance program, and 
almost half of all SNAP recipients are children (Keith Jennings). The Supplemental Nutrition 
Assistance Program also aims to increase low income consumers’ access to healthy food. For this 
reason, we are interested in the link between SNAP program participation and child’s health. 
Almost half of SNAP recipients are children (under 18 years of age) and 71% of SNAP benefits 
go to households with children (USDA 2012). Despite the SNAP program’s verbal commitment to 
increase the nutrients available to SNAP recipients, our findings show a negative relationship between 
SNAP recipiency and child health, which aligns with the results of similar studies focused on the 
relationship between SNAP and child health.   
We will begin by detailing the circumstances under which one is considered eligible to receive 
SNAP benefits, and will contextualize SNAP participation rates in America today. Next, we will 
discuss pre­existing literature focused on the relationship between SNAP and child health before 
introducing our descriptive statistics and our regressions. We will end the paper by highlighting any 
potential bias in our results before making our final remarks on our findings.  
 
SNAP Use and Eligibility 
 
SNAP Eligibility  
Eligibility for SNAP varies by state, however, all states’ eligibilities are based upon the following six 
metrics: resources, income, deductions, employment requirements, special rules for elderly or disabled, 
and immigrant eligibility. The metrics are further detailed below. See the Appendix for a flowchart on 
qualification for SNAP.  
 
Metric #1: Resources  
In order to be eligible to receive SNAP benefits, households’ countable resources (such as a bank 
account) may reach a maximum $2,250, or $3,250 if at least one person is elderly (age 60 or older), or 
disabled. SSI, TANF, and pensions are not included in resources. States have differing rules as to 
whether or not vehicles are included as resources. 
 
Metric #2: Income 
Income requirements include both gross and net income. Net income = gross income ​−​ allowable 
deductions (e.g childcare costs, high housing). The gross income must be 130% of poverty and the net 
income must be 100% of poverty in order for one to be eligible for SNAP benefits; for a family of four, 
this means $1,988 or less in monthly net income. Households with an elderly or disabled member only 
need to meet the net income standard in order to be offered SNAP benefits.   
1 
 
 
 
 
Metric #3: Deductions  
Deductions include: 20% earned income, dependent childcare costs (necessary for work), child support, 
medical expenses for elderly and disabled, excess shelter.  
 
Metric #4: Employment Requirements 
Able bodied adults without dependents may only receive SNAP benefits for 3 months in a 36­month 
period if unemployed or not undergoing training. SNAP benefits do not have a time limit for working 
adults as long as the person benefitting still qualifies for SNAP. However, SNAP benefits must be 
renewed after a set amount of time, which varies by state. Most states require renewal after a 12 month 
period for able­bodied adults, 24 month period for elderly, and 36 month period for disabled persons.  
 
Metric #5: Special Rules for Elderly or Disabled Persons 
Described within the other eligibility requirements. Additional special rules are not applicable to our 
study on child health.  
 
Metric #6: Immigrant Eligibility 
Legal immigrants who have lived in the U.S. for five years, are disabled, or are under 18 qualify for 
SNAP benefits.  
 
For various reasons that we explore later in the paper, some people of those eligible to receive 
SNAP benefits opt out of receiving them. Below is a table detailing the number of people who chose to 
receive SNAP benefits between 1969 and 2014.   
 
The table below details SNAP participation and cost between the years of 1969 and 2014. This 
information provides context to the SNAP program’s usage and spending trends overtime.   
 
Supplemental Nutrition Assistance Program Participation and Costs 
(Data as of April 10, 2015) 
       
Average Benefit 
Per Person ​1] 
   
All 
Other 
Costs ​2] 
   
           
Fiscal 
Year 
Average 
Participation 
Total 
Benefits  Total Costs 
    ­­Thousands­­  ­­Dollars­­    ­­­­­­­­­­Millions of Dollars­­­­­­­­­­ 
1970  4,340  10.55  549.70  27.20  576.90 
1980  21,082  34.47  8,720.90  485.60  9,206.50 
1990  20,049  58.78  14,142.79  1,304.47  15,447.26 
2000  17,194  72.62  14,983.32  2,070.70  17,054.02 
2 
 
 
 
2001  17,318  74.81  15,547.39  2,242.00  17,789.39 
2002  19,096  79.67  18,256.20  2,380.82  20,637.02 
2003  21,250  83.94  21,404.28  2,412.01  23,816.28 
2004  23,811  86.16  24,618.89  2,480.14  27,099.03 
2005  25,628  92.89  28,567.88  2,504.24  31,072.11 
2006  26,549  94.75  30,187.35  2,715.72  32,903.06 
2007  26,316  96.18  30,373.27  2,800.25  33,173.52 
2008  28,223  102.19  34,608.40  3,031.25  37,639.64 
2009  33,490  125.31  50,359.92  3,260.09  53,620.01 
2010  40,302  133.79  64,702.16  3,581.78  68,283.94 
2011  44,709  133.85  71,810.92  3,876.25  75,687.18 
2012  46,609  133.41  74,619.34  3,791.70  78,411.05 
2013  47,636  133.07  76,066.32  3,862.83  79,929.15 
2014  46,536  125.35  69,999.81  4,139.90  74,139.71 
All data subject to revision. 
1
1] Represents average monthly benefits per person. 
2] Includes the Federal share of State administrative expenses, Nutrition Education, and Employment and Training programs. Also 
includes other Federal costs (e.g., Benefit and Retailer Redemption and Monitoring, Payment Accuracy, EBT Systems, Program 
Evaluation and Modernization, Program Access, Health and Nutrition Pilot Projects). 
3] Puerto Rico initiated Food Stamp operations during FY 1975 and participated through June of FY 1982. A separate Nutrition 
Assistance Grant began in July 1982 . 2
 
Literature on SNAP and Child Health   
 
There is a large amount of literature on the topic of the effects of the SNAP program on child 
health, both in academic and everyday forums. The change from the “Food Stamp Program” to the 
“Supplemental Nutrition Assistance Program” in 2008 (USDA 2012) has motivated many to study the 
relationship between SNAP and health, particularly for children. Many academics focus on the 
relationship between SNAP recipiency and obesity.  
In their paper “The Effects of Childhood SNAP Use and Neighborhood Conditions on Adult 
Body Mass Index”, Thomas P. Vartanian and Linda Houser analyze the effects of child SNAP 
recipiency and the neighborhoods they grow up in on adult body mass index, and find a positive 
correlation between SNAP recipiency and adult BMI. In his paper, “The Effect of SNAP and WIC 
1
 ​Supplemental Nutrition Assistance Program (SNAP), ​United States Department of Agriculture, accessed April 14, 
2015, ​http://www.fns.usda.gov/pd/supplemental­nutrition­assistance­program­snap​.  
2
​Supplemental Nutrition Assistance Program (SNAP), ​United States Department of Agriculture, accessed April 14, 
2015, ​http://www.fns.usda.gov/pd/supplemental­nutrition­assistance­program­snap​.  
3 
 
 
 
Programs on Nutrient Intakes of Children,” Steven Yen analyzes the effect of participating in SNAP on 
the nutrients in children’s diets. He concludes that participation in SNAP has negligible effects on child 
health once children are already participating in WIC.  
However, not all academics are in agreement that SNAP and obesity are positively correlated. 
Rebecca Burgstahler argues in “The Supplemental Nutrition Assistance Program, Financial Stress, and 
Childhood Obesity” that when controlling for income, obesity and SNAP recipiency are negatively 
related. Similarly, research by the Center on Budget Policy Priorities and the Economic Research 
Service (ERS) claims that “children in families receiving SNAP are less likely to be underweight or at 
risk of developmental delays than children in households that are eligible for, but not receiving, SNAP” 
(Keith Jennings). ERS studies support a relationship between SNAP participation and households’ 
overall dietary quality, as measured by the USDA Healthy Eating Index. Children, in particular, who 
participate in SNAP, report lower levels of nutrition deficiencies, and have higher levels of essential 
vitamins and minerals (Snap to Health). In November of 2012, Hilary Hoynes, Diane Whitmore 
Schanzenbach, and Douglas Almond reported that “access to food stamps in utero and in early 
childhood leads to significant reductions in metabolic syndrome conditions (obesity, high blood 
pressure, heart disease, diabetes) in adulthood” (Hoynes, ​et al. ​2012). 
The relationship between SNAP and health is also prevalent in the everyday media. Just this 
month, an article in the Huffington Post, titled “Food Stamp Recipients More Likely To Be Obese, 
Study Finds,” cited a recent study by the USDA that showed SNAP recipients were about 8% more 
likely to be obese than U.S citizens  that qualified for, but did not receive SNAP benefits. The article 
points toward less healthy diets (particularly empty caloric consumption through soda) as the main 
cause.  
The relationship between SNAP and health is particularly relevant from a policy perspective, as 
there is an ongoing debate as to whether or not to restrict which foods can be purchased with SNAP 
benefits. Currently SNAP benefits can be used to purchase all groceries except prepared meals.  3
However, many policymakers feel SNAP should be remodeled to more closely mirror WIC ­­ a 
governmental program specifically targeted for women and children that restricts benefits to only 
healthy food options.  In this paper, we build off of previous literature regarding SNAP and child health 4
to explore the question of whether restricting the foods that SNAP benefits can buy is an appropriate 
policy to pursue to decrease childhood obesity and improve child health.  
 
Data and Descriptive Statistics   
 
Data from the Integrated Health Interview Series (IHIS) was analyzed in this study. The IHIS 
was funded through the National Institute of Child Health and Development and harmonizes data from 
the United States National Health Interview Survey (NHIS) in order to allow samples from different 
years to be combined. This study uses samples from 2002, 2010, and 2013 in order to maintain an 
adequate sample size for all regressions. 
Each sample is composed of individual­level data collected by surveying a given household 
member about the other members of their household. Since SNAP eligibility is determined using a 
variety of household­level factors,  several measures were recoded to indicate whether anyone in the 5
child’s ​household​ fit into a given category, rather than the children themselves (e.g. the proportion of 
employed adults in the household, and whether everyone living in the household was a citizen of the 
United States). 
3
 ​SNAP benefits also exclude purchasing of alcohol, tobacco, and restaurant foods. 
4
 ​“Healthy” indicates the products available to WIC recipients must comply with USDA Dietary Guidelines.  
5
 See Appendix. 
4 
 
 
 
 
Table 1: IHIS Dataset Variable Descriptions: 
 
Dependent Variable  Variable Description 
bmikidrec  Body Mass Index (BMI) for children between 12 and 17 years of age, 
calculated from responses from height and weight questions in the IHIS. 
Recoded to adjust for missing values, and multiplied by 0.01 for 
readability, since results were reported as BMI multiplied by a factor of 
100 (e.g. a BMI of 25.00 was reported as 2500). 
healthrec  Self­reported health on a five­point scale, with 5= “Excellent,” 4= “Very 
Good,” 3= “Good,” 2= “Fair,” and 1= “Poor.” Recoded from IHIS which 
reported 5 as “Poor” and 1 as “Very Good,” and recoded to adjust for 
missing values.  
prescriptionmed  Indicator variable coded as 1 if a child needed prescription medication in 
the past three months, and coded as 0 if a child did not need prescription 
medication in this time period. Recoded to adjust for missing values. 
sldayrrec  Number of days that a child missed school in the past twelve months. 
Recoded to adjust for missing values, including marking the 173 children 
who did not attend school in the past twelve months as missing. 
Responses are highly skewed to the right, with slight clustering around 
multiples of five. 
Independent Variable  Variable Description  
chsupfam  Indicator variable coded as 1 if anyone in the child’s household received 
income from child support in the previous calendar year, and coded as 0 
if no one in the household received income from child support in the 
previous calendar year.  
citizenfam  Indicator variable coded as 1 if all members of the child’s household are 
citizens of the United States, and coded as 0 if not all members of the 
household are citizens of the United States. 
citizenrec  Indicator variable coded as 1 if the child is a citizen of the United States, 
and coded as 0 if the child is not a citizen of the United States. 
disabfam  Indicator variable coded as 1 if anyone in the child’s household received 
SSI due to disability, and coded as 0 if no one in the household received 
SSI due to disability. 
elderfam  Indicator variable coded as 1 if anyone in the child’s household is 60 
years of age or older, and coded as 0 if everyone in the household is 
under 60 years of age.   
5 
 
 
 
female  Indicator variable coded as 1 if the individual is female, and coded as 0 if 
the respondent is male. Recoded from the IHIS variable “sex,” which 
coded male as 1 and female as 2, and recoded to adjust for missing 
values. 
foodinsec  Indicator variable coded as 1 if the individual’s household was 
“sometimes” or “often” worried that they would run out of food in the 
past 30 days, and coded as 0 if the individual’s household was “never” 
worried that they would run out of food in the past 30 days. 
gotstampfamrec  Indicator variable coded as 1 if any family member in the household 
received Food Stamps (SNAP) in the last calendar year. Recoded to 
adjust for missing values. 
headstarevrec  Indicator variable coded as 1 if the child ever attended a Head Start 
program, and coded as 0 if the child did not ever attend such a program. 
Recoded to adjust for missing values. 
homeowner  Indicator variable coded as 1 if the child’s family owns their home, and 
coded as 0 if the child’s family does not own their home. 
povline15  Indicator variable coded as 1 if the household’s income is above 150% of 
the poverty level, and coded as 0 if the household’s income is below 
150% of the poverty level. Recoded to adjust for missing values. 
workfam  Proportion of adults age 18­60 in the child’s household who were 
employed (working in the past two weeks at the time of the survey). 
 
 
   
6 
 
 
 
Table 2: Descriptive Statistics for Sample of Children 18 Years or Younger (n = 80,876) 
 
Variable  n  Mean  Std. Dev.  Min  Max 
bmikidrec  7997  22.429  4.971  7.97  57.63 
chsupfam  80876  0.133  0.339  0  1 
citizenfam  80876  0.771  0.420  0  1 
citizenrec  80566  0.957  0.202  0  1 
disabfam  80876  0.046  0.209  0  1 
elderfam  80876  0.072  0.259  0  1 
female  80876  0.486  0.500  0  1 
foodinsec  28022  0.242  0.429  0  1 
gotstampfamrec  79144  0.231  0.422  0  1 
headstarevrec  73092  0.194  0.396  0  1 
healthrec  80749  4.320  0.839  1  5 
homeowner  79415  0.585  0.493  0  1 
povline15  214772  0.717  0.451  0  1 
prescriptionmed  36642  0.130  0.337  0  1 
sldayrrec  25604  3.554  6.937  0  240 
workfam  79533  0.723  0.339  0  1 
   
7 
 
 
 
Table 3: Means of Dependent Variables for Children in Treatment and Control Groups 
 
 
 
Variable 
Families Not Receiving SNAP  Families Receiving SNAP 
Mean  Std. Deviation  Mean  Std. Deviation 
healthrec  3.916  1.032  3.465  1.212 
bmikidrec  22.396  5.040  23.460  5.821 
sldayrrec  3.581  6.934  5.061  9.876 
prescriptionmed  0.128  0.335  0.167  0.373 
 
Modeling the Effects of SNAP Uptake on Child Health 
 
To begin our analysis, we ran simple linear regressions of our child health variables on our 
independent variable of interest, ​gotstampfamrec​. ​gotstampfamrec​ is an indicator variable coded as 1 if 
any family member in the household received SNAP benefits in the last calendar year and as 0 if no 
family member in the household received SNAP benefits in the last calendar year. We chose four 
metrics to measure child health: the child’s health on a scale of 1­5 reported by the survey respondent 
(​healthrec​), the child’s body mass index (​bmikidrec​), whether the child needed prescription medication 
in the last three months (​prescriptionmed​), and the number of school days the child had missed in the 
past year (​sldayrrec​). 
As shown in Table 3, children whose families received SNAP had a wider spread of results for 
all four of our health indicators. On average, this group had lower self­reported health (closer to 
“Good” than “Very Good”), had higher body mass indexes, missed more days of school, and was more 
likely to have needed prescription medication in the past three months. We began with these simple 
regressions in order to highlight the relationship ­ albeit an extremely positively biased relationship ­ 
that we suspect exists between SNAP receipt and child health outcomes. 
 
Four Regression Models 
healthrec=B​0​+B​1​(gotstampfamrec)+ E​i​; 
bmikidrec=B​0​+B​1​(gotstampfamrec)+ E​i​;  
prescriptionmed=B​0​+B​1​(gotstampfamrec)+ E​i​;  
sldayrrec=B​0​+B​1​(gotstampfamrec)+ E​i   
 
   
8 
 
 
 
Table 4: Simple Regression Results 
 
 
We found that SNAP receipt had a significant effect on all four of our health variables. Our 
model predicts that children whose families received any SNAP benefits have self­reported health 
0.342 points lower than children whose families do not receive SNAP, have body mass indexes 1.096 
points higher than children whose families do not receive SNAP, are 3.4% more likely to have needed 
prescription medication in the past three months, and have missed about one more day of school in the 
past year. All four of these results demonstrate negative health effects for children whose families 
receive SNAP. However, since various factors that could also influence health outcomes also influence 
SNAP uptake, we cannot assume that this is a causal relationship. Additionally, our R​2​
 values for these 
models indicate that the variation in SNAP receipt only accounts for 0% to 1% of the variation in the 
health variables, which indicates that these models are poorly fit to the data. While it is clear that 
children in families that receive SNAP have poor health outcomes in relation to children in families that 
do not receive SNAP, it is unclear what portion of these poor outcomes stems from background 
characteristics and what portion stems from SNAP receipt itself. In order to create a more powerful 
model, we must control for additional variables. 
 
Multiple Regression 
 
In our second round of analysis, we ran regressions that account for metrics used to assess 
SNAP eligibility, as well as other variables that may be correlated with both health outcomes and 
SNAP uptake. 
Several of these metrics and variables were modified to be applicable to the children in our 
sample. We chose this family­based approach because if a person in the child’s household fits into 
these categories, there is a chance that the child’s health and well­being would be affected. Children 
with an elderly person in their household may indirectly benefit from programs designed to help the 
elderly, and children living in households in which most of the adults are employed may have different 
health outcomes than children in households in which few adults are employed. Thus, our second round 
of regressions includes variables indicating whether anyone in the child’s household received income 
from child support (​chsupfam​), whether everyone in the child’s household was a citizen of the United 
States (​citizenfam​), whether the child themself was a citizen of the United States (​citizenrec​), whether 
anyone in the child’s household received SSI payments due to disability (​disabfam​), whether anyone in 
the child’s household was over 60 years old (​elderfam​), and the proportion of adults in the child’s 
household who were employed for the past two weeks (​workfam​). 
We controlled for the sex of the child (​female​) since there may be gender differences in health 
outcomes. We also controlled for whether the child’s family owned their own home (​homeowner​) and 
for whether the child’s household income was above or below 150% of the poverty level (​povline15​), 
since wealth and income can affect health outcomes. The value of 150% was selected to approximate 
9 
 
 
 
the gross household income level for SNAP eligibility, 130% of the poverty level. As well, we included 
a measure for household food insecurity (​foodinsec​) and a measure for whether a child had ever been 
enrolled in a Head Start program (​headstarevrec​), both of which could potentially correlate with health 
outcomes and with SNAP uptake. 
Table 5 gives our results for these multiple regressions. With the control variables included, 
SNAP uptake still has a significant effect on self­reported health and missed days of school, but the 
magnitude of the effect is smaller than the magnitude of the effect in the simple regression, since our 
controls are accounting for the simple model’s bias. Additionally, when the control variables are 
included, SNAP uptake no longer has a significant effect on a child’s BMI or the likelihood that a child 
would have needed prescription medication. These results suggest that BMI and prescription 
medication use are closer linked to background characteristics of the child than to SNAP uptake by the 
child’s family. 
In our health status regression, once our controls were added to the model, the magnitude of the 
effect of SNAP uptake on child health shrunk drastically. Respondents in families receiving SNAP 
reported children’s health only 0.089 points lower, on average, than respondents in families that did not 
receive SNAP, as opposed to 0.342 points lower in the simple model. This suggests that our results in 
the simple model were biased by some of the variables we are controlling for. The variable with the 
largest effect on child health was whether anyone in the household was receiving SSI payments related 
to a disability; respondents in these households rated their children’s health 0.307 points lower on 
average than respondents from other households did. Children in food insecure households, children in 
households where someone received child support, and children who attended Head Start programs 
were also were reported to have lower health (0.198, 0.054, and 0.146 points lower, respectively). 
Children living in households where everyone was a citizen were reported to have higher health than 
children living with non­citizens (0.117 points higher), yet children who were citizens were reported to 
have slightly lower health than children who were noncitizens (0.091 points lower). Children living 
above 150% of the poverty level were reported to have higher health than children living below 150% 
of the poverty level (0.093 points higher), and children in households where all of the adults were 
working were reported to have slightly higher health than children in households where fewer adults 
were working (0.036 point difference between 0% of adults working and 100% of adults working).  
Our second model did not find a significant relationship between SNAP uptake and children’s 
BMI. However, the four significant variables in our BMI model highlight how poorer children tend to 
have higher BMIs. Children in food insecure households had BMIs 0.504 points higher than children in 
food secure households, children who had been enrolled in Head Start programs had BMIs 0.379 points 
higher than children who did not, and children living above 150% of the poverty line had BMIs 0.551 
points lower than poorer children. Additionally, children living in households where someone received 
SSI payments related to a disability were predicted to have BMIs 0.979 points higher than children in 
other households. It is possible that children in these households may be less active, as they may care 
for or spend time with the disabled family member in lieu of physical activity. No other variables in 
this model had a significant impact on children’s BMI. 
We also did not find a significant relationship between SNAP uptake and whether a child 
would have needed prescription medication in the past three months. Children in families in which 
someone received SSI payments due to a disability were 13.8% more likely to have needed prescription 
medication, which may imply a condition running in the family, or simply being part of a family that 
visits a doctor more often. Children in families receiving child support were 4.9% more likely to have 
needed prescription medication than other children, and children in households where everyone was a 
citizen were 6.3% more likely to have needed prescription medication. Both children in food insecure 
households and children who attended Head Start programs were 4.4% more likely to have needed 
prescription medication, and children living above 150% of the poverty level were 2.3% more likely to 
10 
 
 
 
have needed prescription medication than children living below this level. Female children were 2.8% 
less likely to have needed prescription medication than male children, and children in households 
where all adults worked were 3.2% less likely to have needed prescription medication than children in 
households where no adults worked. 
Finally, our fourth model found a significant relationship between SNAP uptake and the 
number of school days a child missed per year. Children in families receiving SNAP missed 0.875 
more days of school per year than children whose families did not receive SNAP. Children in 
households where everyone was a citizen missed 0.899 more days than children in households with 
non­citizens, children in food insecure households missed 0.976 more days than children in food secure 
households, children living above 150% of the poverty level missed 0.495 more days than children 
living below this level, and children in households where anyone was receiving SSI payments due to a 
disability missed 1.102 more days than children in other households. Children in families where all the 
adults were working missed 1.002 fewer days of school than children in households where no adults 
worked, likely due to a lack of available child care for sick children during school hours. 
Two variables had zero significant effects on any of our variables of interest: the presence of an 
elder in the household and home ownership status. Since only 7.2% of children in our sample lived in 
households where an elder was present, the lack of significant findings may stem from high variation 
within the comparatively small sample, as elders may be living in the same households as children for a 
wide variety of reasons. Additionally, the effects of family homeownership status on child health may 
be encompassed within the more general effects of poverty and income levels on child health. 
11 
 
 
 
  12 
 
 
 
Results and Bias  
 
There are several demographic characteristics that could influence both child health and SNAP 
eligibility. For one, children in lower­income families may have limited access to health services, and 
thus poorer health. Income levels directly relate to SNAP eligibility, but families living in more 
extreme poverty may have different health outcomes than do families with slightly higher incomes. The 
significant effects of income­linked variables, such as income below 150% of the poverty level and 
food insecurity, may help to explain why SNAP uptake did not have a significant effect on BMI and 
prescription medication use in our models. 
As mentioned earlier, in their paper “The Effects of Childhood SNAP Use and Neighborhood 
Conditions on Adult Body Mass Index”, Thomas P. Vartanian and Linda Houser find a positive 
correlation between SNAP recipiency and adult BMI. Because we were unable to find county­level 
data, we had trouble accounting for the influence of the neighborhood that a child lives in on child 
health. It is important to account for neighborhoods because neighborhoods can influence what and 
how much a child eats, how much a child exercises and in which ways a child exercises, and what type 
of environmental pollution a child may encounter that hinders him or her from spending time outside. 
Additionally, although our research question focuses exclusively on SNAP, we recognize that 
additional government programs may also impact child health. Head Start, which targets low­income 
children’s social, health, and cognitive development, is one such program. We included Head Start 
enrollment in our model to stand in for the effects of enrollment in a variety of additional government 
programs that may correlate with enrollment in SNAP. 
The price of “healthier” foods has also risen in the past thirty years, as depicted by the graph 
below. The prices of cake, cupcakes, cookies, other sugars and sweets, and alcoholic beverages have 
increased but not as much as have the prices of fresh fruits and vegetables, which leads many to argue 
that healthy food has become unaffordable for many SNAP recipients and people of lower 
socioeconomic status. We were unable to account for this price increase of fruits and vegetables in our 
regressions, which could lead to an over­estimated coefficient.   
 
   
(Schanzenbach 2013) 
13 
 
 
 
 
Furthermore, we could not account for the fact that healthier food often takes longer to prepare 
than does unhealthy food, and that many parents of lower socioeconomic status may be too busy 
working many jobs to spend time preparing healthy food for their children. As the table below 
highlights, time allotted for food preparation has decreased overtime, which, as David Cutler ​et al. 
argues, has contributed to the obesity epidemic, however we could not account for the decrease in 
available meal preparation time in our regression.   
   
 
(David Cutler,​ et al.​, 2015) 
 
With the data available to us, we also could not account for the change in SNAP benefit 
transactions in the year 2008. Prior to 2008, SNAP recipients needed to present coupons at the counter 
in order to receive items, thus many people felt “too proud” (NPR 2013) to take advantage of food 
stamps, as coupons made it quite obvious who was on food stamps and who was not. In 2008, SNAP 
recipients were granted the right to obtain SNAP benefits via credit card, or electronic benefit transfer 
(EBT). With this change in transaction method, the transaction of using SNAP benefits to purchase 
food mimics the transaction required for anyone without SNAP benefits to purchase food. Because 
those who are eligible for SNAP feel they can now take advantage of SNAP without the associated 
stigma, SNAP recipiency has increased since 2008. The change in the demographic of people that now 
take up SNAP that didn’t prior to 2008 may be associated with certain behaviors that are also related to 
health. This may may confound the magnitude of the relationship we find between SNAP and child 
health.   
Additional confounds to our model include access to physical education in schools, 
environmental factors in the surrounding communities (secondhand smoke exposure, presence of waste 
disposal sites, buildings with lead paint in the neighborhood, etc.), and certain genetic traits. All three 
of these confounds could influence health outcomes, and could also influence SNAP eligibility, as the 
former two may be common in poorer neighborhoods, and medical bills for the latter could decrease 
monthly household income. While we cannot account for all confounds in our model, the IHIS sample 
size is large enough and diverse enough that any variation in these variables should balance out.  
  
14 
 
 
 
Conclusions 
 
Our results contribute to the highly debated question of the effect of SNAP on health, but 
unsurprisingly do not offer concrete answers as to the sign and magnitude of this relationship. Our 
results show a negative relationship between SNAP recipiency and child health, which decreases in 
magnitude after controlling for other confounding variables, specifically variables that help decide 
whether or not one is eligible for SNAP. This was intended to isolate the effect of SNAP on child 
health, and not include the influence of other factors that might also be related to both SNAP recipiency 
and health (e.g. income, whether or not a household member is disabled.)   
  If we have effectively controlled for other confounding variables, our results suggest that 
participation in the SNAP program does not lead to a healthier outcome, and the program should be 
reformed to ensure that it more closely aligns with the aim of providing low income families with 
supplemental ​nutrition​ assistance. However, it is very possible (given the low magnitude of the 
coefficients) that our results are biased, as is discussed in detail above.  
Our results are consistent with literature that shows a negative relationship between child health 
and SNAP (Vartanian and Houser) but contradict literature that argues a positive relationship (Hoynes, 
ERS). Our study also shows that the effect of SNAP recipiency on BMI is not statistically significant, 
which contradicts Vartanian and Houser’s main finding, and one of the key questions of our study­­ 
whether SNAP recipiency is correlated with obesity.  
It is unsurprising that we did not find a strong positive correlation between SNAP recipiency 
and BMI (obesity), for there is an equal amount of literature that suggests the relationship is in the 
opposite direction.   
While our study intends to add to the discourse on changing SNAP policy, the low values of 
our coefficients are too low for us to make make policy recommendations with significant conviction. 
We would want to see a statistically significant result between SNAP recipiency and BMI in order to 
suggest whether or not the SNAP program should be reformed, such as restricting purchases to healthy 
food.  
Our study highlights the complex relationship between child health and SNAP recipiency, and 
underlines the challenges in creating health policy.   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
15 
 
 
 
Appendix 
Flow Chart on Snap Eligibility  
 
 
16 
 
 
 
Food Preparation Times by Demographic Group   
 
(David Cutler,​ et al.​, 2015) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
17 
 
 
 
Citations 
 
 
David M. Cutler, Edward L. Glaeser and Jesse M. Shapiro. "Why Have Americans Become More Obese?" 
N.p., 2003. Web. 15 May 2015. 
 
Hilary W. Hoynes, Diane Whitmore Schanzenbach, Douglas Almond. "LONG RUN IMPACTS OF 
CHILDHOOD ACCESS TO THE SAFETY NET." (n.d.): n. pag. Nov. 2012. Web. 15 May 2015. 
 
Minnesota Population Center and State Health Access Data Assistance Center, ​Integrated Health Interview 
Series:  Version 5.0.​  Minneapolis: University of Minnesota, 2012. Web. 15 May 2015. 
https://www.ihis.us 
 
Schanzenbach, Diane. "Strengthening SNAP for a More Food­Secure, Healthy America." (n.d.): n. pag. Dec. 
2013. Web. 15 May 2015. 
 
"Signing Up For Food Stamps: The Choice And The Stigma." NPR. NPR, 25 Apr. 2013. Web. 15 May 
2015. 
 
United States Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis. 
"Building a Healthy America: A Profile of the Supplemental Nutrition Assistance Program." (2012). 
Apr. 2012. Web. 15 May 2015. 
 
"What's Behind the Rise in SNAP Participation?" USDA ERS ­. N.p., 01 Mar. 2012. Web. 15 May 2015. 
18 
 
 
 

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