Effects of the Supplemental Nutrition Assistance Program on racial/ethnic and disability-based healthcare disparities

补充营养援助计划对种族/族裔和基于残疾的医疗保健差异的影响

基本信息

批准号：
10310517
负责人：
Rajan Anthony Sonik
金额：
$ 50.62万
依托单位：
ALTAMED HEALTH SERVICES CORPORATION
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-13 至 2023-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10310517
关键词：
Accounting Acute Address Affect Area Blood Glucose Budgets Caring Chronic Clinical Data Disabled Persons Disease Management Economics Eligibility Determination Emergency Care Emergency department visit Ethnic Origin Evaluation Event Expenditure Face Food Goals Growth Health Health Expenditures Health Status Hospitalization Housing Individual Institute of Medicine (U.S.)Link Literature Massachusetts Measures Medicaid Medical Methodology Methods Minority Modeling Natural experiment Outcome Outpatients Persons Pharmaceutical Preparations Policies Population Population Programs Prevention Preventive Preventive healthcare Public Health Race Research Support Secure Statutes and Laws Strategic Planning System Time United States United States National Institutes of Health Visit Work base care outcomes compliance behavior cooking disability disorder prevention ethnic minority ethnic minority population experience food insecurity food resource health care disparity health care service utilization health data health disparity improved inpatient service medication compliance nutrition operation programs racial and ethnic racial population safety net social socioeconomics trend

项目摘要

Project Summary/Abstract This project will examine the impact of losing Supplemental Nutrition Assistance Program (SNAP) benefits on healthcare outcomes and healthcare disparities based on race/ethnicity and disability. Racial/ethnic minorities and people with disabilities experience healthcare disparities in the areas of disease prevention and management, unfavorable clinical events, and acute healthcare expenditures. Food insecurity may affect these disparities: food insecure individuals forgo needed care and medications more often, use emergency and inpatient care more often, and require higher expenditures than food secure individuals. Meanwhile, racial/ethnic minorities and people with disabilities are 2.2 and 2.8 times as likely to be food insecure as non- minorities and people without disabilities, respectively, face starker tradeoffs between food and resources such as housing, and have greater sensitivity to food insecurity given greater economic and health vulnerabilities. SNAP has been shown to reduce food insecurity and is disproportionately utilized by racial/ethnic minorities and people with disabilities. SNAP policy changes could therefore affect healthcare outcomes for racial/ethnic minorities and people with disabilities in different ways than for others. For example, initial studies by our team and others suggest SNAP may reduce poor healthcare outcomes and Medicaid expenditures, particularly for people with disabilities. However, these studies were limited to population-level or cross- sectional data, and all studied non-random changes to SNAP. Further, no studies have examined the effects of SNAP on healthcare disparities empirically. In this project, we exploit a natural experiment in which arbitrary errors in the Massachusetts eligibility evaluation system caused 75,200 SNAP recipients to receive arbitrary terminations despite actually still being eligible. Moreover, because of recent legislation in the state, we will have access to comprehensive longitudinal SNAP, medical claims, and other public health data on the entire state population. Using these linked data and growth curve modeling, we will examine the impact of losing SNAP benefits on healthcare outcomes and disparities related to disease prevention and management (Aim 1), unfavorable clinical events (Aim 2), and healthcare expenditures (Aim 3). We hypothesize SNAP losses are associated with worse healthcare outcomes and elevated racial/ethnic and disability-based disparities. Cuts to SNAP benefits are routinely debated, but there is limited information on how benefit losses for current recipients would affect healthcare outcomes. Our study will help fill this gap. More broadly, programs like SNAP target determinants of health and healthcare disparities, yet their potential effects on these outcomes have received minimal study. By adding to this literature, our analyses will further the NIH Health Disparities Strategic Plan’s goal of supporting “research on the factors underlying health disparities.”

项目概要/摘要该项目将研究失去补充营养援助计划 (SNAP) 的影响基于种族/民族和残疾的医疗保健结果和医疗保健差异的好处。少数族裔和残疾人在疾病预防和治疗方面存在医疗保健差异管理、不利的临床事件和严重的医疗保健支出可能会影响这些。差异：粮食不安全的个人更频繁地放弃所需的护理和药物，使用紧急和与粮食安全个人相比，住院治疗更频繁，并且需要更高的支出。少数种族/族裔和残疾人面临粮食不安全的可能性是非少数族裔/族裔和残疾人的 2.2 倍和 2.8 倍。少数民族和非残疾人分别面临着食物和资源之间更严峻的权衡由于经济和健康方面的脆弱性更大，因此对粮食不安全更加敏感。 SNAP 已被证明可以减少粮食不安全，并且被种族/族裔不成比例地利用因此，少数民族和残疾人的 SNAP 政策变化可能会影响医疗保健结果。以与其他人不同的方式对少数族裔/族裔和残疾人进行研究，例如，初步研究。我们的团队和其他人建议 SNAP 可以减少不良的医疗保健结果和医疗补助支出，然而，这些研究仅限于人群水平或跨群体。截面数据，以及所有研究的 SNAP 的非随机变化此外，没有研究检验 SNAP 的影响。 SNAP 对医疗保健差异的实证研究在这个项目中，我们利用了一个自然实验，其中任意。马萨诸塞州资格评估系统的错误导致 75,200 名 SNAP 受益人收到任意尽管实际上仍然符合资格，但由于该州最近的立法，我们将终止。可以获得全面的纵向 SNAP、医疗索赔和整个整体的其他公共卫生数据使用这些关联数据和增长曲线模型，我们将研究失去人口的影响。 SNAP 对医疗保健结果的益处以及与疾病预防和管理相关的差异（目标 1)、不利的临床事件（目标损失 2）和医疗保健支出（目标 3）。与较差的医疗保健结果以及种族/民族和残疾差异的扩大有关。削减 SNAP 福利经常引起争论，但关于福利损失如何影响的信息有限。目前的受益人将影响医疗保健结果，更广泛地来说，我们的研究将有助于填补这一空白。 SNAP 目标是健康和医疗保健差异的决定因素，但它们对这些因素的潜在影响通过添加这些文献，我们的分析将进一步推动 NIH 健康。差异战略计划的目标是支持“健康差异背后因素的研究”。