Impact of Government Nutrition Benefit Program Participation on Children's Health and Healthcare Utilization

项目总结/摘要 粮食不安全（FI）影响了美国近1800万儿童，使他们在 不良健康后果的风险增加，包括身心健康状况不佳，行为问题， 和发育迟缓。患有FI的儿童也不太可能获得预防性护理， 由于成本和急诊科（艾德）增加，延迟医疗护理的发生率增加 利用率FI不成比例地影响黑人和西班牙裔儿童以及移民家庭的儿童， 因此，可能会加剧这些儿童健康和医疗保健利用方面的现有差距。儿童FI 因此，这是卫生系统、支付者和政策制定者寻求增加 获得护理，改善结果，减少可避免的医疗保健利用和成本。政府 营养福利计划，如WIC和SNAP，是FI家庭营养支持的主要来源。 参与这些计划已被证明对健康有益，包括降低早产率和降低 婴儿的出生体重，改善了饮食质量，降低了儿童的FI。然而，只有50%的 符合条件的妇女和儿童目前接受妇女、儿童和儿童保险，只有75-85%的符合条件的家庭接受SNAP。 因此，医疗保健提供者和卫生系统可以减轻儿童FI对健康的负面影响。 通过确定有资格但没有参加WIC或SNAP的家庭，并为他们提供 入学援助。入学援助干预措施有可能提高健康水平， 社会服务整合并为支付者和卫生系统节省跨部门成本。为了 通知设计和实施新颖，有效的入学援助干预措施，有一个关键的 需要（1）描述WIC和SNAP参与对儿童整体健康和获得 医疗保健，（2）表征以下儿童的医疗保健利用模式和医疗保健支出： 有资格获得但未获得WIC和SNAP福利，以确定在何处进行登记干预 应该关注和估计与增加入学率相关的潜在成本节约，以及（3）发展家庭- 在医疗保健环境中提供WIC和SNAP登记帮助的中心战略。具体 本申请的目的是：（1a）检查WIC和SNAP参与和护理人员之间的关联- 报告的儿童健康和获得护理，（1b）检查WIC和SNAP参与之间的关联 和医疗保健利用和支出，以及（2）探讨粮食不安全家庭的感知决定因素 政府福利登记及其对基于健康系统的福利登记的偏好 支持.

PROJECT SUMMARY/ABSTRACT Food insecurity (FI) affects almost 18 million children across the United States, placing them at increased risk of adverse health outcomes including poor physical and mental health, behavioral problems, and developmental delay. Children experiencing FI are also less likely to access preventive care and experience increased rates of delayed medical care due to cost and increased emergency department (ED) utilization. FI disproportionately impacts Black and Hispanic children and children from immigrant families and can therefore exacerbate existing disparities in these children's health and healthcare utilization. Childhood FI therefore represents an important priority for health systems, payers, and policymakers seeking to increase access to care, improve outcomes, and reduce avoidable healthcare utilization and costs. Government nutrition benefit programs, such as WIC and SNAP, are key sources of nutritional support for families with FI. Participation in these programs has proven health benefits, including decreased rates of preterm birth and low birthweight among infants, and improved diet quality and reduced FI among children. However, only 50% of eligible women and children currently receive WIC, and only 75-85% of eligible households receive SNAP. Healthcare providers and health systems could therefore mitigate the negative health impacts of childhood FI by identifying families who are eligible for, but not enrolled in, WIC or SNAP and providing them with enrollment assistance. Enrollment assistance interventions have the potential to both enhance health and social service integration and generate cross-sector cost savings for payers and health systems. In order to inform the design and implementation of novel, effective enrollment assistance interventions, there is a critical need to (1) characterize the impact of WIC and SNAP participation on children's overall health and access to healthcare, (2) characterize healthcare utilization patterns and healthcare expenditures for children who are eligible for, but not receiving, WIC and SNAP benefits, in order to determine where enrollment interventions should focus and estimate potential cost savings associated with increasing enrollment, and (3) develop family- centered strategies for providing WIC and SNAP enrollment assistance in healthcare settings. The specific aims of this application are: (1a) to examine associations between WIC and SNAP participation and caregiver- reported child health and access to care, (1b) to examine the association between WIC and SNAP participation and healthcare utilization and expenditures, and (2) to explore food insecure families' perceived determinants of government benefits enrollment and their revealed preferences for health-system based benefits enrollment support.