Examining state SNAP policies as a primary prevention strategy for early life exposure to violence and other adverse childhood experiences

项目摘要/摘要 在美国，儿童和青少年接触暴力是一个普遍而紧迫的公共卫生问题。 新出现的研究表明，一种不同形式的经济压力--粮食不安全(即有限或不确定) 获得足够食物)，是多种形式暴力和其他不良童年的风险因素 经验(A)，在美国儿童和青年中。补充营养援助计划(SNAP) 是美国最大的解决粮食不安全问题的计划，而SNAP的规则和法规在很大程度上已经制定 在联邦一级，各州可以选择采用几项SNAP政策，以扩大资格并简化 招生。先前的研究表明，州政府采用这些政策与SNAP的增加有关 参与度和粮食不安全程度的下降。因此，鉴于粮食不安全是暴力的风险因素， 其他ACE，州政府采用扩大资格和简化登记的SNAP政策也可能起到作用 减少儿童和青年接触暴力和其他A级毒品的比率。在家庭压力的指引下 模型中，随着时间的推移，我们将利用州采用特定SNAP资格和登记政策的可变性 审查它们与多种形式的暴力的联系，包括虐待儿童和忽视儿童、青年约会 暴力、青少年和父母自杀行为、亲密伴侣暴力以及其他王牌，包括 父母心理健康和物质使用障碍。我们将使用多种调查和管理数据 来源和纵向、准实验研究设计，以解决这一时期的三个具体目标 2005-2019年：(目标1)审查国家通过SNAP政策扩大资格和 通过早年接触暴力和其他王牌来简化招生；(目标2)评估 州采用SNAP资格和招生政策与早年接触暴力和 其他A在州医疗补助扩大和更高的州最低工资的背景下有所不同；以及(目标3) 评估州采用SNAP资格和登记政策是否与早期生活有关 接触暴力和其他王牌的机会因种族/民族而异。这项拟议的研究将是第一个 检查SNAP资格和注册政策与暴力和其他A级的关联。这 研究具有潜在的翻译影响，通过直接告知我们的理解(目标1)， 在什么情况下(目标2)以及针对哪些人群(目标3)特定的SNAP资格和登记政策 有效地防止早年接触暴力和其他王牌。这项建议是对疾控中心 目标一，因为它将审查改善社会状况的计划的影响，粮食不安全，作为 暴力和其他王牌的一级预防战略。

PROJECT SUMMARY/ABSTRACT Child and youth exposure to violence is a prevalent and pressing public health issue in the United States. Emerging research indicates that a distinct form of economic pressure, food insecurity (i.e., limited or uncertain access to adequate food), is a risk factor for multiple forms of violence, and other adverse childhood experiences (ACEs), among U.S. children and youth. The Supplemental Nutrition Assistance Program (SNAP) is the largest program addressing food insecurity in the U.S. While SNAP rules and regulations are largely set at the federal level, states have the option to adopt several SNAP policies that expand eligibility and simplify enrollment. Prior research indicates that state adoption of these policies is associated with increases in SNAP participation and decreases in food insecurity. Thus, given that food insecurity is a risk factor for violence and other ACEs, state adoption of SNAP policies that expand eligibility and simplify enrollment may also contribute to decreases in rates of child and youth exposure to violence and other ACEs. Guided by the Family Stress Model, we will leverage variability in state adoption of specific SNAP eligibility and enrollment policies over time to examine their association with multiple forms of violence, including child abuse and neglect, youth dating violence, youth and parental suicidal behavior, and intimate partner violence, and other ACEs, including parental mental health and substance use disorders. We will use multiple survey and administrative data sources and a longitudinal, quasi-experimental study design to address three specific aims over the period 2005-2019: (Aim 1) Examine the association of state adoption of SNAP policies that expand eligibility and simplify enrollment with early life exposure to violence and other ACEs; (Aim 2) Assess whether the association of state adoption of SNAP eligibility and enrollment policies with early life exposure to violence and other ACEs differs in the context of state Medicaid expansion and higher state minimum wage; and (Aim 3) Assess whether the association of state adoption of SNAP eligibility and enrollment policies with early life exposure to violence and other ACEs differs by race/ethnicity. The proposed research will be the first to examine the association of SNAP eligibility and enrollment policies with violence and other ACEs. This research has the potential for translational impact by directly informing our understanding of whether (Aim 1), in what contexts (Aim 2), and for which populations (Aim 3) specific SNAP eligibility and enrollment policies are effective in preventing early life exposure to violence and other ACEs. This proposal is responsive to CDC’s Objective One as it will examine the impact of a program that improves a social condition, food insecurity, as a primary prevention strategy for violence and other ACEs.