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

项目摘要/摘要 食品不安全(FI)影响着全美近1800万儿童，使他们处于 增加不良健康后果的风险，包括身心健康不良、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和 由于费用和急诊科(ED)增加而导致的延迟医疗比率增加 利用率。FI对黑人和西班牙裔儿童以及移民家庭儿童的影响不成比例 因此，这可能会加剧这些儿童在健康和医疗保健利用方面的现有差距。童年小说 因此，对于卫生系统、支付者和政策制定者来说，寻求增加 获得医疗服务，改善结果，并降低可避免的医疗保健利用率和成本。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。 参加这些计划已证明对健康有益，包括降低早产率和低早产率。 减少婴儿出生体重，改善饮食质量，降低儿童的FI。然而，只有50%的人 目前，符合条件的妇女和儿童获得WIC，只有75%-85%的符合条件的家庭获得SNAP。 因此，医疗保健提供者和卫生系统可以减轻儿童肥胖症对健康的负面影响 通过确定有资格但未参加WIC或SNAP的家庭，并为他们提供 招生援助。入学援助干预措施有可能既提高健康水平，又能 社会服务一体化，并为支付者和保健系统节省跨部门成本。为了 通知设计和实施新颖、有效的招生援助干预措施，有一个至关重要的 需要(1)描述WIC和SNAP参与对儿童总体健康和获得 医疗保健，(2)描述以下儿童的医疗保健利用模式和医疗保健支出 有资格但不能获得WIC和SNAP福利，以确定在哪里进行登记干预 应重点关注并估计与增加入学人数相关的潜在成本节约，以及(3)发展家庭- 以战略为中心，在医疗保健环境中提供WIC和SNAP注册援助。具体的 本申请的目的是：(1A)检查WIC和SNAP参与与照顾者之间的关联- 报告的儿童健康和获得护理的机会，(1b)审查WIC和SNAP参与之间的联系 和医疗保健利用和支出，以及(2)探索粮食不安全家庭的感知决定因素 的政府福利登记及其对基于医疗系统的福利登记的显露偏好 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.