Population level Determinants of SNAP Participation Patterns among Residents of North and South Carolina

Population level Determinants of SNAP Participation Patterns among Residents of North and South Carolina Population-level Determinants of SNAP Participation Patterns among Residents of North and South Carolina Background: In 2020, about 14 million U.S households experienced food insecurity (FI)-a critical social determinant of health that has been associated with sub-optimal health outcomes. About 35% of households with annual income below the poverty level experienced FI in 2020 compared to 7% among those with incomes at or above 185 percent of the poverty level. About 22% of households with a Black household head experienced food insecurity compared to 7% among households with a White household head. About 54 million U.S residents were projected to experience food insecurity due to the pandemic. The Supplemental Nutrition Assistance Program (SNAP), the largest safety-net program that targets food insecurity in the United States, reduces food insecurity and poverty and improves health outcomes among participants. The importance of SNAP is highlighted by the Families First Coronavirus Response Act (FFCRA) which was enacted at the onset of the COVID-19 pandemic. FFCRA leveraged SNAP to address increased FI due to the pandemic. Continuous SNAP enrollment is necessary for the optimal impact of SNAP on food insecurity, poverty, and health to be achieved. The routine recertification required to maintain SNAP participation results in administrative burdens that sometimes lead to SNAP disenrollment among eligible individuals. To reduce recertification burden, some states have implemented interventions such as electronic access to applications and special assistance by SNAP administrators. For such interventions to result in equitable impact, there is a need to identify whether there is an association between stable SNAP participation and population-level factors. Objective: To use the 2014-2021 North Carolina and South Carolina data to analyze the relationship between stable SNAP participation and population-level factors (food deserts, rural/urban residence, residential segregation). Specific Aims: To determine: 1) trends in SNAP participation patterns (2014-2021; 2) the relationship between population-level factors and measures of stable SNAP participation before the COVID-19 pandemic; 3) the association between population-level factors and stable SNAP participation during the pandemic. For each aim, we will also determine any difference between White and Black clients. Stable SNAP participation will be measured over a 12-month period and will include: 1) number of months on SNAP; 2) churning-exit and re-entry into SNAP within four months (yes, no) and 3) participation pattern (continuous vs discontinued/intermittent).