SNAP May Attenuate Racial Disparities in Food Insecurity, SDOH

Getting eligible families enrolled in food assistance programs like SNAP could be key to closing the racial disparities in food insecurity, according to a new study out in JAMA Network Open.

According to researchers from the Johns Hopkins School of Nursing and Johns Hopkins School of Medicine, Black families are more likely to face food insecurity, a key social determinant of health, than their White counterparts. But when those Black families are enrolled in SNAP, the Supplemental Nutrition Assistance Program, those differences go away, they wrote in an analysis.

Food insecurity is a leading social determinant of health linked to other social determinants of health like income. Food insecurity is also directly linked to clinical outcomes, especially for diet-related illnesses like diabetes or heart disease.

But, like other social factors, food insecurity doesn’t impact all sociodemographics equally.

“Black individuals have had consistently higher food insecurity rates during the past 20 years than White individuals in the US, even after accounting for relatively lower mean income levels,” the researchers wrote in the study’s introduction.

The research team zeroed in on interventions to mitigate food insecurity, like SNAP, and how they can influence racial disparities in experience of food insecurity.

Using data about nearly 5,000 households that qualify for SNAP (meaning they make 130 percent of the Federal Poverty Level), the researchers determined that food insecurity was 20 percent more likely in Black households and 28 percent higher in multiracial households than White households.

But, notably, the data also showed that SNAP was able to mitigate some of those disparities.

Looking just at households that did not participate in the safety-net program, the researchers found that Black and multiracial households were more likely to report food insecurity than White households.

But when looking just at households that did participate in SNAP, that trend was no longer apparent. Black households that participated in SNAP were, in fact, less likely to be food insecure than White households that also participated in the program.

Although it is positive news that SNAP benefits can help mitigate racial disparities in food insecurity, the researchers stressed that those disparities still exist.

“Although SNAP benefits may help address racial economic inequality by providing money for food and despite evidence from prior studies that SNAP participation reduces food insecurity, our results contribute to the literature by suggesting that the current SNAP program is not eliminating racial disparities in food insecurity,” they wrote. “This situation is likely attributable to the pervasive nature of structural and systemic factors that contribute to racial disparities in food insecurity.”

For one thing, there could be differences in the types of food Black and multiracial families can access, a byproduct of structural racism. The researchers pointed to evidence that there are fewer grocery stores in predominantly Black neighborhoods, which can add to the cost of food. In some cases, SNAP may only partially attenuate the financial barriers to food security, the researchers said.

Moreover, there could be issues with SNAP enrollment.

“Although SNAP can reduce food insecurity, the results from this study may also be due in part to racial differences in SNAP access,” the researchers said.

“In other words, the findings of differences in food insecurity disparities based on SNAP participation may be because Black households that participate in SNAP are qualitatively different from Black households that do not,” they continued. “Because of pervasive structural racism in the US, it is plausible that there are race-based barriers to SNAP enrollment.”

The current SNAP enrollment process is arduous, the researchers said, and requires a high level of self-efficacy and systems navigation. There could also be state-level eligibility differences that affect Black and multiracial populations more than White people.

“One study found that changes to the work requirements for working-age adults without dependents were more strongly associated with SNAP participation changes for individuals who were Black vs White, suggesting that these requirements perpetuate structural racism with regard to SNAP access,” the researchers said.

“Therefore, there is a need to systematically evaluate SNAP program administrative requirements and practices for their potential role in racial disparities in SNAP access,” they concluded.