What Do We Know? the Effects of Food Assistance Programs on Child Health and Cognitive Development

Background:The primary objectives of food assistance programs are to improve diets and reduce food insecurity among low-income households, especially, those with children. Childhood obesity has more than doubled in the last 30 years (CDC, 2015), and 15.8 million of children are living in food insecurity in 2014 (USDA, 2015). There has no consensus among the vast body of literature documenting the food assistance programs’ effectiveness on food insecurity, the nutritional quality of diets, and overall health of participants. Given that the participants of food assistance programs are not randomly selected and unobserved factors may determine their participation in the programs (Kaushal, 2007; Mykerezi & Mills, 2010; Meyerhoefer & Yang, 2011), identification strategies are crucial to understand the food assistance programs’ impacts on child health and cognitive development outcomes. Thus, I focus on the effects of food assistance programs by addressing the endogeniety of the program participation.

Methods:This study used data from the Fragile Families and Child Wellbeing Study (FF), which contains rich measures of child health and cognitive development in low-income households in the US. I used four follow-up waves: 1-year, 3-year, 5-year, and 9-year for health outcomes; while I used three follow-up waves: 3-year, 5-year, and 9-year for cognitive outcome. The sample consists of 3,860 children who were identified in all four waves. The food assistance programs consist of Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Participations of each program are measured as binary variables and the amounts of benefits are continuous variables. Child health outcomes are measured by self-reporting health status and BMI. The child cognitive development was measured by standardized PPVT test scores. I first used growth curve models to capture how child health status and cognitive development change as the program participation changes. Then, I expand the model to cross-classified multi-level modeling to control for unobservable state-benefit heterogeneity, which may influence the program participation. 

Results:Results from the simple growth curve model show that participation in the programs has negatively influenced self-reporting health outcome (β_SNAP=-.051, p<.01; β_WIC=-.075, p<.001) and cognitive outcome (β_SNAP=-.081, p<.01 β_WIC=-.055, p<.05). These results are consistent with previous studies reporting that children with parents’ receipt of welfare are more likely to have health problems and lower educational attainment (Danzinger et al., 1999; Ku & Plotnick, 2003). However, the model does not take into account the endogeniety problems of program participation. I expanded the simple growth model to the cross-classified multi-level modeling. Then, I found counter results as the negative relationships disappeared even though the coefficients were no longer significant for both outcome variables.

Implications: This study found that receiving food assistance program benefits does not negatively influence child health and cognitive development. The findings indicate that food assistance programs are desirable, efficient policy priorities to help improve children’s health and cognitive development in vulnerable populations as early prevention of these disparities is easier and more cost-effective.