Material Hardships, Obesity, and SNAP Participation

Background: The rise in obesity has been attributed to multiple behavioral and economic factors (Baum and Chou, 2011; Courtemanche et al., 2015). Many of the factors considered in this literature are thought to influence obesity through changes in the cost of consuming and expending calories. A separate body of literature has considered the impact of biological responses to stress on body weight accumulation (Bjorntorp, 2001; De Vriendt et al., 2009). These studies posit that physiological responses to stress can directly (e.g. metabolic processes) and indirectly (e.g. appetite and behavior) affect weight outcomes of individuals exposed to chronic stressors. There is growing evidence linking various measures of stress to obesity, particularly in children (Garasky et al., 2009; Gundersen et al., 2011). The goal of this paper is to first examine the relationship between obesity and chronic stress, using reports of experiencing one or more types of material hardships due to lack of financial resources as proxies for chronic stress exposure. Given the higher prevalence of both hardship and obesity among low-income groups, it is important for policy-makers to consider how the social safety net can help reduce obesity via reductions in chronic stress caused by experiencing economic hardships. This paper also explores the potential ameliorating effects of government welfare program participation, with a particular emphasis on SNAP participation, on obesity among low-income mothers and children of mothers experiencing hardships.

Methods: We use the Fragile Families and Child Wellbeing Study, which contains rich measures of socioeconomic and health outcomes. Following a similar approach to Pilkauskas et al., (2012), responses to eleven economic wellbeing questions asked in the 1-, 3-, 5-, and 9-year waves are used to create our different measures economic hardship experience. The eleven questions are used to construct the following five hardship classifications: food, bill, utility, medical care, and housing hardship for the 1-, 3-, 5-, and 9-year waves. A cumulative hardship index is also constructed by summing the responses to the eleven questions described earlier. Participations in SNAP are measured as binary variables and the amounts of benefits are measured as continuous variables. To address endogeneity concerns, we use an instrumental variables method for panel-data to control for unobservable state-benefit heterogeneity, which may influence the program participation.

Results: We first show that chronic stress from economic hardship experience is associated with higher BMI and greater risk of obesity among mothers. However, this positive association is reduced as the number of hardship experiences increases for mothers who also experience food hardship. Furthermore, we find the opposite relationship between economic hardship experience and child obesity. Specifically, hardships are associated with reductions in the likelihood of a child being classified as obese. However, this relationship is reduced as the number of economic hardship experiences increases for those children belonging to households that also experience food hardship. Finally, participating in public assistance programs does not significantly affect the hardship/obesity relationship. However, after controlling for potential endogeneity, SNAP participation may have beneficial effects on mothers’ weight outcomes.