What pediatricians have learned about SNAP

Debbie PicAs pediatricians and researchers, my colleagues and I see every day the many ways in which poverty and food insecurity are written on the bodies and brains of our very young patients.

In 1998 we watched with concern as the 1996 Welfare Reform Act was debated and passed.  There was no plan to monitor the effects of that legislation on the health and well-being of young children.  Therefore, we decided that we needed to take action to bring scientific evidence and rigorous analysis from the front lines of pediatric care to policy makers and the public on this issue. We started what we thought would be a time-limited research study.  However, as time went on, we saw a strong and ongoing need for non-partisan, original research across a wide array of policy issues that impact health and nutrition of very young children.  This research study eventually grew into Children’s HealthWatch, which came to fill that unique niche by offering research on the many ways public policies, fluctuations in the economy, and living conditions found in impoverished communities impact our youngest neighbors.

From Children HealthWatch’s inception, we have focused on a vulnerable population of very young children (0-48 months of age) from low-income families. This focus is both scientific and sociological. A child grows the brain that s/he will have for the rest of his/her life in the first three years.  From a scientific perspective, during the developmental window from birth to preschool, the rapidly increasing size and function of the developing brain demands consistently high levels of quality nutrients. These nutrients serve as building blocks for all the complex biological processes that underlie children’s current and future capacity for learning and for positive behaviors and relationships. During this sensitive period, deficits in the growth of brain and body from food insecurity or other hardships are difficult to compensate later in life.

Sociologically, this sensitive period is also the developmental time during which children in the U.S. are most likely to live in poverty and least likely to participate in formal child care or educational settings. Thus, children of this age are typically “visible” only to their family members and health care providers. My colleagues and I work to tell the stories of these children, who may be largely “invisible” to the public, through our clinical experience and our research, which we hope will inform policy changes that benefit the health and well-being of our patients.

Through our research, we serve as a resource to provide an evidence base for policy makers, advocates, and a public that strongly desires to create a nation of healthy, stable, and economically independent people. To reach that goal, we have developed a unique and timely system, for interviewing caregivers of young children in five different medical centers across the nation to provide the most current, available information on the youngest and poorest Americans, as policies and conditions change.  The research we present in policy briefs, reports and peer-reviewed articles has, as its source, mothers and fathers living with limited resources and doing their best to care for their young children.

As we unveil our new website, this blog will give us a platform to comment on current policy issues through the lens of our research and participate in discussions about ways in which we, the public, can invest in the future by creating an environment where children receive adequate food, housing, and resources such as heat and electricity that are vital to healthy growth and development.

One pertinent and timely example of this is the current Congressional debate on funding for SNAP (the Supplemental Nutrition Assistance Program, formerly the Food Stamp Program). For years, Children’s HealthWatch has been concerned as the rates of food insecurity, a technical term for hunger, have fluctuated in households with children. The recent release of the 2012 food insecurity data collected by the USDA indicates that 20% of American household with children are food insecure, a prevalence rate that has remained relatively unchanged since 2008. Our own work and our review of the work of other scientists, which was published in our 2012 report “The SNAP Vaccine,” shows that food insecurity has been tied to short and long-term damage to children’s health, including increased risks of hospitalizations and developmental delays. However, we know that SNAP helps children to be food secure, in good health and achieve in school, from the prenatal period through the school years. Yet, in spite of evidence demonstrating the beneficial effects of SNAP on child health, development and school success, U.S. legislators are targeting SNAP for enormous cuts as they struggle with the Farm Bill, the primary blueprint of U.S. food and agriculture policy. Simultaneously, sequestration threatens another essential nutritional support for pregnant and breastfeeding women, infants and children younger than 5 years – the Special Supplemental Nutrition Program for Women, Infants, Children (WIC).

SNAP is in jeopardy, meaning that the health of thousands of children, our future workforce, is in jeopardy as well. Not only do current proposals include a cut to SNAP, such as the $40 billion cut proposed by House Republicans, but without Congressional intervention, the American Recovery and Reinvestment Act (ARRA) benefit boost (an increase in SNAP benefits that was a part of the 2009 stimulus package) will end in November 2013. This will effectively create a double benefit cut, leading to many more hungry, sick, and developmentally at risk children. Children cannot vote or visit legislators, so their health providers must speak for them. Scientific evidence demonstrates that SNAP is a wise investment in the brains and bodies of our nation’s children, an investment that should be enhanced, not curtailed.