Cardiometabolic Mortality by Supplemental Nutrition Assistance Program Participation and Eligibility in the United States

    loading  Checking for direct PDF access through Ovid

Abstract

Objectives

To investigate total and cause-specific cardiometabolic mortality among Supplemental Nutrition Assistance Program (SNAP) participants, SNAP-eligible nonparticipants, and SNAP-ineligible individuals overall and by age, gender, race/ethnicity, and other characteristics.

Methods

We performed a prospective study with nationally representative survey data from the National Health Interview Survey (2000-2009), merged with subsequent Public-Use Linked Mortality Files (2000-2011). We used survey-weighted Cox proportional hazards models adjusted for age and gender to estimate hazard ratios of total and cause-specific cardiometabolic mortality for 499 741 US adults aged 25 years or older.

Results

Over a mean of 6.8 years of follow-up (maximum 11.9 years), 39 293 deaths occurred, including 7408 heart disease, 2185 stroke, and 1376 diabetes deaths. Individuals participating in SNAP exhibited higher total and cardiovascular disease mortality, largely limited to non-Hispanic Whites and non-Hispanic Blacks, than both SNAP-eligible nonparticipants and SNAP-ineligible individuals, and higher diabetes mortality across races/ethnicities (P < .01).

Conclusions

Participants in SNAP require greater focus to understand and further address their poor health outcomes.

Public Health Implications

Low-income Americans require even greater efforts to improve their health than they currently receive, and such efforts should be a priority for public health policymakers.

Related Topics

    loading  Loading Related Articles