Mental Health and Early Termination of Supplemental Nutrition Assistance Program Emergency Allotments After COVID

• In Event: Health Impacts of Social Safety Net Policies: Interactions between Nutrition and Medical Care

Abstract

The COVID-19 pandemic and associated social and economic turmoil resulted in a noted increase in not only physical health but also mental health problems. Improving access to adequate food and nutrition can affect mental health by improving nutrition and also by decreasing anxiety over an inability to meet basic needs in the future. During COVID, the size of the benefits provided by the Supplemental Nutrition Assistance Program (SNAP), a federal program that provides electronic benefit cards to support food purchases, was temporarily expanded through emergency allotments (EA) to the maximum per household size or by $95, whichever was greater. The benefit increase ended in March 2023 or earlier in 18 states at state discretion. Previous research has shown that the early termination of EAs was associated with increases in self-reported levels of household food insufficiency, a measure that indicates food inadequacy in the last 7 days.

We use data from the national representative Household Pulse Survey, focusing on 3,001,647 responses collected from August 2020 to February 2023 to estimate the direct effect of early termination of EA on anxiety, depression, and serious psychological distress and the indirect effect operating through food insufficiency and difficulty paying for expenses. Using both an instrumental variables approach and mediation analysis, we explore the direct effect of early termination of EAs on mental health and the extent that the effect is mediated by changes in food insecurity and difficulty paying for expenses.

In preliminary results we find that the increase in food insufficiency and ability to meet essential expenses is associated with the early termination of EA, which in turn is associated with an observable increase in anxiety, depression and serious psychological distress. These patterns are consistently observed among the full population, self-identified SNAP participants, households with children, and older adults. No such association is observed among our falsification group—non-SNAP households with annual incomes of $100,000 or more.

As policymakers consider changes to the structure and generosity of the safety net, these results suggest that policymakers should be mindful of the mental health consequences associated with reductions in food assistance benefits.

Authors

• Colleen M Heflin, Syracuse University
  Presenting Author

• Michiko Ueda, Syracuse University
  Non-Presenting Co-Author

• Hyeryung Jo, Syracuse University
  Non-Presenting Co-Author