SNAP Work Requirements and Mortality Impacts

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

Abstract

SNAP is the largest nutrition assistance program in the United States, providing benefits to millions of participants each year. “Able-bodied adults without dependents” (ABAWDs) are typically subjected to a time limit on benefit receipt unless they meet additional work requirements. States may request to temporarily waive the time limit based on local economic conditions at the substate level, which historically has led to variation in the implementation of the ABAWD requirements. Previous literature suggests that the primary effect of these work requirements is removing ABAWDs from SNAP participation, which may have downstream effects on health. Generally, SNAP could impact participant health by affecting food security or nutrition, freeing up income for health-affecting goods, and/or providing a safety net, which could support mental health during times of hardship. Previous work has examined the relationship between SNAP and health outcomes in several ways, but only one study we identify estimates the health impacts of changes in ABAWD requirements.

We hypothesize that the ABAWD work requirements reduce SNAP participation among targeted households, which increases mortality, particularly among working-age adults and from “deaths of despair.” We incorporate waiver information from every state using data on the county-month-level status of SNAP ABAWD waivers, defining counties as fully waived, partially waived, or not waived. We will pair this novel dataset with information on county-level mortality rates obtained from the CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER), as well as information on county-level SNAP participation and other covariates.

Focusing on the time periods before and after two national suspensions of the ABAWD time limit (2009-19 and 2020-24), we will employ a staggered difference-in-differences model to examine the relationships between reinstating ABAWD time limits, SNAP participation rates, and various cause- and age-specific mortality rates. Because local economic conditions are a criteria for ABAWD waivers, we will also employ a triple-difference methodology to estimate the impacts of reinstatement using differences across 1) time, 2) county ABAWD status, and 3) age groups, considering mortality rates for adults just below and above the ABAWD work requirement cutoff. Because of the varying national economic contexts, we will also compare estimates from these two periods to contribute to a fuller understanding of the ABAWD work requirements’ impact.

This study will contribute to the growing body of literature on the impacts of work requirements in safety net programs as well as the relationship between SNAP and adult health. Among other proposals to restrict SNAP, policymakers have recently enacted changes to the SNAP ABAWD work requirements and proposed additional changes that would apply these requirements to more people. This study will generate evidence on the potential health effects of these requirements, and we accordingly expect our findings to be of interest to both researchers and policymakers concerned with means-tested program design as well as the downstream impacts of work requirements and related policies.

Authors

• Jordan W. Jones, USDA Economic Research Service
  Presenting Author

• Kaitlyn Wilson
  Non-Presenting Co-Author