Supplemental Nutrition Assistance Program Eligibility and HIV Incidence in the United States

Abstract

Introduction The connection between food insecurity and HIV outcomes is well-established. The Supplemental Nutrition Assistance Program (SNAP), the primary food safety net program in the US, may have collateral impacts on HIV incidence. “Broad-based categorical eligibility” for SNAP is a policy that provides a mechanism for states to increase the income or asset limits for SNAP eligibility. Methods We estimated the association between the number of new HIV diagnoses 2010-2014 for each state and (1) state income limits and (2) state asset limits for SNAP eligibility. We fitted multivariable negative binomial regression models with number of HIV diagnoses specified as the outcome; SNAP policies as the primary explanatory variable of interest; state and year fixed effects; and time-varying covariates related to the costs of food, health care, housing, employment, other SNAP policies, and Temporary Assistance for Needy Families spending. Results HIV diagnoses within states had a statistically significant association with state income limits for SNAP eligibility (IRR 0.94 per increase in the income limit by 35% of federal poverty level, 95% CI 0.91-0.98), but no association with state asset limits (increased asset limit vs. no change, IRR 1.02, 95% CI 0.94-1.10; eliminated asset limit vs. no change, IRR 1.04, 95% CI 0.99-1.10). Conclusions State income limits for SNAP eligibility were inversely associated with the number of new HIV diagnoses for states between 2010-2014. Proposals to eliminate the use of broad-based categorical eligibility to increase the income limit for SNAP may undercut efforts to end the HIV epidemic in the US

Age at diagnosis and social risks among Black cancer survivors: Results from the Detroit Research on Cancer Survivors cohort

“…Approximately 30% of ROCS participants were enrolled during the coronavirus disease 2019 (COVID‐19) pandemic (since March 2020). Black and Hispanic adults were disproportionately affected by pandemic‐related unemployment and social risks, including food insecurity and housing instability 56–58 ; however, COVID response measures also included several important social supports, such as an expansion of benefits for participants in the Supplemental Nutrition Assistance Program and a requirement that Medicaid enrollees maintain coverage regardless of changes in eligibility status that may have decreased social risks 59–61 . The effect of the COVID‐19 pandemic on social risks likely varied between Detroit ROCS participants and over time through the pandemic.…”