CHAPTER 4
likely to enter the world with a low birth weight, a condition associated with higher health
care costs and worse health outcomes for the rest of the person’s life.23
Children’s brains—and the rest of their bodies—don’t stop developing once they enter
school. In elementary school, children who are hungry are four times more likely than nonhungry children to need mental health counseling.24 By the time they are teenagers, children
are twice as likely as their peers to have seen a psychologist.25
Adults who were malnourished as children are also more
“I have never been
likely to have mental health problems than peers who were
so hungry or food
well nourished. “Society, in turn, bears the costs of increased
conscious in my life as
health problems, lost worker productivity, and lost tax revenue
I was during the week
as individuals achieve and earn less,” wr ite John Cook and
of the SNAP/food
Karen Jeng in their report Child Food Insecurity: The Economic
26
stamp challenge.”
Impact on our Nation.
Cook, an associate professor of pediatrics at the Boston
— Dr. Lewis First
University School of Medicine, is also a research scientist with
Children’s HealthWatch, a pediatric clinical research program. Children’s HealthWatch
argues that the federal nutrition programs are one of the most cost-effective investments in
public health. In a 2004 report, Children’s HealthWatch found that a single hospitalization
for a pediatric illness cost an average of $11,300, equivalent in value to “almost five years of
food stamps for a family receiving the average household benefit.”27
Figure 4.5 The Supplemental Nutrition Assistance Program (SNAP) Eligibility, Benefits, and Health Pathway
Policy
Proximal Impacts
Access to and Consumption
of Healthful Foods
SNAP Participation
SNAP Eligibility
Farm Bills
(S. 954, H.R.
1947)
SNAP Benefit Amounts
Access to SNAP
Employment & Training
State and Local
Administrative Costs
Intermediate Effects
Household
Budget
Income/Assets
Access to
Assistance
Programs
(National School
Meals Programs,
Medicaid)
Health Outcomes
Cognitive Development and
Behavioral Health
Obesity, Diabetes, Hypertension,
Heart Disease, Stroke
Food Insecurity
Access to and Utilization of Health
Care and Other Essential Services
Adequate and Affordable Housing,
Home Heating and Cooling
Employment, Educational
Performance and Attainment
Asthma
Anxiety and Depression
Low Birth Weight, Infant Mortality
Cognitive Development and
Behavioral Health
Self-Reported Health Status
A pathway diagram is a tool used to display the hypothetical links between a proposed policy and health that is often used in HIA practice to guide research and analysis.
This pathway diagram maps out the possible health outcomes that could result from the proposed policy changes.
Source: The Health Impact Project (July 2013), Health Impact Assessment on Proposed Changes to Supplemental Nutrition Assistance Program,
Robert Wood Johnson Foundation and the Pew Charitable Trusts.
www.bread.org/institute?
? 2014 Hunger Report? 131
n