Nearly half of all American children will reside in a household receiving food stamps at some point between the ages of 1 and 20, according to a report in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.1
“Research has repeatedly demonstrated that two of the most detrimental economic conditions affecting a child’s health are poverty and food insecurity,” the authors write as background information in the article. The receipt of food stamps serves as a marker of both, since families receiving them must have low incomes and few assets. “Understanding the degree to which American children are exposed to the risks of poverty and food insecurity across the length of childhood would appear to be an essential component of pediatric knowledge, particularly in light of the growing emphasis on the importance of community pediatrics.”
Mark R. Rank, Ph.D., of the George Warren Brown School of Social Work, Washington University, St. Louis, and Thomas A. Hirschl, Ph.D., of Cornell University, Ithaca, New York, analyzed 30 years of longitudinal data from a nationally representative sample of the U.S. population, the Panel Study of Income Dynamics. During household interviews conducted between 1968 and 1997, demographic and other information was collected regarding children ages 1 through 20, and families reported whether they had received food stamps over the prior year.
By age 1, 12.1 percent of children had lived in households receiving food stamps; 26.1 percent had by age 5, 35.9 percent by age 10, 43.6 percent by age 15, and 49.2 percent by age 20. By age 20, in addition to nearly half receiving food stamps during at least one year of the study period, about one-third of children received them for two or more years, 28.1 percent for three or more years, 26.4 percent for four or more years and almost one-fourth (22.8 percent) for five or more years.
Race, education and marital status all were associated with the receipt of food stamps among children. Black children and those who lived in households headed by adults who were unmarried or had less than 12 years of education were more likely to receive food stamps.
Poverty has been estimated to raise the direct expenditures on children’s health care by approximately $22 billion per year. “American children are at a high risk of encountering a spell during which their families are in poverty and food insecure as indicated through their use of food stamps,” the authors conclude. “Such events have the potential to seriously jeopardize a child’s overall health.”
“This experience with the Food Stamp Program/Supplementary Nutritional Assistance Program reflects the broader fact that a large portion of American families rely on safety net programs for the necessities of life,” writes Paul H. Wise, M.D., M.P.H., of Lucile Packard Children’s Hospital and Stanford University, Stanford, Calif., in an accompanying editorial.2
“The paradox at the heart of our current safety net system is that the economic conditions generating the growing need for services are, at the same time, also undermining our collective ability to provide them,” Dr. Wise writes. “The bottom line is that the current recession is likely to generate for children in the United States the greatest level of material deprivation that we will see in our professional lifetimes. The recession is harming children by both reducing the earning power of their parents and the capacity of the safety net to respond.”
“However, it is also essential to recognize that children have been made extremely vulnerable to this recession by a decades-long deterioration in their social position,” Dr. Wise continues. “In response, the pediatric community will have to address the enhanced needs of patients, strengthen its capability to take collective action and invigorate its voice in public discourse.”
1. Arch Pediatr Adolesc Med. 2009;163:994-999.