Peer-reviewed article
Social programme receipt and child health, healthcare access and utilisation among low-income US households: a cross-sectional analysis of the National Survey for Child Health.
Taneja S, He J, Marcil L, Chang L, Weller E et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether US social programmes—cash assistance, food stamps, women and infant nutrition support, and school meal programmes—improve child health and healthcare access among low-income families. Using data from nearly 7,300 children from low-income households, the researchers found that receiving these programmes was not associated with better child health. Unexpectedly, programme recipients reported more frustrating experiences accessing healthcare and used emergency departments more often, but not preventative care services. The findings suggest that simply providing financial assistance may not solve underlying barriers to healthcare access for low-income families.
Key points
- About a quarter of low-income US children receive none of the four major social programmes studied
- Social programme receipt showed no association with parent-reported child health status
- Children whose families received programmes were more likely to report frustrating healthcare access experiences
- Programme recipients used emergency departments more frequently, with no increase in preventative healthcare visits
- The study suggests policy changes beyond financial assistance may be needed to improve healthcare access for low-income families
Limitations
This is a cross-sectional study, so it cannot determine whether programme receipt causes worse access experiences or whether families with worse healthcare experiences are more likely to seek programmes. The study relies on parent-reported health measures and subjective experiences of healthcare access rather than clinical health outcomes.
Abstract
Background Poverty is associated with poor health and increased healthcare utilisation. Social programmes may mitigate these effects by enhancing the ability to purchase direct inputs into health, improving access. We aimed to examine associations between receipt of cash assistance, Supplemental Nutrition Assistance Program, Special Supplemental Nutrition Program for Women, Infants and Children, and free/reduced cost school meals with child health measures among children from low-income US households. Methods We conducted a retrospective, cross-sectional analysis of data from the 2019 National Survey for Child Health. Households with incomes <185% of the federal poverty level were included. Multivariable logistic regressions assessed associations, reporting OR with 95% CIs for the following outcomes: parent-reported child health; health access as defined by unmet healthcare need, inability to pay medical bills and experiencing frustrating access to care; and healthcare utilisation defined by the number of preventative healthcare visits and number of emergency visits in the past year. Results The sample included 7279 children aged 0-17, representing 27 million children nationally. Among low-income households, 24.6% received none of the four programmes. Programme receipt was not associated with child health. Programme receipt was associated with frustrating healthcare access (OR 1.72, 95% CI 1.23 to 2.41) and increased emergency department utilisation (OR 1.63, 95% CI 1.16 to 2.29), with no association with preventative care. Conclusion Social programme receipt was associated with frustrating healthcare access and greater emergency care utilisation. Policy efforts to facilitate access for low-income families may improve child health outcomes.