Food seal business requirements increase mental health care use

A new Northwestern University study found that exposure to work requirements in order to receive nutritional benefits from the US government significantly increased the use of mental health care resources for depression and anxiety. The negative effects of the policy occurred much sooner on women than on men.

No wonder people’s pressure increased when they realized that they would lose access to food unless they met these requirements.”

Lindsey Allen
Assistant Professor of Emergency Medicine, Northwestern University Feinberg School of Medicine

This is the first study to look at how job requirements associated with a Supplemental Nutrition Assistance Program (SNAP) – sometimes referred to as food stamps – affect mental health.

The study was published July 28 in the journal Health Services Research.

SNAP improves the food security, health, and economic well-being of low-income individuals and families and is provided through the USDA Food and Nutrition Service.

“We’ve known for some time that food insecurity is associated with poorer mental health outcomes due to fear, stigma, depression, anxiety, and stress around it,” said corresponding author Lindsey Allen, associate professor of emergency medicine at Northwestern Feinberg School. of medicine. “So it’s no wonder that people became more nervous when they realized that they would lose their ability to get food unless they met these requirements.”

SNAP background, how did the study work

While SNAP business requirements are federally mandatory, states can obtain exemptions for counties where economic opportunities are scarce. As hiring rates and job availability have soared over the past decade, these concessions are being scrapped, exposing hundreds of thousands of SNAP registrants to requirements.

In 2016, West Virginia introduced these business requirements in a pilot program for nine counties. Scientists analyzed Medicaid claims data in West Virginia to assess whether health care visits for depression and anxiety changed after residents in treatment counties were exposed to SNAP work requirements. The study sample included individuals between the ages of 18 and 49 who were enrolled in both SNAP and Medicaid at the start of the study.


For women, work demands increased visits for depression by 26% and 12% for anxiety. The increase was slower for men


The study found that exposure to work demands exacerbated depression and anxiety among those who lived in the nine pilot counties.

For women, work demands increased visits for depression and anxiety by 26% and 12%, respectively. Visits also increased for men, but at a slower rate than for women. The difference in timing may be due to the greater role women play in managing household nutrition, Allen said, making them more immediately vulnerable to the consequences of food insecurity.

The study adds to a growing body of recent evidence that SNAP job requirements do not improve employment rates – the intended outcome – but reduce SNAP participation, especially among vulnerable groups such as those without income, those without housing and those living in rural areas.

“So, basically, these business requirements are hurting people who don’t have a measurable benefit to the economy,” Allen said.

Allen said that policymakers and future researchers should seek to better understand these trade-offs when considering the net impact of SNAP’s business requirements policies on already marginalized populations.

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