Public Benefit Use and Social Needs in Hospitalized Children With Undocumented Parents

Abstract

BACKGROUND AND OBJECTIVES Studies supporta recent decline in public benefit enrollment among immigrant families. We aimed to describe health and resource use, barriers to use, and immigration-related fear in families with undocumented parents compared with families without undocumented parents. We also aimed to assess associations with discontinuation of public benefits and fear of deportation. METHODS We assessed immigration concerns and enrollment in Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with an 89-item anonymous, cross-sectional survey of English- and Spanish-speaking caregivers of hospitalized children. Multivariable logistic regression was used to assess associations with discontinuation of public benefits and fear of deportation. RESULTS Of 527 families approached, 399 enrolled (105 with 1 or more undocumented parent, 275 with no undocumented parent, and 19 with undisclosed immigration status). Compared with families without undocumented parents, families with undocumented parents had higher levels of poverty and food insecurity. Controlling for perceived eligibility, public benefit use was similar across groups. Of families with undocumented parents, 29% reported public benefit discontinuation because of immigration concerns, and 71% reported fear of deportation. Having an undocumented parent was associated with public benefit disenrollment (odds ratio: 46.7; 95% confidence interval: 5.9–370.4) and fear of deportation (odds ratio: 24.3; 95% confidence interval: 9.6–61.9). CONCLUSIONS Although families with undocumented parents had higher levels of poverty and food insecurity compared with families without undocumented parents, public benefit use was similar between groups. Immigration-related fear may be a barrier to public benefit use in this population.

Longitudinal Associations of Food Security with Health and Dietary Factors among Food FARMacy Participants during COVID-19 in New York City

“…In the current study, using the USDA Six-item Food Security Module among people presenting for enrollment in an emergency food assistance program, household food insecurity decreased from 88% at baseline to 61% at 6-month follow-up. Prior research suggests that food insecurity can persist despite enrollment in nutrition programs such as WIC and SNAP because of benefits inadequacy, high food costs, and barriers to continuous enrollment, and because by definition, these programs are meant to be supplemental in nature [33][34][35][36][37]. Contrary to our hypothesis that WIC/SNAP enrollment would increase associations of improved food security with health and dietary outcomes, we did not find evidence that WIC/SNAP enrollment modified the current results.…”

Feasibility of Food FARMacia: Mobile Food Pantry to Reduce Household Food Insecurity in Pediatric Primary Care

“…SNAP enrollment was similar among retention and attrition groups. Lack of baseline SNAP enrollment may be related to ineligibility, fear about use of public benefits among immigrants [ 30 , 31 ], or difficulties with completing necessary paperwork for maintaining enrollment. Although supplemental nutrition programs help reduce household food insecurity, our study sample experienced household food insecurity despite enrollment in benefits programs.…”

The potential role of social care in reducing childhood obesity

“…Enrollment in federal supplemental nutrition programs can reduce food insecurity, but food insecurity may persist because of benefits inadequacy, high food costs, and barriers to continuous enrollment [54][55][56][57][58]. Clinical interventions that go beyond referrals to existing federal supplemental nutrition programs may be needed.…”