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The impact of the Supplemental Nutrition Assistance Program on the cardiovascular health of low-income adults

Award Number: R01HL171157
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 01/01/2024
PERIOD OF PERFORMANCE END DATE: 12/31/2028

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The impact of the Supplemental Nutrition Assistance Program on the cardiovascular health of low-income adults - PROJECT SUMMARY/ABSTRACT Food insecurity—the economic and social condition of inconsistent access to healthy food—is associated with worse cardiovascular health. Whether food assistance related social policies can improve cardiovascular health among low-income adults in the US is unknown. The Supplemental Nutrition Assistance Program (SNAP) is the largest US government-funded program providing food assistance. In 2021, at the cost of approximately $114 billion, 41.5 million Americans received SNAP benefits. As SNAP is administered by individual states, there are variations in policies related to eligibility assessment and ease of application that significantly impact participation levels. Although SNAP participation has been associated with improved food security, poverty reduction, and lower healthcare expenditures, it's impact on cardiovascular health is unknown. The mechanisms by which SNAP, and poverty reduction programs in general, influence cardiovascular health is unknown, but may be mediated through mechanisms such as medication adherence and psychosocial stress. In a previously published analysis, we found that implementation of state level policies associated with higher SNAP participation was associated with slower growth in diabetes prevalence. However, whether SNAP participation, or the policies impacting this participation, impacts cardiovascular health at an individual level is unknown. During the COVID-19 pandemic, the amount of SNAP benefits received by participants increased, but some of these increases are scheduled to expire. How SNAP benefit amounts impact cardiovascular health related measures is therefore important to understand. Aim 1 of the proposed research will use data from a nationally representative survey of older adults – the Health and Retirement Study (HRS) – linked with Medicare or Medicaid administrative claims data to identify whether SNAP participation among low-income individuals with cardiovascular disease is linked with improvements in medication adherence and psychosocial stress as well as lower healthcare utilization. Aim 2, using Medicare and all-payer claims data, will examine whether changes in state-level SNAP policies associated with SNAP participation lead to changes in the incidence of acute cardiovascular events among low-income adults. We will also study whether specific policy categories are associated with a greater change in health outcomes. In Aim 3 we will examine how changes in SNAP benefit amounts influence cardiovascular health-related measures. We will examine the temporary increase in SNAP benefit amounts that occurred nationwide from 2009 to 2013 as a result of the Recovery Act of 2009 and evaluate whether these changes resulted in differences in medication adherence, healthcare utilization, and health outcomes among SNAP participants with cardiovascular disease. The proposed research aims will require robust causal inference techniques to disentangle the effect of SNAP from other potential confounders. This research will provide important insights to policymakers regarding the potential public health benefits of investments in food assistance programs.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $631,371 )
2026	2026	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT STREET	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	000	3	2/16/2026	NON-COMPETING CONTINUATION	$631,371
														Subtotal = $631,371

Issue Date FY: 2025 ( Subtotal = $716,892 )
2025	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	000	2	12/17/2024	NON-COMPETING CONTINUATION	$645,202
2025	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	001	2	8/26/2025	NON-COMPETING CONTINUATION	$71,690
														Subtotal = $716,892

Issue Date FY: 2024 ( Subtotal = $768,849 )
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	001	1	6/21/2024	NEW	$76,883
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cardiovascular Diseases Research	000	1	12/12/2023	NEW	$691,966
														Subtotal = $768,849

Grand Total All Awards = $2,117,112

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The impact of the Supplemental Nutrition Assistance Program on the cardiovascular health of low-income adults

Award Number: R01HL171157

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 01/01/2024

PERIOD OF PERFORMANCE END DATE: 12/31/2028

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