Transition to Adulthood: Dynamics of Disability, Food Security, Health, and SNAP Participation. University of Kentucky Center for Poverty Research Discussion Paper Series, DP2018-01
Author: Guo, Baorong
Date: 2018-02-00
Type: Reports - Research
Subjects: Disabilities,Hunger,Barriers,Access to Health Care,Welfare Services,Low Income Groups,Adolescents,Young Adults,State Policy,At Risk Persons,Correlation,Predictor Variables,Food,Mental Health,Physical Health,Poverty

Young adults face enormous economic, social and psychological challenges when they transition into adulthood. This transition can be especially overwhelming and daunting for young adults with disabilities. Among the challenges young adults with disabilities are faced with are greater risk of low food security and barriers to healthcare. This study examines how the transition to adulthood may affect food security, health, and access to healthcare for youth with disabilities, and estimates the effects that SNAP has on this group in those turbulent years. The study used five years of data (2011-2015) from the National Health Interview Survey (NHIS). We combined the public and restricted NHIS data with the state SNAP policy variables. The sample included low-income individuals ages 13-25 (and their families) to reflect the life stage from pre-transition, to transition, and then to post-transition. Analyses were conducted at the Census Research Data Center in Columbia, MO. A difference-in-difference (DID) approach in linear models was applied to compare individuals with and without disabilities regarding changes in food security status and their health-related outcomes in the transition to adulthood. State SNAP policy variables were used as exogenous instruments to estimate the effects of SNAP participation on food security and health/healthcare use for youth and young adults with disabilities in the models of instrumental variables. Below is a summary of the main findings in which youth are referred to as individuals under 18, and young adults are referred to as individuals ages 18 to 25. (1) Compared to those without disabilities, individuals with disabilities have a greater risk of low food security in both childhood and young adulthood; (2) Transition into adulthood results in greater food security for individuals without disabilities but an increased risk of low food security for individuals with disabilities. The increased risk for young adults with disabilities may well put them at very low food security, the most severe category on the food security scale; (3) Food security status is associated with health and access to healthcare for all the four groups, youth and young adults, with or without disabilities. However, the associations between low food security and health-related outcomes do not seem to vary by disability status for young adults, indicating the additional risk of low food security that young adults with disabilities experience does not correlate with their health-related outcomes; (4) Contrary to our expectation, SNAP participation does not seem to have statistically significant effects on food security and health-related outcomes for individuals with disabilities. These impacts, although insignificant, show expected directions (i.e., improving food security and health) that are different from those often found in the OLS estimation that does not address the selection bias; and (5) SNAP participation is a statistically significant predictor of youth's food security status measured by the food security raw score only, but not the other three food security measures. SNAP participation appears to have greater impacts for youth than for young adults. In other words, the protective effects of SNAP decrease for young adults perhaps because they encounter greater barriers accessing SNAP than when they were young. The study's limitations are closely examined with a focus on the constraints that we had in the DID analysis and the IV analysis. We also suggested directions for future research. Since food security likely has a profound impact on the long-term development, economic independence, and self-sufficiency, we discussed a few policy strategies that may help individuals with disabilities in their transition to adulthood. These include special outreach services to improve SNAP accessibility, an embedded alert system that serves to bring awareness of a SNAP participant's upcoming transition to adulthood, incorporation of nutrition assistance in transition planning for youth, and better coordination of multiple public programs.