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Whats a Child Nutrition Program

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Patrick Casey, MD, MPH. Diana Cutts, MD. Alan Meyers, MD, MPH. Nieves Zaldivar, MD ... the Annie E. Casey Foundation, the Anthony Spinazzola Foundation, the Candle ... – PowerPoint PPT presentation

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Title: Whats a Child Nutrition Program


1
Whats a Child Nutrition Program?
  • Subsidized Housing and the Low-Income Home Energy
    Assistance Program (LIHEAP) Are Linked to
    Improved Growth Outcomes for Young Children of
    Color

Stephanie Ettinger de Cuba, MPH
Childrens Sentinel Nutrition Assessment Program
(C-SNAP) Boston University School of Public Healt
h Boston Medical Center Tuesday, November 7, 200
6
2
Authors
  • Stephanie Ettinger de Cuba, MPH
  • Deborah A. Frank, MD
  • Nicole Neault, MPH
  • Mariana Chilton, PhD
  • John Cook, PhD
  • Carol Berkowitz, MD
  • Maureen Black, PhD
  • Patrick Casey, MD, MPH
  • Diana Cutts, MD
  • Alan Meyers, MD, MPH
  • Nieves Zaldivar, MD
  • Suzette Levenson, MPH, EdM
  • Timothy Heeren, PhD
  • Zhaoyan Yang, MS

3
Childrens Sentinel Nutrition Assessment Program
(C-SNAP)
  • A national network of clinicians and public
    health specialists for research in multiple
    pediatric settings on the effect of U.S. social
    policy on young, low-income childrens health and
    nutrition.

4
C-SNAP Study Sites
C-SNAP Study Sites
  • Little Rock, AR -Boston, MA -Washington, D.C.
  • Baltimore, MD -Minneapolis, MN
  • Philadelphia, PA -Los Angeles, CA

5
Study Objective
  • Evaluate the importance of federal assistance
    programs not commonly identified with child
    nutrition, such as LIHEAP and Subsidized Housing,
    to child growth and health outcomes among young
    black and Latino children

6
Study Methods
  • August 1998 December 2004
  • Sentinel sample
  • Interview caregivers
  • Children 0-3 years
  • Emergency departments acute care clinics
  • Black and Latino children - over 80
  • Weight length measurements -- outcome of
    interest accepted international indicator of
    wellbeing

7
Eligible Families
  • Sample restricted to
  • Low-income renters of color with children under
    3
  • Participate in at least one means-tested program
  • Subsidized Housing sample
  • (n 13,069)
  • LIHEAP sample (n 4,091)
  • additionally
  • Excludes private insurance
  • Only renters - heat not included

8
Analytic Methods
  • Multiple logistic regression
  • Covariates for each program separate
  • - depending on correlation with program/outcome

9
Subsidized Housing analyses controlled for
  • Mother born in US
  • Receipt of TANF
  • Receipt of WIC
  • Food insecurity status

10
LIHEAP analyses controlled for
  • Mother born in US
  • Year of interview
  • Food insecurity status
  • Receipt of either TANF or Food Stamps
  • Receipt of WIC
  • Receipt of Housing Subsidy
  • Caregiver marital status
  • Caregiver employment

11
2004 Poverty Rates AmongHouseholds with Children
Poverty Highest among black and Latino families
US Census Bureau, 2005
12
2004 Food Insecurity Rates among Households with
Children
Food insecurity highest among black and Latino
families
Nord, Andrews, and Carlson, 2005
13
2004 National Eligible Household Participation in
LIHEAP
U.S. Department of Health Human Services, 2004
14
Housing LIHEAP onlyreach a fraction of
eligibleC-SNAP families
15
Subsidized Housing Helps Black Children Grow
16
LIHEAP Improves YoungBlack Childrens Growth
Nutritional risk weight-for-age or weight-for-height
17
Subsidized Housing Helps Latino Children Grow
18
LIHEAP and Latino Children
  • Results for Latino children and LIHEAP not
    presented since did not reach statistical
    significance, probably due to small sample size.
  • Limited program participation reflects sample
    characteristics
  • most Latino children lived in California, where
    few families of any ethnicity access LIHEAP.

19
Overweight?
  • No associations between overweight and LIHEAP or
    Subsidized Housing

20
Limitations
  • Interviews in English, Spanish, and Somali (MN
    only)
  • Only blacks and Latinos
  • Exclusion of the most severely ill or injured
    children
  • Associations are not causation
  • Difficult to make national extrapolations

21
Non-food assistance programscan improve
childrens growth
  • Programs like LIHEAP and Subsidized Housing
    linked to improved growth outcomes
  • Heat or eat phenomenon Food budget only
    variable expense
  • Food most easily decreased to pay for other
    expenses, leading to increased food insecurity,
    particularly during winter months.

22
Implications for Young Black Latino Children
  • Growth is indicator of health in young children
  • Adverse child growth outcomes associated with not
    receiving benefits
  • Safety net programs buffer young children from
    effects of poverty

23
UN Convention on the Rights of the Child
  • Article 27
  • 1.States Parties recognize the right of every
    child to a standard of living adequate for the
    childs physical, mental, spiritual, moral and
    social development
  • 3. States Parties shall take appropriate
    measures to assist parentsto provide material
    assistance and support programmes, particularly
    with regard to nutrition, clothing and housing.

24
Why does it matter?
  • Housing and Energy are Health Issues
  • Early growth failure sets children up for
    long-term health development problems.

25
Why does it matter?
  • Affordable Housing and Energy are Human Rights
    Issues
  • Black Latino children 35 of all children in
    US.
  • Black Latino children higher risk for living in
    poor HHs
  • Also at greater risk for negative growth effects
    associated with poverty and food insecurity.
  • Food insecurity and its effects exacerbate
    achievement gaps and deepen racial/ethnic health
    disparities, depriving victims of other rights.
  • Society Has a Duty to Guarantee Childrens Basic
    Rights
  • Macro perspective Denial of basic rights -
    disastrous effects on workforce participation and
    health of national economy.

26
What can we do aboutchanging policy?
  • Educate Policymakers to
  • Reconsider standard view of which assistance
    programs influence child nutrition.
  • Food Non Food Optimal Child Health
  • Understand that safety-net programs good
    medicine but dosage and availability
    inadequate.
  • Stop cutting or freezing funding for safety-net
    programs - created health crisis for poor
    children, especially children of color
  • Give recommended dosage Full package of
    benefits - social investment - reduction of
    racial/ethnic disparities

27
Acknowledgements
  • Report sponsored by the Joint Center for
    Political and Economic Studies
  • Thanks to Avi Perry, Bill Emerson National Hunger
    Fellow, for his assistance in preparing this
    presentation.

C-SNAP operations and analyses have been
supported by the Abell Foundation, the Annie E.
Casey Foundation, the Anthony Spinazzola
Foundation, the Candle Foundation, the Claneil
Foundation, the Daniel Pitino Foundation, the EOS
Foundation, the Gold Foundation, the Gryphon
Fund, the Hartford Foundation for Public Giving,
Jennifer Kaminsky, MAZON A Jewish Response to
Hunger, the Minneapolis Foundation, the New
Hampshire Charitable Foundation, Project Bread,
the Sandpiper Philanthropic Foundation, the
Schaffer Foundation, Susan P. Davies and Richard
W. Talkov, Susan Schiro and Peter Manus, the
Thomas Wilson Sanitarium for Children of
Baltimore City, the United States Department of
Agriculture, Vitamin Litigation Funding, with
major funding from the W. K. Kellogg Foundation.
28
  • Please visit us on the web
  • www.c-snap.org
  • Thank you!
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