Zach Conrad1, Colin D Rehm1, Parke Wilde1, Dariush Mozaffarian1. 1. All of the authors are with Tufts Friedman School of Nutrition Science and Policy, Boston, MA. Colin D. Rehm is also with the Office of Community and Population Health, Montefiore Medical Center, Bronx, NY.
Abstract
OBJECTIVES: To investigate total and cause-specific cardiometabolic mortality among Supplemental Nutrition Assistance Program (SNAP) participants, SNAP-eligible nonparticipants, and SNAP-ineligible individuals overall and by age, gender, race/ethnicity, and other characteristics. METHODS: We performed a prospective study with nationally representative survey data from the National Health Interview Survey (2000-2009), merged with subsequent Public-Use Linked Mortality Files (2000-2011). We used survey-weighted Cox proportional hazards models adjusted for age and gender to estimate hazard ratios of total and cause-specific cardiometabolic mortality for 499 741 US adults aged 25 years or older. RESULTS: Over a mean of 6.8 years of follow-up (maximum 11.9 years), 39 293 deaths occurred, including 7408 heart disease, 2185 stroke, and 1376 diabetes deaths. Individuals participating in SNAP exhibited higher total and cardiovascular disease mortality, largely limited to non-Hispanic Whites and non-Hispanic Blacks, than both SNAP-eligible nonparticipants and SNAP-ineligible individuals, and higher diabetes mortality across races/ethnicities (P < .01). CONCLUSIONS: Participants in SNAP require greater focus to understand and further address their poor health outcomes. Public Health Implications. Low-income Americans require even greater efforts to improve their health than they currently receive, and such efforts should be a priority for public health policymakers.
OBJECTIVES: To investigate total and cause-specific cardiometabolic mortality among Supplemental Nutrition Assistance Program (SNAP) participants, SNAP-eligible nonparticipants, and SNAP-ineligible individuals overall and by age, gender, race/ethnicity, and other characteristics. METHODS: We performed a prospective study with nationally representative survey data from the National Health Interview Survey (2000-2009), merged with subsequent Public-Use Linked Mortality Files (2000-2011). We used survey-weighted Cox proportional hazards models adjusted for age and gender to estimate hazard ratios of total and cause-specific cardiometabolic mortality for 499 741 US adults aged 25 years or older. RESULTS: Over a mean of 6.8 years of follow-up (maximum 11.9 years), 39 293 deaths occurred, including 7408 heart disease, 2185 stroke, and 1376 diabetes deaths. Individuals participating in SNAP exhibited higher total and cardiovascular disease mortality, largely limited to non-Hispanic Whites and non-Hispanic Blacks, than both SNAP-eligible nonparticipants and SNAP-ineligible individuals, and higher diabetes mortality across races/ethnicities (P < .01). CONCLUSIONS:Participants in SNAP require greater focus to understand and further address their poor health outcomes. Public Health Implications. Low-income Americans require even greater efforts to improve their health than they currently receive, and such efforts should be a priority for public health policymakers.
Authors: E M Andresen; J A Lee; R E Pecoraro; T D Koepsell; A P Hallstrom; D S Siscovick Journal: Am J Public Health Date: 1993-07 Impact factor: 9.308
Authors: Ashkan Afshin; Jose Penalvo; Liana Del Gobbo; Michael Kashaf; Renata Micha; Kurtis Morrish; Jonathan Pearson-Stuttard; Colin Rehm; Siyi Shangguan; Jessica D Smith; Dariush Mozaffarian Journal: Curr Cardiol Rep Date: 2015-11 Impact factor: 2.931
Authors: Michael W Long; Steven L Gortmaker; Zachary J Ward; Stephen C Resch; Marj L Moodie; Gary Sacks; Boyd A Swinburn; Rob C Carter; Y Claire Wang Journal: Am J Prev Med Date: 2015-07 Impact factor: 5.043
Authors: Thomas A Gaziano; Renata Micha; Siyi Shangguan; Dariush Mozaffarian; Stephen Sy; Yujin Lee; Junxiu Liu; Parke E Wilde; Andrea L Sharkey; Erin A Dowling; Matti Marklund; Shafika Abrahams-Gessel Journal: Circulation Date: 2021-08-27 Impact factor: 29.690
Authors: Parke Edward Wilde; Zach Conrad; Colin D Rehm; Jennifer L Pomeranz; Jose L Penalvo; Frederick Cudhea; Jonathan Pearson-Stuttard; Martin O'Flaherty; Renata Micha; Dariush Mozaffarian Journal: J Epidemiol Community Health Date: 2018-05-10 Impact factor: 3.710
Authors: Timothy H Ciesielski; David K Ngendahimana; Abigail Roche; Scott M Williams; Darcy A Freedman Journal: Am J Prev Med Date: 2021-05-11 Impact factor: 6.604
Authors: Jonathan Pearson-Stuttard; Piotr Bandosz; Colin D Rehm; Jose Penalvo; Laurie Whitsel; Tom Gaziano; Zach Conrad; Parke Wilde; Renata Micha; Ffion Lloyd-Williams; Simon Capewell; Dariush Mozaffarian; Martin O'Flaherty Journal: PLoS Med Date: 2017-06-06 Impact factor: 11.069