A Penn Medicine study found that lower cardiovascular death rates are associated with increased participation in food assistance programs.
Cardiology professor Sameed Khatana led the study, identifying an correlation between policies that improve access to the Supplemental Nutrition Assistance Program and fewer heart deaths. The program — commonly known as SNAP — is the largest United States service providing food purchasing assistance and is administered at the state level.
“A major takeaway is that large programs like SNAP that are primarily targeting something like food insecurity can have important spillover effects on health,” Khatana, a Leonard Davis Institute Senior Fellow, wrote.
States allocate funding and determine program eligibility based on their own standards. Khatana’s team compared over 11 million cardiovascular death records from more than 3,100 U.S. counties against a zero to 10 index measuring how easy each state makes it to enroll in and stay on SNAP benefits.
In a previous study, Khatana found that “more generous” state policies focused on increasing SNAP participation were independently associated with lower diabetes prevalence. The new study, published in JAMA Network on July 20, built upon these results to examine how state SNAP policies influence county-level cardiovascular mortality.
After accounting for extraneous factors, states with higher index scores — signifying fewer registration hurdles — saw consistently lower county-level cardiovascular mortality. The research team found that an estimated “15,000 fewer adult cardiovascular deaths would have occurred compared with the observed trajectory of SNAP generosity” if all states adopted the most generous policies from 2006-2019.
“While the study cannot make inferences at the individual level, it suggests that for populations at least, improved SNAP access may improve cardiovascular health,” Khatana wrote. “It also speaks to the important link between socioeconomic and psychosocial factors and health in general.”
When examining two scenarios set in 2019 — “one in which all states adopted the most generous policies compared to one in which states adopted the least generous policies” — the researchers hypothesized there would be 46,123 fewer cardiovascular deaths in one year when following the former.
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“We did not model a scenario in which the SNAP doesn’t exist, so it is not possible for us to directly estimate the number of deaths prevented by the program overall,” Khatana added.
Khatana’s team did not test the specific mechanisms linking SNAP access to improved cardiovascular health, but he pointed to two possibilities: the ability to direct financial resources towards medical care — “including prescription medication costs” — and psychosocial stress, which has already been linked with cardiovascular health and “may also play a role.”
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Staff reporter Saanvi Ram covers science and health and can be reached at ram@thedp.com. At Penn, she studies health and societies. Follow her on X @Saanvi_vivi.
