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Nutrition Assistance No Guarantee Against Food Insecurity for Families Fighting Cancer

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A recent study showed that receiving Supplemental Nutrition Assistance Program advantages was not enough to deal with food insecurity amongst families whose children were fighting acute lymphoblastic leukemia.

Across health care, there was some discussion about how providers can assist patients whose health is impacted by poverty, creating an inability to acquire basic needs, like protected housing, healthy food—and even enough food.

But a recent study showed that even when patients—on this case, families of youngsters with acute lymphoblastic leukemia (ALL)—are connected to resources through large medical centers, they still experience food insecurity.

The research was presented earlier this month on the fifteenth American Association of Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.

Because receiving Supplemental Nutrition Assistance Program (SNAP) advantages has been shown to scale back food insecurity and is one strategy to address antagonistic social determinants of health (SDOH), researchers sought to find out how most of the families were eligible for SNAP and if SNAP reduced food insecurity. The Dana-Farber Cancer Institute (DFCI) Acute ALL Consortium Trial 16-001 is the primary pediatric oncology clinical trial to prospectively collect parent-reported SDOH, including income, SNAP receipt, and food insecurity, the authors said.

The pediatric patients, aged 1 to 17 years, were enrolled within the clinical trial at 6 cancer centers from 2017 to 2022. As a secondary evaluation, researchers analyzed parent-reported income at diagnosis and 6 months into therapy as a proxy to discover families that were SNAP eligible. In keeping with federal guidelines, households with incomes lower than 130% of the federal poverty level are eligible for SNAP.

Food insecurity among the many group of 262 evaluable families was assessed using a validated 2-item screening tool.

Multiple regression techniques examined the association between SNAP eligibility, SNAP receipt, and parent-reported food insecurity.

The study showed that 21% of the 262 families at diagnosis and 25% of 223 families evaluable 6 months into therapy reported food insecurity.

At diagnosis, 20% of the families were SNAP eligible. Of those, 60% reported food insecurity but only 53% were receiving SNAP advantages.

Six months into therapy, 28% of the families were SNAP eligible, and of those, 58% reported food insecurity and 58% were receiving SNAP—in other words, receiving the profit was not enough to turn out to be food secure.

Among the many 33 families that were SNAP eligible at each time points, the fraction receiving SNAP advantages increased from 52% to 70%.

“Food insecurity is connected to worse health outcomes normally pediatrics,” Rahela Aziz-Bose, MD, a pediatric oncology fellow at Boston Children’s Hospital and Dana-Farber Cancer Institute and lead writer of the study, said in an announcement. “A very powerful finding was that poverty and food insecurity are quite common on this group of patients,” she said.

“It’s promising that we could help a number of the families who were eligible at diagnosis to enroll and receive advantages,” said Aziz-Bose. “Nevertheless, there have been families who became newly eligible between the two time points and weren’t receiving advantages at 6 months, highlighting that poverty is a dynamic state⁠—families can move from one category to a different as they progress through treatment, especially as the consequences of out-of-pocket payments, transportation to visits, and lost income from a parent/caregiver having to offer up a job all add up.”

“We’d like to universally screen for financial hardship at multiple points throughout pediatric cancer treatment,” Aziz-Bose said, adding that perhaps “due to financial stress related to cancer treatment, the SNAP profit amount must be higher for these families.”

The predominant limitation of this study is that SNAP eligibility could only be assessed through a proxy measure (self-reported income) and, since this was a retrospective evaluation, it couldn’t be confirmed. As well as, a more detailed evaluation is required to find out the cause/effect relationship between food insecurity and receiving SNAP advantages.

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