Hunger Pains? SNAP Timing, and Emergency Room Visits

Poor nutrition has been established as an important determinant of health. It has also been demonstrated that the single monthly treatment of SNAP benefits leaves meaningful deficiencies in recipient households during the final weeks of their benefit cycle. Additionally, the day that households receive benefits is shown to be associated with changes in household behavior. This project exploits linked administrative data on health care utilization and randomized food stamp receipt dates to allow us to examine how receipt date affects both ER usage on SNAP receipt date and whether ER utilization is changed near the end of the benefit cycle month. We find no overall increase in ER usage at the end of the benefit month, except for individuals 55 and over. Within this older population, the share of ER visits that comes from individuals that are past the third week of their SNAP benefit month, i.e. received benefits more than 21 days ago, is 1.67% larger than would be expected. Notably, this effect is much larger when the end of the benefit cycle coincides with the end of the calendar month. This suggests that within this older group, increased food insecurity leads to increased ER utilization. On the day of SNAP benefit receipt we find that the share of ER visitors that received benefits on that day is 3.1% lower than would be expected. This effect is present across all age groups, although the magnitude is smallest for young children. Further, analysis of time-use data presents additional support for time use reallocation on receipt days, while an investigation of specific conditions is consistent with the ER utilization decline being related to a drop in less urgent conditions