ArticleInternational journal of environmental research and public health2025
Safety Net Programs as Primary Prevention Against Adverse Childhood Experiences (ACEs) in the United States: Natural Experiments with Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP).
Article in International journal of environmental research and public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We examine access to U.S. welfare programs-Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)-as primary prevention strategies against adverse childhood experiences (ACEs). Using the University of Kentucky's National Welfare Data and National Survey of Children's Health (2016-2022), we estimate two-way fixed effects models linking state-level access rates to child-level ACE incidence. TANF access predicts reduced parental mental illness (fully adjusted β = -5.40, 95% CI: -8.80, -2.00), and parental incarceration in the model adjusted for state-level factors (β = -4.44, 95% CI: -8.84, -0.05), though the latter attenuates with child-level covariate adjustment. Unexpectedly, SNAP access correlates with slight increases in neighborhood violence exposure (fully adjusted β = 0.95, 95% CI: 0.39, 1.51) and parental substance use (crude β = 0.48, 95% CI: 0.04, 0.93) in crude models. Robustness checks show greater TANF access is associated with fewer total ACEs (β = -0.27, 95% CI: -0.46, -0.07). Results suggest that welfare programs hinge on broader social contexts; TANF access appears protective, while SNAP findings diverge from prior research, likely reflecting measurement or contextual limitations that merit careful further investigation, rather than overinterpretations of program harm.
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