Understanding Multiprogram Take-Up of Safety Net Programs Among California Families

Marisa M. Tsai MS, MPH , Joseph A. Yeb BS , Kaitlyn E. Jackson MPH , Wendi Gosliner DrPH , Lia C.H. Fernald PhD, MBA , Rita Hamad MD, PhD
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Abstract

Introduction

The U.S. safety net, which provides critical aid to households with low income, is composed of a patchwork of separate programs, and many people with low income benefit from accessing <1 program. However, little is known about multiprogram take-up, that is, participation conditioned on eligibility. This study examined individual and multiprogram take-up patterns and sociodemographic factors associated with multiprogram take-up of U.S. safety net programs.

Methods

The Assessing California Communities’ Experiences with Safety Net Supports study interviewed Californians and reviewed their 2019 tax forms between August 2020 and May 2021. Take-up of safety net programs was calculated among eligible participants (n=365), including the Earned Income Tax Credit; Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; and Medicaid. Multivariable regressions identified sociodemographic factors associated with take-up of multiple programs.

Results

Take-up was highest for Medicaid (90.6%) and lowest for Supplemental Nutrition Assistance Program (57.5%). Among people who received benefits from at least 1 other program, take-up ranged from 81.7% to 84.8% for the Earned Income Tax Credit; 54.4%–62.0% for Supplemental Nutrition Assistance Program; 74.3%–80.1% for Special Supplemental Nutrition Program for Women, Infants, and Children; and 89.7%–98.1% for Medicaid. Having a lower income and being younger were associated with concurrent take-up of Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children. Among Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children recipients, having higher income, being older, and being primarily English speaking were associated with Earned Income Tax Credit take-up.

Conclusions

Individual and multiprogram take-up vary between programs and by sociodemographic factors. Findings suggest opportunities to increase take-up of potentially synergistic programs by improving cross-program coordination, data sharing, and targeted recruitment of underenrolled subgroups (Supplemental Nutrition Assistance Program and Special Supplemental Nutrition Program for Women, Infants, and Children).

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了解加利福尼亚州家庭对安全网计划的多种参与情况
导言美国的安全网为低收入家庭提供重要援助,它由一系列独立的计划组成,许多低收入者都受益于这些计划。然而,人们对多重计划的参与(即以资格为条件的参与)知之甚少。本研究考察了美国安全网计划的个人和多重计划参与模式,以及与多重计划参与相关的社会人口因素。方法 "评估加利福尼亚社区的安全网支持经验 "研究在 2020 年 8 月至 2021 年 5 月期间采访了加利福尼亚人,并审查了他们的 2019 年纳税表。在符合条件的参与者(人数=365)中计算了安全网计划的使用率,包括挣得收入税收抵免计划、补充营养援助计划、妇女、婴儿和儿童特别补充营养计划以及医疗补助计划。结果医疗补助计划的参与率最高(90.6%),补充营养补助计划的参与率最低(57.5%)。在至少从其他一项计划领取福利的人群中,收入所得税抵免计划的参与率为 81.7% 至 84.8%;补充营养援助计划的参与率为 54.4% 至 62.0%;妇女、婴儿和儿童特别补充营养计划的参与率为 74.3% 至 80.1%;医疗补助计划的参与率为 89.7% 至 98.1%。收入较低和年龄较小与同时参加补充营养援助计划和妇女、婴儿和儿童特别补充营养计划有关。在 "补充营养援助计划 "和 "妇女、婴儿和儿童特别补充营养计划 "的受益人中,收入较高者、年龄较大者和主要讲英语者与 "赚取收入税收抵免计划 "的使用率相关。研究结果表明,通过改善跨计划协调、数据共享以及有针对性地招募未加入计划的亚群体(补充营养援助计划和妇女、婴儿和儿童特别补充营养计划),有机会提高潜在协同计划的参与率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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AJPM focus
AJPM focus Health, Public Health and Health Policy
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