More expansive state supplemental nutrition assistance program eligibility, intimate partner violence, and mental health during the preconception, prenatal, and postpartum periods.
Intimate partner violence (IPV) and depressive symptoms are major public health concerns during the preconception, prenatal, and postpartum periods and are shaped by both interpersonal and structural conditions, including economic hardship and food insecurity. State-level Supplemental Nutrition Assistance Program (SNAP) eligibility policies, including eliminating the SNAP asset test and increasing the SNAP income limit under broad-based categorical eligibility (BBCE), influence access to food assistance and may be associated with maternal well-being.
We conducted a repeated cross-sectional analysis of data from 66,677 women with lower income in the 2016-2020 Pregnancy Risk Assessment Monitoring System. We categorized states as having two BBCE policies, one BBCE policy, or no BBCE policies, reflecting more expansive SNAP eligibility. We conducted log-binomial regression with generalized estimating equations to calculate adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs), estimating associations of state BBCE policies with preconception and prenatal physical IPV and postpartum depressive symptoms.
Compared to women in states with no BBCE policies, those in states with both BBCE policies had a lower prevalence of preconception and prenatal physical IPV (PR: 0.79, 95% CI: 0.66-0.94) and postpartum depressive symptoms (PR: 0.83, 95% CI: 0.75-0.93). Estimates for states with one BBCE policy were smaller and less precise but also suggested a decreased prevalence of preconception and prenatal physical IPV and postpartum depressive symptoms compared to states with no BBCE policies (PR = 0.80, 95% CI: 0.64-1.00; PR = 0.91, 95% CI: 0.81-1.03, respectively).
Results suggest that structural conditions shaping access to economic resources may represent a pathway through which risk for IPV and maternal mental health challenges can be prevented.
We conducted a repeated cross-sectional analysis of data from 66,677 women with lower income in the 2016-2020 Pregnancy Risk Assessment Monitoring System. We categorized states as having two BBCE policies, one BBCE policy, or no BBCE policies, reflecting more expansive SNAP eligibility. We conducted log-binomial regression with generalized estimating equations to calculate adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs), estimating associations of state BBCE policies with preconception and prenatal physical IPV and postpartum depressive symptoms.
Compared to women in states with no BBCE policies, those in states with both BBCE policies had a lower prevalence of preconception and prenatal physical IPV (PR: 0.79, 95% CI: 0.66-0.94) and postpartum depressive symptoms (PR: 0.83, 95% CI: 0.75-0.93). Estimates for states with one BBCE policy were smaller and less precise but also suggested a decreased prevalence of preconception and prenatal physical IPV and postpartum depressive symptoms compared to states with no BBCE policies (PR = 0.80, 95% CI: 0.64-1.00; PR = 0.91, 95% CI: 0.81-1.03, respectively).
Results suggest that structural conditions shaping access to economic resources may represent a pathway through which risk for IPV and maternal mental health challenges can be prevented.