Proposed changes to federal nutrition program would risk families' oral health

This guest post was authored by Kasey Wilson, who is a Policy Analyst on the Community Catalyst Dental Access Project.

More than 750,000 people are at risk of losing critical nutrition assistance under a proposed rule from the Trump Administration that would make harmful changes to the Supplemental Nutrition Assistance Program (SNAP). SNAP is an important part of our nation’s efforts to help families avoid hunger and afford nutritious foods — and it is also an integral program for supporting oral health. Both Community Catalyst and the Children’s Dental Health Project are concerned about the threat this rule change would pose to individuals’ and families’ oral health and stability. We urged the Administration to withdraw it in a public comment submitted by the Oral Health Progress and Equity Network, of which both of our organizations are members.

The proposed rule and its impact on oral health

"The bottom line is, when children and families don’t have access to nutritious foods, their oral health suffers."

Access to food, especially nutritious food, is clearly important for overall health, and that includes oral health. Barriers to accessing healthy foods are associated with higher sugar, less nutrient dense diets, which can lead to increased risk for the disease that causes cavities, called dental caries. Gum disease and gingivitis are also associated with malnutrition. The bottom line is, when children and families don’t have access to nutritious foods, their oral health suffers.

Under current regulations, some adults without children have access to SNAP benefits for only three months before they are subject to a work requirement. However, states are able to waive this time limit for some communities – or an entire state – where unemployment rates are high or there is a lack of sufficient jobs. The proposed rule would impede states’ ability to get these waivers in several ways. It would:

• Limit states’ ability to group different geographic areas together when applying for a waiver,
• Limit the types of data states can use in their applications,
• Limit waivers to one year. 

Time limits already cause harm by denying people food benefits when they most need it. Restricting such support exposes them to the oral and other health problems associated with scarce access to nutritious food. The proposed rule, which would make more people subject to this requirement, would only increase those harms.

Work requirements don’t work…but SNAP benefits do

SNAP benefits support better nutrition, which improves oral health. Research shows that when people are healthy, they are more likely to get or maintain employment. Conversely, work requirements have been shown to result in people losing coverage for benefits – like SNAP and Medicaid – that help them get and keep work. Given that the Administration’s stated goal of this proposed rule is to increase employment, the best way to do that is to ensure more people have access to SNAP nutrition support, not fewer. Indeed, restricting food security may only compound the barriers to employment caused by poor oral health.
Dental disease undermines adults’ job prospects, while good oral health supports their employment opportunities and earnings. There is simply no evidence that taking away this support will result in higher employment rates.

One of the most concerning aspects of this proposed rule is the way it could reinforce existing health and economic disparities. Racism and related structural barriers have resulted in fewer jobs and economic opportunities in communities of color. Discrimination in hiring creates additional barriers even in places where, on paper, there may seem to be available employment. Similar structural barriers exist with respect to accessing dental care, which is expressed in persistent racial disparities in oral health and access to care. Immigrant communities also face particular barriers related to discrimination and legal limits on their eligibility for social programs that support oral and overall health.

Making it more difficult for people to achieve good oral health when they are already struggling to afford food is harmful to individuals, families, and communities. In the context of persistent employment, economic and health disparities, it is also inequitable. Rather than pursuing this proposal, which would restrict nutrition support, our lawmakers should focus on advancing policies that support every person’s ability to access nutritious food and achieve good oral health.