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)

Int J Environ Res Public Health. 2025 Nov 19;22(11):1750. doi: 10.3390/ijerph22111750.

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.

PMID:41302696 | DOI:10.3390/ijerph22111750