Participation in the Supplemental Nutrition Assistance Program (SNAP) 2019–2024: A Systematic Review of Barriers and Enablers

Abstract

The Supplemental Nutrition Assistance Program (SNAP), the largest U.S. food safety net program, serves over 42 million people. This study synthesizes evidence of barriers and enablers to participation in SNAP among income-eligible individuals and relevant stakeholders. Peer-reviewed studies based in the United States and published between 2019 and 2024 were included in this review. Data were extracted and synthesized across five (5) databases, and through forward and backward reference searches. Screening and data extraction were conducted using Covidence. The Mixed Methods Appraisal Tool was used for quality assessment. A total of 17 articles were included; 50 factors were identified as barriers or enablers to SNAP participation. Relevant stakeholders identified a similar number of barriers and enablers, while income-eligible individuals identified more barriers compared to enablers to SNAP participation. Findings from this evidence synthesis highlight the need to strengthen SNAP-related policies to preserve adjustments sustained during COVID-19, to maximize participation and health promotion, and to build capacity for future public emergencies.

Keywords

food assistance food security nutrition security Supplemental Nutrition Assistance Program systematic review

Get full access to this article

View all access options for this article.

References

Allard

S. W.

Wathen

M. V.

Danziger

S. K.

(2022). The spatial context of food assistance: Examining local food assistance environment in the context of SNAP. Journal of Hunger & Environmental Nutrition, 17(4), 501–520. https://doi.org/10.1080/19320248.2021.1934214

Bitler

Gennetian

L. A.

Gibson-Davis

Rangel

M. A.

(2021). Means-tested safety net programs and Hispanic families: Evidence from Medicaid, SNAP, and WIC. The ANNALS of the American Academy of Political and Social Science, 696(1), 274–305. https://doi.org/10.1177/00027162211046591

Bleich

S. N.

Moran

A. J.

Vercammen

K. A.

Frelier

J. M.

Dunn

C. G.

Zhong

Fleischhacker

S. E.

(2020). Strengthening the public health impacts of the Supplemental Nutrition Assistance Program through policy. Annual Review of Public Health, 41(1), 453–480. https://doi.org/10.1146/annurev-publhealth-040119-094143

Caldwell

J. I.

Shah-Patel

Cohen

D. A.

Palimaru

A. I.

Kuo

(2020). Food insecurity, participating in the Supplemental Nutrition Assistance Program, and the degree to which patients anticipate help from clinics to find food in Los Angeles county. Preventive Medicine, 141(December 2020), 106297. https://doi.org/10.1016/j.ypmed.2020.106297 .

Caspi

C. E.

De Marco

Welle

Sadeghzadeh

Chapman

Harnack

L. J.

Pratt

(2022). A qualitative analysis of SNAP and minimum wage policies as experienced by workers with lower incomes. Journal of Hunger & Environmental Nutrition, 17(4), 521–539. https://doi.org/10.1080/19320248.2021.1997859

Chaparro

M. P.

Auchincloss

A. H.

Argibay

Ruggiero

D. A.

Purtle

Langellier

B. A.

(2023). County-and state-level immigration policies are associated with Supplemental Nutrition Assistance Program (SNAP) participation among latino households. Social Science & Medicine, 333(September 2023), 116141. https://doi.org/10.1016/j.socscimed.2023.116141 .

Cheng

T. C.

Tang

(2016). SNAP Out of it: A study of low-income families’ underutilization of food stamps. Journal of Poverty, 20(2), 152–167. https://doi.org/10.1080/10875549.2015.1094765

Cordeiro

L. S.

Sibeko

Nelson-Peterman

(2018). Healthful, cultural foods and safety net use among Cambodian and Brazilian immigrant communities in Massachusetts. Journal of Immigrant and Minority Health, 20(4), 991–999. https://doi.org/10.1007/s10903-017-0607-3

Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia. Available at www.covidence.org.

10.

Dillman

Eichner

Humienny

Kinsky

Liang

Kwok

E. Y. L.

Xie

(2023). The impact of Supplemental Nutrition Assistance Program (SNAP) enrollment on health and cost outcomes. NEJM Catalyst Innovations in Care Delivery, 4(6). https://doi.org/10.1056/cat.22.0366

11.

Ettinger de Cuba

Chilton

Bovell-Ammon

Knowles

Coleman

S. M.

Black

M. M.

Cook

J. T.

Cutts

D. B.

Casey

P. H.

Heeren

T. C.

Frank

D. A.

(2019). Loss of SNAP is associated with food insecurity and poor health in working families with young children. Health Affairs, 38(5), 765–773. https://doi.org/10.1377/hlthaff.2018.05265

12.

Huang

Liu

(2023). Unemployment benefits, food insecurity, and supplemental nutrition assistance program spending. American Journal of Agricultural Economics, 105(2), 479–502. https://doi.org/10.1111/ajae.12322

13.

Ganong

Liebman

J. B.

(2018). The decline, rebound, and further rise in SNAP enrollment: Disentangling business cycle fluctuations and policy changes. American Economic Journal: Economic Policy, 10(4), 153–176. https://doi.org/10.1257/pol.20140016

14.

Gregory

Ver Ploeg

Andrews

Coleman-Jensen

(2013). Supplemental Nutrition Assistance Program (SNAP) participation leads to modest changes in diet quality.

15.

Hatton

C. R.

Bresnahan

Tucker

A. C.

Johnson

John

Wolfson

J. A.

(2024). Food for thought: The intersection between SNAP stigma, food insecurity, and gender. Social Science & Medicine, 361(November 2024), 117367. https://doi.org/10.1016/j.socscimed.2024.117367 .

16.

Headrick

Ellison

Bresnahan

Green

Lyons

Moran

(2022). State implementation of SNAP waivers and flexibilities during the COVID-19 pandemic: Perspectives from state agency leaders. Journal of Nutrition Education and Behavior, 54(11), 982–997. https://doi.org/10.1016/j.jneb.2022.07.009

17.

Healthy People 2030 (2024). Social Determinants of Health: Food Insecurity. Retrieved from: https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/food-insecurity.

18.

Hines

C. T.

Markowitz

A. J.

Johnson

A. D.

(2021). Food insecurity: What are its effects, why, and what can policy do about it?. Policy Insights from the Behavioral and Brain Sciences, 8(2), 127–135. https://doi.org/10.1177/23727322211032250

19.

Homonoff

Somerville

(2021). Program recertification costs: Evidence from SNAP. American Economic Journal: Economic Policy, 13(4), 271–298. https://doi.org/10.1257/pol.20190272

20.

Hong

Q. N.

Fàbregues

Bartlett

Boardman

Cargo

Dagenais

Gagnon

M. P.

Griffiths

Nicolau

O’Cathain

Pluye

(2018). The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Education for Information, 34(4), 285–291. https://doi.org/10.3233/EFI-180221

21.

Hudak

K. M.

Racine

E. F.

(2019). The supplemental nutrition assistance program and child weight status: A review. American Journal of Preventive Medicine, 56(6), 882–893. https://doi.org/10.1016/j.amepre.2019.01.006

22.

Kenney

E. L.

Soto

M. J.

Fubini

Carleton

Lee

Bleich

S. N.

(2022). Simplification of Supplemental Nutrition Assistance Program recertification processes and association with uninterrupted access to benefits among participants with young children. JAMA Network Open, 5(9), e2230150–e2230150. https://doi.org/10.1001/jamanetworkopen.2022.30150

23.

Kogan

(2017). Administrative centralization and bureaucratic responsiveness: Evidence from the food stamp program. Journal of Public Administration Research and Theory, 27(4), 629–646. https://doi.org/10.1093/jopart/mux022

24.

Liu, R., Owoputi, I., Chiong, R., & Figueroa, R. (2023). Barriers and enablers to supplemental nutrition assistance program participation, access, and reach: A systematic review. Journal of Nutrition Education and Behavior, 55(7), 34.

25.

Louie

N. T.

Kim

L. P.

Chan

S. E.

(2020). Perceptions and barriers to SNAP utilization among Asian and Pacific Islanders in Greater Los Angeles. American Journal of Health Promotion, 34(7), 779–790. https://doi.org/10.1177/0890117120925746

26.

Mabli

Ohls

(2015). Supplemental Nutrition Assistance Program participation is associated with an increase in household food security in a national evaluation. The Journal of Nutrition, 145(2), 344–351. https://doi.org/10.3945/jn.114.198697

27.

Martinez

S. M.

Singh

Esaryk

Ritchie

(2024). SNAP Student rules are not so snappy: Lessons learned from a qualitative study of California county agency workers. Journal of Nutrition Education and Behavior, 56(3), 133–144. https://doi.org/10.1016/j.jneb.2023.12.004

28.

Melnick

E. M.

Ganderats-Fuentes

Ohri-Vachaspati

(2022). Federal food assistance program participation during the COVID-19 pandemic: Participant perspectives and reasons for discontinuing. Nutrients, 14(21), 4524. https://doi.org/10.3390/nu14214524

29.

Meza

Tester

J. M.

Yen

I. H.

Laraia

B. A.

Wolfson

J. A.

Leung

C. W.

(2021). Perceptions of SNAP and stocking standards: A qualitative study of California small food store owners and managers. Nutrients, 13(3), 752. https://doi.org/10.3390/nu13030752

30.

Nazmi

Condron

Tseng

Volpe

Rodriguez

Lopez

M. L.

Martinez

S. M.

Freudenberg

Bianco

(2023). SNAP Participation decreases food insecurity among California public university students: A quasi-experimental study. Journal of Hunger & Environmental Nutrition, 18(1), 123–138. https://doi.org/10.1080/19320248.2022.2099777

31.

Odoms-Young

Bruce

M. A.

(2018). Examining the impact of structural racism on food insecurity: Implications for addressing racial/ethnic disparities. Family & Community Health, 41(S2), S3–S6. https://doi.org/10.1097/FCH.0000000000000183

32.

Ohri-Vachaspati

Acciai

DeWeese

R. S.

(2021). SNAP Participation among low-income US households stays stagnant while food insecurity escalates in the months following the COVID-19 pandemic. Preventive Medicine Reports, 24(December 2021), 101555. https://doi.org/10.1016/j.pmedr.2021.101555 .

33.

Page

M. J.

McKenzie

J. E.

Bossuyt

P. M.

Boutron

Hoffmann

T. C.

Mulrow

C. D.

Shamseer

Tetzlaff

J. M.

Akl

E. A.

Brennan

S. E.

Chou

Glanville

Grimshaw

J. M.

Hróbjartsson

Lalu

M. M.

Loder

E. W.

Mayo-Wilson

McDonald

, … Moher

(2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Journal of Clinical Epidemiology, 134(June 2021), 103–112. https://doi.org/10.1016/j.jclinepi.2021.02.003

34.

Parks

Calloway

Chiappone

Fricke

Stern

Yaroch

A. L.

(2019). Perceptions of SNAP Policies among food pantry clients in the Midwest: A comparison between SNAP and non-SNAP participants. Journal of Hunger & Environmental Nutrition, 14(1-2), 82–97. https://doi.org/10.1080/19320248.2018.1549519

35.

Pelto

D. J.

Ocampo

Garduño-Ortega

Barraza López

C. T.

Macaluso

Ramirez

González

Gany

(2020). The nutrition benefits participation gap: Barriers to uptake of SNAP and WIC among latinx American immigrant families. Journal of Community Health, 45(3), 488–491. https://doi.org/10.1007/s10900-019-00765-z

36.

Pinard

C. A.

Bertmann

F. M.

Byker Shanks

Schober

D. J.

Smith

T. M.

Carpenter

L. C.

Yaroch

A. L.

(2017). What factors influence SNAP participation? Literature reflecting enrollment in food assistance programs from a social and behavioral science perspective. Journal of Hunger & Environmental Nutrition, 12(2), 151–168. https://doi.org/10.1080/19320248.2016.1146194

37.

Singleton

C. R.

Young

S. K.

Kessee

Springfield

S. E.

Sen

B. P.

(2020). Examining disparities in diet quality between SNAP participants and non-participants using Oaxaca-Blinder decomposition analysis. Preventive Medicine Reports, 19(September 2020), 101134. https://doi.org/10.1016/j.pmedr.2020.101134 .

38.

Smith

D. I.

Tatum

K. L.

Lefbom

Moore

Barnard

Harnack

Foster

Bean

M. K.

(2024). Stretch your SNAP: Stakeholder perspectives of a novel benefits program to enhance diet quality. Preventive Medicine Reports, 40(April 2024), 102676. https://doi.org/10.1016/j.pmedr.2024.102676 .

39.

Spence

E. H.

Niles

M. T.

Bertmann

Belarmino

E. H.

(2024). Experiences participating in federal nutrition assistance programs during the early months of the COVID-19 pandemic: An investigation in Vermont. Nutrition Journal, 23(1), 74. https://doi.org/10.1186/s12937-024-00963-z

40.

Suttles

Babb

Knudsen

D. C.

(2024). Submitted and Denied: Understanding variation in case status across Supplemental Nutrition assistance program (SNAP) applications. Food Policy, 123(February 2024), 102588. https://doi.org/10.1016/j.foodpol.2023.102588 .

41.

Swavely

Whyte

Steiner

J. F.

Freeman

S. L.

(2019). Complexities of addressing food insecurity in an urban population. Population Health Management, 22(4), 300–307. https://doi.org/10.1089/pop.2018.0126

42.

Thomas

Kneale

McKenzie

J. E.

Brennan

S. E.

Bhaumik

(2024). Chapter 2: Determining the scope of the review and the questions it will address [last updated August 2023]. In Higgins

J. P. T.

Thomas

Chandler

Cumpston

Page

M. J.

Welch

V. A.

(Eds.), Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane. www.training.cochrane.org/handbook

43.

Treuhaft

Karpyn

(2010). The Grocery Gap. Who has access to healthy food and why it matters. Policy Link and Food Trust. Retrieved on October 20, 2024 from: http://thefoodtrust.org/uploads/media_items/grocerygap.original.pdf Accessed October 20, 2024.

44.

United States Department of Agriculture (USDA)-Economic Research Service (ERS). (2024a). Food Security in the US: Food Security Status of U.S. Households in 2023. ERS. Retrieved from: https://www.ers.usda.gov/webdocs/publications/109896/err-337.pdf?v=9576.5

45.

USDA-ERS. (2024b). Chronic disease risk increased with U.S. household food insecurity. Retrieved from: https://www.ers.usda.gov/data-products/chart-gallery/gallery/chart-detail/?chartId=108913.

46.

USDA-FNS. (2024a). SNAP Data Tables. Retrieved from: https://www.fns.usda.gov/pd/supplemental-nutrition-assistance-program-snap.

47.

USDA-FNS. (2024b). SNAP Participation Rates by State, All Eligible People (FY 2019). Retrieved from: https://www.fns.usda.gov/usamap/2019.

48.

USDA-Food and Nutrition Service (FNS). (2024). FNS Nutrition Programs. Retrieved from: https://www.fns.usda.gov/programs.

49.

Zhang

Wang

Yen

S. T.

(2021). Does supplemental nutrition assistance program reduce food insecurity among households with children? Evidence from the current population survey. International Journal of Environmental Research and Public Health, 18(6), 3178. https://doi.org/10.3390/ijerph18063178

50.

Zhao

J. J.

Kaiser

H. M.

Zheng

(2022). Do grocery food taxes incentivize participation in SNAP? Regional Science and Urban Economics, 95(July 2022), 103736. https://doi.org/10.1016/j.regsciurbeco.2021.103736 .