Social programme receipt and child health, healthcare access and utilisation among low-income US households: a cross-sectional analysis of the National Survey for Child Health.

BACKGROUND: Poverty is associated with poor health and increased healthcare utilisation. Social programmes may mitigate these effects by enhancing the ability to purchase direct inputs into health, improving access. We aimed to examine associations between receipt of cash assistance, Supplemental Nutrition Assistance Program, Special Supplemental Nutrition Program for Women, Infants and Children, and free/reduced cost school meals with child health measures among children from low-income US households. METHODS: We conducted a retrospective, cross-sectional analysis of data from the 2019 National Survey for Child Health. Households with incomes <185% of the federal poverty level were included. Multivariable logistic regressions assessed associations, reporting OR with 95% CIs for the following outcomes: parent-reported child health; health access as defined by unmet healthcare need, inability to pay medical bills and experiencing frustrating access to care; and healthcare utilisation defined by the number of preventative healthcare visits and number of emergency visits in the past year. RESULTS: The sample included 7279 children aged 0-17, representing 27 million children nationally. Among low-income households, 24.6% received none of the four programmes. Programme receipt was not associated with child health. Programme receipt was associated with frustrating healthcare access (OR 1.72, 95% CI 1.23 to 2.41) and increased emergency department utilisation (OR 1.63, 95% CI 1.16 to 2.29), with no association with preventative care. CONCLUSION: Social programme receipt was associated with frustrating healthcare access and greater emergency care utilisation. Policy efforts to facilitate access for low-income families may improve child health outcomes.