Abstract：
BACKGROUND: The Supplemental Nutrition Assistance Program (SNAP) has been established to reduce food insecurity. Limited evidence is available on SNAP participation status over time and depressive symptoms. We aimed to examine the associations of SNAP status over time among low-income individuals, with depressive symptoms in the U.S.
METHODS: NHANES participants aged ≥20 years of low family income from 2011 to 2018 with information available on depressive symptoms and SNAP use were included in analysis. Depressive symptoms were assessed using 9-item Patient Health Questionnaire (PHQ-9), and PHQ-9 score ≥ 10 is indicative of significant depressive symptoms. Multivariable linear and logistic regressions models were conducted to examine the associations of SNAP participation status over time (never receiving SNAP, receiving SNAP prior to >12 months ago, current receiving SNAP, receiving SNAP in the last 12 months but not currently) with depressive symptoms and significant depressive symptoms.
RESULTS: Currently receiving SNAP (beta (β) = 0.17, 95 % CI: 0.10, 0.25; odds ratio (OR) = 1.52, 95 % confidence interval (CI): 1.16, 2.00) and receiving SNAP in the last 12 months but not currently (β = 0.24, 95 % CI: 0.04, 0.43; OR = 1.83, 95 % CI: 1.16, 2.89) were associated with higher depressive symptoms and higher prevalence of significant depressive symptoms.
CONCLUSIONS: The cross-sectional design precludes causal interpretation, and key variables were measured with self-report.
CONCLUSIONS: Receiving SNAP in the last 12 months was associated with higher levels of depressive symptoms among individuals with low family income. Improvement on diet quality may be important for reducing depressive symptoms among SNAP users.
METHODS: NHANES participants aged ≥20 years of low family income from 2011 to 2018 with information available on depressive symptoms and SNAP use were included in analysis. Depressive symptoms were assessed using 9-item Patient Health Questionnaire (PHQ-9), and PHQ-9 score ≥ 10 is indicative of significant depressive symptoms. Multivariable linear and logistic regressions models were conducted to examine the associations of SNAP participation status over time (never receiving SNAP, receiving SNAP prior to >12 months ago, current receiving SNAP, receiving SNAP in the last 12 months but not currently) with depressive symptoms and significant depressive symptoms.
RESULTS: Currently receiving SNAP (beta (β) = 0.17, 95 % CI: 0.10, 0.25; odds ratio (OR) = 1.52, 95 % confidence interval (CI): 1.16, 2.00) and receiving SNAP in the last 12 months but not currently (β = 0.24, 95 % CI: 0.04, 0.43; OR = 1.83, 95 % CI: 1.16, 2.89) were associated with higher depressive symptoms and higher prevalence of significant depressive symptoms.
CONCLUSIONS: The cross-sectional design precludes causal interpretation, and key variables were measured with self-report.
CONCLUSIONS: Receiving SNAP in the last 12 months was associated with higher levels of depressive symptoms among individuals with low family income. Improvement on diet quality may be important for reducing depressive symptoms among SNAP users.
摘要：
背景：已经建立了补充营养援助计划（SNAP），以减少粮食不安全。关于SNAP参与状态随时间变化和抑郁症状的证据有限。我们的目的是研究低收入个人之间SNAP状态随时间的关联，在美国有抑郁症状
方法:NHANES参与者,年龄≥20岁,家庭收入低,从2011年到2018年,有关于抑郁症状和SNAP使用的信息被纳入分析.使用9项患者健康问卷（PHQ-9）评估抑郁症状，PHQ-9评分≥10分表明有明显的抑郁症状。进行了多变量线性和逻辑回归模型，以检查SNAP参与状态随时间的关联（从未收到SNAP，在>12个月前收到SNAP,当前接收SNAP，在过去12个月内接受SNAP，但目前尚未接受SNAP），伴有抑郁症状和明显的抑郁症状。
结果：目前正在接受SNAP（β（β）=0.17，95％CI：0.10，0.25；比值比（OR）=1.52，95％置信区间（CI）：1.16，2.00），并在过去12个月内接受SNAP，但目前未接受SNAP（β=0.24，95％CI：0.04，0.43；OR=1.83，95％CI：1.16
结论：横截面设计排除了因果解释，关键变量采用自我报告进行测量。
结论：在过去12个月内接受SNAP与家庭低收入人群的抑郁症状水平较高有关。改善饮食质量对于减少SNAP使用者的抑郁症状可能很重要。
方法:NHANES参与者,年龄≥20岁,家庭收入低,从2011年到2018年,有关于抑郁症状和SNAP使用的信息被纳入分析.使用9项患者健康问卷（PHQ-9）评估抑郁症状，PHQ-9评分≥10分表明有明显的抑郁症状。进行了多变量线性和逻辑回归模型，以检查SNAP参与状态随时间的关联（从未收到SNAP，在>12个月前收到SNAP,当前接收SNAP，在过去12个月内接受SNAP，但目前尚未接受SNAP），伴有抑郁症状和明显的抑郁症状。
结果：目前正在接受SNAP（β（β）=0.17，95％CI：0.10，0.25；比值比（OR）=1.52，95％置信区间（CI）：1.16，2.00），并在过去12个月内接受SNAP，但目前未接受SNAP（β=0.24，95％CI：0.04，0.43；OR=1.83，95％CI：1.16
结论：横截面设计排除了因果解释，关键变量采用自我报告进行测量。
结论：在过去12个月内接受SNAP与家庭低收入人群的抑郁症状水平较高有关。改善饮食质量对于减少SNAP使用者的抑郁症状可能很重要。
