SNAP Disruption During a Government Shutdown and Implications for Chronic Disease Self-Management: A Qualitative Study
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ID: 322499
2026
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Abstract
Abstract Introduction Government shutdowns expose safety-net programs to unplanned disruptions, but little is known about how unexpected benefit interruptions affect chronic disease management. In November 2025, a shutdown–related delay in Supplemental Nutrition Assistance Program (SNAP) benefit issuance disrupted food access for millions of Americans. Methods We conducted semi-structured interviews with 20 SNAP recipients living with HIV, nested within a 54-person cohort with daily antiretroviral therapy (ART) adherence monitoring. Interviews explored monthly SNAP-cycle experiences, food-HIV management connections, and the November 2025 benefit delay. Pre-shutdown adherence is reported across the parent cohort; during-shutdown adherence is reported across 9 participants whose monitoring extended into the disruption. Results Four themes emerged: routine food access required planning; the monthly SNAP cycle imposed cognitive and material burden affecting chronic disease self-management; the November 2025 disruption was qualitatively distinct because added uncertainty compounded burden and destabilized self-management; and community supports partially buffered consequences. Across the 54-person parent cohort, median pre-shutdown adherence was 72%; among 9 participants monitored during the disruption, median during-shutdown adherence was 40%. Conclusions Unexpected benefit disruptions impose uncertainty that adds cognitive burden and upsets the routines essential for chronic disease management. Safety-net programs should prioritize benefit reliability alongside adequacy, with implications extending across chronic conditions that depend on daily self-management.
| Reference Key |
openalex_W7170199725
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| Authors | Elizabeth Whidden, Nicole Ellingson, Charlotte Babbin, Eliza W. Kinsey, Aaron Richterman |
| Journal | Health Affairs Scholar |
| Year | 2026 |
| DOI |
10.1093/haschl/qxag194
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| URL | |
| Keywords | Keywords not found |
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