ECONOMIC HARDSHIP, SLEEP, AND SELF-RATED HEALTH Evidence from the Supplemental Nutrition Assistance Program (SNAP)

Helmut Farbmacher, Maximilian Hartmann, Heinrich Kögel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The Supplemental Nutrition Assistance Program (SNAP) distributes vouchers for grocery shopping to around 43 million individuals across the United States to counteract food insecurity. In this study, we take advantage of the random interview day assignment of the American Time Use Survey (ATUS) and the variation in voucher issuance dates across states to identify changes in self-rated health and sleep over the monthly SNAP payment cycle. We find that the economic hardship experienced at the end of the payout period causes a significant and sizable negative effect on self-assessed physical health and sleep quality. SNAP recipients were 18 percent more likely to report fair or poor physical health at the end of the payment cycle compared with the rest of the month. During this period of scarcity, recipients were also 50 percent more likely to report sleeplessness, with the number of minutes being sleepless more than doubling while total sleep duration remained unchanged. Drawing upon information on time use in the ATUS, we discuss evidence suggesting that higher levels of stress, changed eating patterns, and reduced sleep quality may be potential mechanisms of the adverse health effects. Our findings extend the literature on sleep quality as a mediator between low socioeconomic status and self-rated health in the short run.

Original languageEnglish
Pages (from-to)216-251
Number of pages36
JournalAmerican Journal of Health Economics
Issue number2
StatePublished - 1 Mar 2022


  • Financial circumstances
  • Food Stamp Program
  • Health
  • Poverty
  • Sleep
  • Supplemental Nutrition Assistance Program


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