Weighing checkbook balances against the delicate equilibrium of insulin in their bloodstream may be getting more difficult for low-income diabetics, according to a University study published in today’s Journal of the American Medical Associations.
And with the study conducted in the first few months following the implementation of the historic 1996 welfare overhaul, researchers say the results should serve as a red flag for lawmakers.
The study looked specifically at the relationship between welfare, poor health and hunger.
“We were surprised by the level of hunger,” said co-author Dr. Karen Nelson, a third-year resident at the Hennepin County Medical Center. “This may be just the tip of the iceberg for low-income patients.”
The study was conducted in 1997 after co-author Dr. Nicole Lurie, professor of medicine, learned diabetic patients who could not afford food stopped taking insulin to balance out blood sugar levels.
Low blood-sugar levels can cause blackouts or brain damage. High blood sugar levels lead to dehydration or complications that can send a patient to the hospital.
Researchers interviewed all adult patients admitted to Hennepin County Medical Center and those patients visiting the hospital’s general clinic for outpatient treatment for two weeks in April and one week in June. The interviews found 13 percent did not eat for a day. An additional 12 percent reported not having enough food available.
Twenty percent of the study’s 567 participants experienced a decline in or loss of their food stamps.
The group was 20 percent more likely to report not eating for a day and 28 percent more likely to report they did not have enough food.
A second survey focusing on diabetics found 31 percent attributed adverse reactions to their insulin to the fact that they could not afford food.
“We hope this sends a message to policy-makers,” Lurie said in a press release. “Cuts in food stamps may not be benign. There are clear health consequences and often expensive ones, at least for people with diabetes.”
Malnourishment only aggravates poor health, Nelson said. Benefit reductions might not serve the state or its citizens, she said.
The state has worked to minimize the damage from the most drastic federal cuts, said Deborah Huskins, assistant commissioner of Minnesota’s Department of Human Services. But the state has limited control over food stamps, which are distributed by the federal government.
“The general message, be careful what you do,’ is certainly warranted,” she said. More detailed information surrounding how the study’s participants lost their benefits would be needed in order to influence state policy, she added.
Minnesota’s 1998 legislative session concluded Friday, following a debate about how to distribute a $1.9 billion budget surplus, the largest in the state’s history.
Now resting on Gov. Arne Carlson’s desk, the package includes a provision for $9 million to continue extending food stamps to legal immigrants for another fiscal year. After Congress eliminated the stamps for legal immigrants in August of 1996, the Minnesota Legislature voted to restore the aid on an annual basis.
These Band-Aid funds are one example of the tango between states and the federal government as they attempt to put together a patchwork of policy in the wake of the 1996 welfare overhaul.
“It’s so new we just don’t have enough experience yet to know what’s going to happen,” said Sen. Don Samuelson, DFL-Brainerd, chief author of Minnesota’s 1997 reform bill.
Minnesota’s healthy economy has contributed to the program’s success, Samuelson said. An economic downturn could strain the state’s resources.
“What we’ve got to be concerned with is the future,” he said.
Samuelson said the state continues to monitor the program through counties who handle and track cases.