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August 2019 Highlights

Date: Aug 15 2019

CONTACT: Arnice Cottom, 202-777-3913

American Journal of Public Health October issue research highlights:

SNAP participants lost benefits after expansion of work requirements

This study found that after the adoption of work requirements for able-bodied adults without dependents enrolled in the federal Supplemental Nutrition Assistance Program, participation dropped. Adoption of work requirements was followed by reductions of 3% in total SNAP participation, 4.5% in SNAP households and 3.8% in SNAP benefit dollars, after controlling for the unemployment, poverty and Medicaid expansions.

The expansion of work requirements for SNAP resulted in 600,000 participants losing SNAP benefits between 2013 and 2017 with a $2.5 billion reduction in federal SNAP benefits in 2017. One-third of able-bodied adults without dependents lost their benefits despite comprising only 8% to 9% of all SNAP participants.

Authors concluded that SNAP work requirements rapidly reduce caseloads and benefits, reducing food and health access, and suggested that effects on participation could be similar for work requirements in Medicaid or other programs.

[Author Contact: Leighton Ku, PhD, MPH, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC. “The effects of SNAP Work Requirements in Reducing Participation and Benefits From 2013 to 2017”

Medicaid expansion areas saw increase in HIV testing rates

Medicaid expansion promoted HIV testing without increasing HIV risk behavior, according to a new study published in AJPH.

Researchers found that Medicaid expansion under the Affordable Care Act was associated with a more than 3% increase in HIV test rates for individuals below 138% of the federal poverty line between 2010 and 2017. Non-Hispanic blacks, those ages 35 to 44 and 55 to 64, and people living in rural areas were most greatly impacted.

Authors concluded that nonexpansion states, mostly in the South, might have missed an opportunity to increase HIV test rates, which could have serious future health and financial consequences

[Author Contact: Yunwei Gai, Economics Division, Babson College, Babson Park, MA. “Medicaid Expansion, HIV Testing, and HIV-Related Risk Behaviors in the United States, 2010-2017”

Psychological attempts to change a person’s gender identity remain prevalent in US

Using a sample of 27,716 transgender people from the 2015 U.S. Transgender Survey, researchers examined the prevalence of lifetime exposure to psychological attempts to change a person’s gender identity from transgender to cisgender (PACGI) in the U.S.

Overall, 13.5% indicated lifetime exposure to PACGI, ranging across all U.S. states from 9.4% in South Carolina to 25% in Wyoming. The percentage of transgender adults in the U.S. reporting exposure to PACGI between 2010 and 2015 was 5% overall, and across all states ranged from 1.2% in Alaska to 16.3% in South Dakota.

Authors concluded that despite major medical organizations identifying PACGI as ineffective and unethical, this practice has continued in every U.S. state as recently as the period 2010 to 2015

[Author Contact: Jack L. Turban, Division of Child & Adolescent Psychiatry, Massachusetts General Hospital, and the Department of Psychiatry, Harvard Medical School, Boston, MA. “Psychological Attempts to Change a Person’s Gender Identity From Transgender to Cisgender: Estimated Prevalence Across US States, 2015”].

Find a full list of AJPH research papers published online below:

  • Menthol smokers' response to restrictions on menthol cigarettes: longitudinal results among U.S. young adults
  • Psychotherapeutic Attempts to Change a Person’s Gender Identity from Transgender to Cisgender: Estimated Prevalence Across U.S. States, 2015
  • Vape Versus E-cigarette: The Relationship Between Language and Newspaper Content
  • The Impact of HUD-VASH Vouchers on Veterans? Homelessness
  • Teen Dating Violence Prevention Program for Early Adolescents: the Me and You Randomized Controlled Trial (2014-2015)
  • Price promotions by food category and product healthiness in an Australian supermarket chain, 2017-2018
  • Estimating the Prevalence of Human Trafficking in Ohio 2014-2016
  • Effects of Medicaid Expansion on HIV Testing and Risk Behavior for Individuals 25 to 64 Years Old
  • The Effects of Work Requirements in Reducing SNAP Participation and Benefits from 2013 to 2017
  • Characterizing housing instability among transgender veterans utilizing health care in the Veterans Health Administration, 2013-2016
  • The Effects of the ACA Medicaid Expansion on Nationwide Home Evictions and Eviction-Court Initiations, 2000-2016
  • Engaging Parents to Prevent Adolescent Substance Use: A Randomized Controlled Trial
  • Investigating the strength of causal language used in health warning labels: An online survey study of US adults

The articles above were published online August 15, 2019, at 4 p.m. EDT by AJPH under “First Look.”

“First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. AJPH is published by the American Public Health Association, and is available at

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to Arnice Cottom at APHA. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions Department. If you are not a member of the press, a member of APHA or a subscriber, online single-issue access is $30, and online single-article access is $22 at For direct customer service, call 202-777-2516, or email us.
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