Abstract
INTRODUCTION: The aim of this study was to examine the associations between state-level expansion of Supplemental Nutrition Assistance Program eligibility and adolescent bullying. METHODS: This cross-sectional ecologic study used data from the Supplemental Nutrition Assistance Program Policy Database and the Youth Risk Behavior Survey (2013-2021) in 41 states. Log-binomial regression compared the risk of any bullying, school bullying, and electronic bullying among adolescents (Grades 9-12) in states that had both broad-based categorical eligibility policies to expand Supplemental Nutrition Assistance Program eligibility (i.e., asset test eliminated and income limit increased) and the asset test eliminated only with the risk among adolescents in states with neither policy. RESULTS: In primary analyses (2013-2019), including 645,244 adolescents, those in states with both broad-based categorical eligibility policies had lower risk of experiencing any bullying (RR=0.87, 95% CI=0.84, 0.89), school bullying (RR=0.86, 95% CI=0.83, 0.89), and electronic bullying (RR=0.85, 95% CI=0.82, 0.88) than adolescents in states with neither policy. Similarly, adolescents in states with the asset test eliminated only had lower risk of experiencing any bullying, school bullying, and electronic bullying than adolescents in states with neither policy. Secondary analyses that included 2021, a COVID-19 pandemic year, showed that adolescents in states with both policies had lower risk of experiencing each type of bullying, whereas adolescents in states with the asset test eliminated only had lower risk of experiencing electronic bullying, than adolescents in states with neither policy. CONCLUSIONS: State broad-based categorical eligibility policies were associated with a lower risk of adolescent bullying. Results suggest that expanding Supplemental Nutrition Assistance Program eligibility, including through state broad-based categorical eligibility policies, may contribute to reductions in bullying.