AAN 2026: How SNAP Policy, School Meal Programs, and Minimum Wage Laws Shape Adolescent Neurological Health

In an interview with Pharmacy Times at the 2026 American Academy of Neurology (AAN) Annual Meeting, Nour Hammad, MSc, RDN, a PhD candidate in population health sciences at Harvard T.H. Chan School of Public Health, explained that social, environmental, and political determinants of health are deeply interconnected and remain largely underrecognized in neurology. She noted that analysis of Youth Risk Behavior Surveillance System (YRBSS) data from 16 states found that 13% of adolescents experienced food insufficiency—a condition linked to a cluster of brain health risk factors, including concussion, depression, inadequate sleep, and high sugary drink consumption.

Pharmacy Times: Can you introduce yourself and explain your current role?

Nour Hammad, MSc, RDN: Hi. My name is Nour Hammad. I'm a PhD candidate in population health sciences at the Harvard T.H. Chan School of Public Health, and I specialize in public health nutrition and social determinants of brain health.

Pharmacy Times: Your research spans social, environmental, and political determinants of brain health—which of these do you find most underrecognized in neurology, and why?

Hammad: That's a great question, and to be clear, these are not distinct determinants of health—they are deeply overlapping and interrelated. When we think about social determinants of health like food access, that is shaped by political determinants of health, such as food and nutrition policy, and also by environmental determinants of health, such as food marketing and labeling. All of these are underrecognized in neurology. In our work using Youth Risk Behavior Surveillance System (YRBSS) data—representative across 16 states in 2017 and 2019—we found that 13% of adolescents often went hungry because they did not have enough food at home. We refer to this as hunger due to food insufficiency. We found that it was associated with multiple brain health risk factors: concussion, sugary drink consumption, and depression, among others. So it is really a cluster of brain health risk factors, not just one isolated domain. It is imperative for the field of neurology to consider social determinants of health, like whether a patient has access to adequate food, particularly during critical neurodevelopmental windows. These exposures are socially, politically, and environmentally structured, but they are often clinically invisible unless clinicians are deliberate about assessing for them. That is the gap.

Pharmacy Times: How significantly do early-life exposures like lead, pollution, and food insecurity shape long-term neurological disease risk, and are we doing enough to screen for them clinically?

Hammad: Early-life exposures shape health outcomes detrimentally across the entire life course. There are short-term impacts on children and adolescents, and there are also long-term consequences that emerge later in adulthood. For example, when thinking about malnutrition and food insecurity, we see short-term impacts on cognitive health. We also see later outcomes—such as cardiometabolic risk factors like hypertension and diabetes—linked to early exposure to nutritionally poor diets. It is very important to take a life course approach and recognize the lasting impacts of these social determinants of health. What we found particularly striking was the association between hunger due to food insufficiency and multiple brain health outcomes simultaneously: higher odds of concussion, depression, low fruit intake, inadequate sleep, and high sugary drink consumption. This suggests that these exposures are associated with neurodevelopmental trajectories and health behaviors in concert, not in isolation. In terms of screening, from my understanding, these factors are not routinely assessed in neurology—they are more commonly addressed in primary care settings. I think that is a problem. It is imperative for neurologists to screen for these fundamental social needs, especially given the associations we have observed, if we truly want to understand a patient's brain health risk architecture.

Pharmacy Times: How are financial and political forces—insurance coverage, Medicaid policy, and recent US Supreme Court decisions—actively widening inequities in neurological care right now?

Hammad: Given the focus of my work on food security, I will speak to that specifically. It is really important to think about policies that shape food access: who is eligible for SNAP—the Supplemental Nutrition Assistance Program, formerly known as food stamps—as well as school breakfast programs, the National School Lunch Program, and minimum wage policies, which directly affect how much disposable income a family has. All of these shape food insecurity levels and, by extension, adolescent brain health. When we talk about policy discussions, it is important to remember that these conversations are ongoing—they are not a single moment in time. It is therefore essential for both clinicians and public health practitioners to remain actively engaged in these policy conversations and to keep the health of patients at the forefront of every policy decision.

Pharmacy Times: What practical strategies can neurologists implement today, both in the clinic and in policy advocacy, to meaningfully move the needle on equitable brain health?

Hammad: What we found striking is this association between hunger due to food insufficiency and multiple brain health risk factors. This tells us that these are modifiable risk factors—and if something is modifiable, it is actionable. At the clinical level, I encourage clinicians to incorporate validated screening tools into their practice. For food insecurity specifically, there is the 2-item Hunger Vital Sign screening tool, which assesses food insufficiency directly. Clinicians can also screen for other basic social needs such as social isolation, housing instability, and unemployment. After identifying these needs, the next step is referring patients to appropriate community organizations—food pantries and similar resources—that can provide support. At the policy level, I would encourage clinicians and public health practitioners alike to be deliberate and actively engaged in policy discussions around economic stability and food access, given the direct associations with brain health outcomes. Being at that table—advocating for patients' needs—is one of the most meaningful things both groups can do.