Persistent Food Insecurity is Associated with Higher Levels of Cost‐Related Medication Non Adherence in Low‐Income Older Georgians

Abstract

The purpose of this study was to examine the relationship between changes in food insecurity (FI) and cost‐related medication non‐adherence (CRN) among Older Americans Act Nutrition Program participants and waitlisted people in Georgia. This study used 3 waves of self‐administered mail surveys, conducted 4 months apart between 2008 and 2009 (n = 664, mean age 74.6 ± 8.9, 71.5% women, 31.0% African American). FI was assessed by using a modified version of the nationally validated standard 6‐item US Household Food Security Survey Module. Practice of 5 CRN behaviors (i.e., splitting pills, delaying refills, and skipping doses) was evaluated. Changes in FI and CRN were determined based on ≥ 2 repeated measures. Over the 8‐month period, 35.8% were persistently food insecure, 12.7% became food insecure, 16.7% became food secure, and 34.8% were persistently food secure; 29.2% persistently practiced CRN, 16.7% started practicing CRN, 15.7% stopped practicing CRN, and 38.4% were persistently medication adherent. Participants with persistent FI and CRN were more likely to be younger, low‐income, and in poorer health. After controlling for potential confounders, persistently food insecure and newly food insecure individuals were 8.2 times (95% CI: 5.4, 12.5) and 5.3 times (95% CI: 3.2, 8.8) more likely to report higher levels of CRN than persistently food secure individuals. This study was funded in part by UGA FACS.