SNAP Benefits Go Beyond Food Access: The Impact on Cost-Related Medication Nonadherence for Older Adults

Abstract

One in five older adults engage in cost-related medication nonadherence (CRN), which can result in hospitalizations and adverse health outcomes, and rates are higher for those at-risk of hunger. This study sought to examine whether participation in the Supplemental Nutrition Assistance Program (SNAP) may help older adults better afford their medications, plausibly by reducing out-of-pocket food expenditure. Using data from the 2013-2015 U.S. National Health Interview Survey and Propensity Score Matching, we create matched intervention and comparison groups of adults age 60 and over. The treatment group (n=1,717) comprises SNAP participants, and the comparison group (n=3,329) includes eligible non-participants. The outcome is a binary variable for engaging in CRN, and the treatment is SNAP participation. Probit regression models are used to determine the impact of SNAP on CRN while controlling for a wide array of sociodemographic and health-related factors. SNAP participants are 3.1 percentage points less likely to engage in CRN than eligible non-participants (p=0.06). This effect is magnified for the subgroup of older adult SNAP participants at-risk of hunger, who were 5.8 percentage points less likely to engage in CRN than their counterparts (p=0.04). Approximately 42 percent of eligible older adults participate in SNAP. Health systems and payers have a vested interest in connecting low-income older adults with food assistance programs given the direct connection between food insecurity and poor health outcomes, and now strong evidence that SNAP participation can help older adults afford their prescription medications.