Cost-Related Medication Nonadherence for Older Adults Participating in SNAP, 2013-2015

To estimate the impact of Supplemental Nutrition Assistance Program (SNAP) participation on cost-related medication nonadherence (CRN) for older adults in the United States, with a particular focus on those who are food insecure and those threatened by hunger.

We used propensity score matching to create matched intervention and comparison groups of SNAP-eligible US adults aged 60 years and older with data from the 2013-2015 National Health Interview Survey. Intervention group participants were identified on the basis of self-reported SNAP participation in the past year.

SNAP participants were 4.8 percentage points less likely to engage in CRN than eligible nonparticipants (P < .01). The effect of SNAP is about twice as large for older adults threatened by hunger (9.1 percentage points; P < .01), and considerable even for those who are food insecure (7.4 percentage points; P < .05).

Findings point to a spillover "income effect" as SNAP may help older adults better afford their medications, conceivably by reducing out-of-pocket food expenditures. When prescribing treatment plans, health systems and payers have a vested interest in connecting older patients to SNAP and other resources that may help address barriers to care.