New Study Shows SNAP’s Positive Impact on Medication Nonadherence Among Older Adults

Columbia, MD


January 18, 2018

For Immediate Release

Unaffordable medication is one of the primary reasons older adults do not adhere to treatment regimens in the US, and IMPAQ researchers have found evidence that increasing access to the Supplemental Nutrition Assistance Program (SNAP) may lead to reduced rates of nonadherence. The findings of this study have been published in the February 2018 copy of the prestigious American Journal of Public Health (“Cost-Related Medication Nonadherence for Older Adults Participating in SNAP, 2013–2015”:

Lead author and co-principal investigator, Dr. Mithuna Srinivasan, explained why a food assistance program may help older adults with a seemingly unrelated challenge: “The high cost of prescription medication can lead to tradeoffs between medication and other necessities, such as food or utilities. This in turn, can manifest as cost-related nonadherence (CRN), including such behaviors as skipping or stopping medications due to cost. While SNAP’s primary goal is to improve access to food, we wanted to test whether the program might help older adults better afford their prescription medications, conceivably by reducing out-of-pocket expenditures on food.”

The study found that even after controlling for important predictors of CRN such as health conditions, out-of-pocket health care costs, and prescription drug coverage, on average, SNAP participants were 4.8 percentage points less likely to engage in CRN than eligible nonparticipants. SNAP participation had an even greater impact for older adults threatened by hunger and who were food insecure. These findings suggest that increasing access to SNAP may allow low-income older adults to better afford their prescription medications, which is important, not only for their health and well-being, but for reducing costly consequences of nonadherence.

“It’s important to note, however,” study co-author, Ms. Jennifer Pooler explains, “that while SNAP reduced CRN among participants, it did not eliminate CRN entirely – more efforts are needed to overcome the financial barriers to medication adherence than SNAP can address on its own.”

These results have a number of policy implications for state and Federal governments, as well as health insurance payers and health systems. States and the Federal government must continue to reduce barriers to SNAP participation for older adults: only about 40-45 percent of eligible, low-income older adults participate in the program. Stakeholders can also reduce the stigma associated with SNAP participation by touting the “health benefits” of participation and reframing the program as a health subsidy. Health plan sponsors, government payers, and health systems should also explore opportunities to screen for food insecurity and refer food-insecure older adult patients to community-based organizations that can help those individuals access SNAP and other resources for which they may be eligible. Finally, health plan sponsors and government payers can reimburse health systems for food security screening and referrals.

About the Authors

Mithuna Srinivasan, lead author and co-principal investigator, is a Research Associate in the Workforce Development Division. She has a PhD in Economics from The Ohio State University. Dr. Srinivasan is a mixed-methods researcher who works across diverse topic areas spanning food and nutrition, workforce development and health. She has extensive training in applied econometrics, and in experimental and quasi-experimental program evaluation techniques.

Jennifer Pooler, co-principal investigator, is a Senior Research Associate in IMPAQ Health’s Advanced Analytics team. She has an MPP from the University of Southern Maine. Ms. Pooler has conducted mixed methods research and evaluation for over 10 years in a variety of areas related to nutrition assistance programs, food security, and older adult health. 

About IMPAQ International

With research studies, implementation assistance, surveys and data collection, advanced analytics and technology solutions, and communications strategies, IMPAQ helps governments, businesses, foundations, non-profits, and universities evaluate and enhance their programs and policies.​