Older Adults and Social Determinants: Our Work and Resources

Through in-depth research and policy relevant evaluation, IMPAQ seeks to improve the lives of older adults in America, especially those with limited or low incomes. Our research spans a wide range of areas that can impact the lives of older adults aging in place, such as food security, Internet use, and federal program participation. Our resources provide actionable information for policymakers and practitioners to engage in meaningful discussions and ultimately make sound decisions to improve the health and well-being of older adults.

The resources listed below address two important topics for older adult health and well-being, Social Determinants and Federal Program Participation, and Food Security Screening and Referral in Primary Care.

Additional non-IMPAQ resources addressing older adult food security, SNAP, and health are also provided at the bottom of the page.

Social Determinants and Federal Program Participation

Association Between Supplemental Nutrition Assistance Program Participation and Cost-Related Medication Nonadherence Among Older Adults with Diabetes

January 2019 - Diabetes is a costly condition affecting more than 1 in 5 older adults and low-income older adults are at increased risk of skipping or reducing medications due to cost. IMPAQ researchers investigated whether older adults participating in the Supplemental Nutrition Assistance Program (SNAP) may be at lower risk of cost-related medication nonadherence.

Published in the January 2019 issue of JAMA – Internal Medicine, our findings suggest that food assistance programs such as SNAP may have a spillover income benefit by helping older adults with diabetes better afford their medications, perhaps by reducing out-of-pocket food expenditures.

Social Determinants of Health and the Aging Population

May 2018 - Social determinants of health (SDOH) are social, economic, and environmental conditions that can help or hinder individuals’ health and well-being. For older adults in particular, SDOH can significantly impact health outcomes and experiences of aging, especially their ability to live independently and age in place. Using data from a survey of 1,590 adults aged 50 or above, this issue brief discusses older adults' experiences of SDOH and their concerns about these factors for the future. This brief provides insight into the SDOH-related challenges older adults currently face, as well as their outlook for the future.

Webinar: Toward Better Integration of Health and Human Services: Linkages between Food Insecurity, SNAP and Health Care.
Originally recorded Monday, April 9, 2018. 1 Hour.

Food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), can play an important role in alleviating food insecurity and contributing to improved health outcomes, and thereby decreasing the cost of health care. In this webinar, hosted by IMPAQ International, four leading experts present research on linkages between food insecurity, food assistance programs, health, and health care.

View as Adobe Connect

View Q&A

View Transcription

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

February 2018 - Unaffordable medication is one of the primary reasons why older adults do not adhere to treatment regimens in the U.S., and IMPAQ researchers have found evidence that increasing access to the Supplemental Nutrition Assistance Program (SNAP) may lead to reduced rates of nonadherence. This study was published in the February 2018 issue of the American Journal of Public Health.

Older Adults and Unmet Social Needs: Prevalence and Health Implications

November 2017 - Social determinants of health (SDOH) are environmental, societal, and economic conditions that contribute to older adults’ ability to live healthy and full lives. Having multiple unmet social needs increases the risk of poor health outcomes. Using data from a nationally-representative survey of adults aged 50 and older, this Issue Brief informs policy makers, practitioners, and advocates about the prevalence of SDOH-related needs and the threat they pose to older adults’ health. 

Internet Use among Older Adults: Implications for Federal Program Management

May 2017 - Technology offers federal programs cost-effective methods for serving clients, especially in times of lean administrative budgets. This Issue Brief seeks to inform policy makers, practitioners, and advocates about Internet use among older adults in the United States, and the implications of low rates of Internet use for program enrollment and benefit utilization. Suggestions for incorporating a human-centered approach to services are provided.

Missed Opportunities: Lifting Barriers to SNAP Participation among Eligible Seniors

January 2016 - This IMPAQ Issue Brief summarizes barriers seniors continue to face in participating in the Supplemental Nutrition Assistance Program and provides recommendations for improving participation rates.

Efforts to Increase Access to SNAP for Homebound Seniors through Purchasing and Delivery Services 

October 2015 - This IMPAQ Issue Brief explores a newly proposed rule governing Supplemental Nutrition Assistance Program (SNAP) food retailers that will allow purchasing and delivery (P&D) services of SNAP foods to homebound participants and participants with a disability. We also outline the potential impact and challenges of implementing this new rule. 

Food Security Screening in Primary Care

In 2014, more than 10 million adults aged 60 and older in the United States were at risk of hunger or were food insecure, meaning that they lacked access to enough nutritious foods to lead a healthy, active lifestyle.  IMPAQ has created a number of resources to support health care systems seeking to implement food security screening and referral processes. 

Food Insecurity: A Key Social Determinant of Health for Older Adults

December 2018 - This editorial published in the Journal of the American Geriatrics Society details the importance of addressing food insecurity among older adults and how clinicians and health systems can support older adults struggling with food insecurity. 

Primary Care Providers’ Perspectives on Screening Older Adult Patients for Food Insecurity

January 2018 - IMPAQ conducted a qualitative study to better understand the beliefs of primary care providers (PCPs) about food security screening and referrals in a primary care setting and perceived barriers to implementation. The results, published in the January 2018 issue of the Journal of Aging & Social Policy, identify a number of concerns in implementing a systematic screening and referral process: limited time to meet with patients, a lack of resources for addressing food insecurity, and prioritizing food insecurity at both the health system and the patient levels. Despite perceived challenges, PCPs are receptive to the idea of systematically screening and referring patients to external resources for food assistance and support.

Food Security Screening and Referrals Overview Video

March 2017 - In this short video, IMPAQ researchers discuss the issue of food insecurity for older adults and introduce our resources for Implementing Food Security Screening and Referrals for Older Patients in Primary Care.

Implementing Food Security Screening and Referrals for Older Patients in Primary Care: A Resource Guide and Toolkit

November 2016 - IMPAQ developed this resource guide in collaboration with the AARP Foundation to aid health professionals in implementing systematic food security screening and referral processes. The guide explains how screening and referrals have been implemented in primary care, the characteristics of successful systems, an overview of food assistance programs available to older adults, and community partnerships that can help ensure patients’ needs are addressed. It also discusses potential challenges and solutions to implementing such a screening and referral process.

Also available: Quick Guide to get started

Addressing Food Insecurity in Primary Care

September 2016 - Developed in conjunction with AARP Foundation, this Issue Brief describes ways in which health systems have implemented food security screening and referral processes, including partnering with community organizations for referrals, and key factors in their success.

Additional Resources (links to non-IMPAQ websites)

Screen and Intervene: Addressing Food Insecurity Among Older Adults

January 2018 - This free, online course by FRAC and the AARP Foundation is designed for health care providers and community-based partners working with older adults. After completing the course, learners will be able to: define food insecurity; identify the risk factors for food insecurity among older adults; identify the negative health outcomes that food-insecure patients may face; use the Hunger Vital Sign™ screening tool; and connect individuals to SNAP, additional nutrition resources, and community partners.

SNAP Is Linked with Improved Nutritional Outcomes and Lower Health Care Costs

January 2018 - The Center for Budget and Policy Priorities produced a report summarizing recent research linking SNAP with improved health outcomes and lower health care costs.

The Role of the Supplemental Nutrition Assistance Program in Improving Health and Well-Being

December 2017 – In this report, FRAC provides background information on SNAP; briefly summarizes the harmful impacts of poverty, food insecurity, and poor nutrition on health and well-being; summarizes research on SNAP’s role in addressing these issues among low-income Americans; and describes how this role of furthering the public’s health would be enhanced if SNAP benefits were more adequate.

NOPREN Clinical Linkages Food Insecurity Screening and Referral Algorithms

November 2017 - The Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) Clinical Linkage workgroup has produce a series of algorithms to support clinicians in screening and referring patients experiencing food insecurity. Three algorithms are available for specific patient populations: adults, patients with diabetes, and children.

Combating Food Insecurity: Tools for Helping Older Adults Access SNAP

2014 - FRAC and the AARP Foundation produced a toolkit that offers practical tips and examples to help organizations of all sizes address food insecurity in all types of communities with a goal of increasing senior SNAP participation. The toolkit walks through the basics of SNAP, and then provides practical resources to help organizations craft successful programs of education, outreach, and application assistance.