Low-Income Adults Using SNAP Have Reduced Health Expenditures

A new study finds that participation in the Supplemental Nutrition Assistance Program (SNAP) is associated with significantly lower healthcare expenditures, pointing to the role of social determinants (eg, food insecurity) as contributors to health spending.

The complex relationship between socioeconomic status and healthcare expenditures likely has a number of factors, but the authors of a recent JAMA Internal Medicine study hypothesized that food insecurity, or the financial inability to access nutritious food, could be a driver of the higher care costs observed among low-income Americans.

SNAP, a federal program that serves 1 in 7 Americans, “provides a hunger safety net” by offering benefits that allow shoppers to buy foods and beverages for their household, according to the website of the Department of Agriculture, which administers the program. While not technically a health intervention, interest in food insecurity as a driver of health status has been on the rise, and efforts like the CMS Accountable Health Communities program will evaluate the effects of nutrition assistance on health expenditures.

The current study used responses from the 2011 National Health Interview Survey to identify respondents who had received SNAP or food stamp benefits within the last year, then linked SNAP status to data from the Medical Expenditure Panel Survey. The total sample consisted of 4447 patients who were eligible for SNAP as their incomes were less than 200% of the federal poverty level.

Overall, those who participated in SNAP were more likely to be younger, a racial/ethnic minority, and poorer. After adjusting for just age and gender, SNAP participants had mean annual healthcare expenditures of $4628, slightly higher than the $4594 average among those who did not receive SNAP.

However, after adjusting for a broader range of observed factors, including race/ethnicity, education, geographic location, insurance type, and comorbidities, the researchers determined that SNAP participation was associated with $1409 lower expenditures per year compared with those who did not report SNAP participation (95% confidence interval, ­—$2694 to –$125; P = .03).

The study authors also found that age, insurance type, disability, and comorbidity were to strongest cofounders of the association between SNAP participation and health expenditures. For instance, among individuals with coronary heart disease, those partaking in SNAP had expenditures $4109 lower than their counterparts who did not receive SNAP benefits.

These findings, which were consistent with those of other studies on health status, food insecurity, and health spending, could have important implications for policy making, the researchers wrote. Federal funding of SNAP benefits could help contain the healthcare costs borne by federal and state governments for Medicaid enrollees. Future studies may want to examine whether SNAP benefits are associated with long-term health expenditures or clinical outcomes.

“SNAP participation was associated with lower subsequent health care expenditures for low-income adults,” the study concluded. “Helping to address food insecurity by making SNAP enrollment easier may be an important way to contain health care costs for vulnerable Americans.”