Food stamp program participation could impact health costs

Participation in the Supplemental Nutritional Assistance Program (SNAP, formerly known as the Food Stamp Program) may reduce healthcare costs for recipients, according to a new study. 

Berkowitz

For the study, published in JAMA Internal Medicine, Seth Berkowitz, MD, MPH, of the MGH Division of General Internal Medicine, and researchers found that, after controlling for factors known to be common among SNAP participants, annual healthcare costs for recipients were approximately $1,400 less than for low-income individuals not participating in SNAP.

Berkowitz and colleagues analyzed data from two surveys:

· The 2011 National Health Interview Survey (NHIS) of the National Center for Health Statistics.

· The 2012-13 Medical Expenditure Panel Survey (MEPS) of the Agency for Healthcare Research and Quality.

Data used for the study reflected 4,447 MEPS respondents with family incomes below 200% of the federal poverty level and who, on the 2011 NHIS, answered whether they had received SNAP benefits at any time during the previous year.

The researchers do not know why there is a correlation between SNAP and lower healthcare costs, but they speculate that:

• SNAP may make it easier to follow the diets recommended to manage chronic disease;

• SNAP may free up resources needed for medical care;

“We know that trade-offs between food and medications-i.e., putting off filling medications to buy food-are common in people with food insecurity,” Berkowitz says. “SNAP may provide resources that negate having to make this choice.”

• SNAP could then help counteract the stress and mental health burden of food insecurity.

“Food insecurity is known to increase stress, increase depressive symptoms, and decrease self-efficacy for chronic disease management. Reducing food insecurity via SNAP could … provide the mental space needed to manage your illnesses,” he says.

“With increasing pressure to contain healthcare spending, addressing social determinants of health, such as food insecurity, have been suggested as one way to do this,” says Berkowitz. “The results of this study suggest that such an approach may work, and managed care executives might consider designing programs for their organizations to address social determinants.”

Interest is growing in addressing social determinants of health to improve health and healthcare costs, he says. “SNAP is one of the nation’s largest programs to address social determinants of health, so it made sense to see if participating in SNAP had any association with change in healthcare costs,” he says.