Food Insecurity Is Associated with Cost-Related Medication Non-Adherence in Community-Dwelling, Low-Income Older Adults in Georgia

Abstract

Low-income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined the relationship between food insecurity and cost-related medication non-adherence (CRN) in low-income Georgian older adults. The study sample includes new Older Americans Act Nutrition Program participants and waitlisted people assessed by a self-administered mail survey (N = 1000, mean age 75.0 + so - 9.1 years, 68.4% women, 25.8% African American). About 49.7% of participants were food insecure, while 44.4% reported practicing CRN. Those who were food insecure and/or who practiced CRN were more likely to be African American, low-income, younger, less educated, and to report poorer self-reported health status. Food insecure participants were 2.9 (95% CI 2.2, 4.0) times more likely to practice CRN behaviors than their counterparts after controlling for potential confounders. Improving food security is important inorder to promote adherence to recommended prescription regimens.

Food Insecurity, Food and Nutrition Programs, and Aging: Experiences from Georgia

“…Food insecurity in older adults may lead to forced trade-offs between paying for basic needs including food, housing, heating, medication, social services, and medical care. (See also the article by Bengle et al in this issue [38]. )…”

“…Food insecurity contributes to the development or exacerbation of diet-related chronic illnesses. Food insecurity was associated with non-adherence to prescribed medications due to cost (38), increased hypoglycemic episodes (39), and increased health care utilization (40). Food insecurity in older adults may lead to forced trade-offs between paying for basic needs including food, housing, heating, medication, social services, and medical care.…”

Linking Neighborhood Characteristics to Food Insecurity in Older Adults: The Role of Perceived Safety, Social Cohesion, and Walkability

“…About 9% indicated that in the past year they ate less due to financial insecurity, while roughly 5% reported that they went hungry because they were not able to get out and purchase food. Neighborhood safety had a mean of 6.83 (range, [3][4][5][6][7][8][9][10][11][12]; the mean of neighborhood social cohesion was 12.29 (range, 5-20). The average walkability score among study sample respondents was 5.26 out of 8.0.…”

“…3 More broadly, the salience of food insecurity has been underscored by its links to cardiovascular risk, 4,5 self-rated health, 6 body mass index or obesity, [7][8][9] risk of emergent and overnight care, 10 and non-adherence to pharmaceutical regimes. 10,11 In older adults specifically, food insecurity has been found to predict poor nutritional outcomes, 12 including lower caloric intake, fewer meals per day, and foods lower in nutrients. 1,13 Such outcomes are significantly more prevalent among older adults with lower incomes.…”

The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey

“…12 All the questions in the module were based on validated questions used in previous studies or in previous versions of the Canadian Community Health Survey. 4,7,8,[13][14][15][16] Some questions were also informed by our team's recent qualitative study of cost-related nonadherence. 17 The entire module underwent qualitative testing by Statistics Canada, which involved 13 in-depth one-onone interviews lasting 45-60 minutes that were conducted in French or English.…”