Hypertension, Diabetes and Medication Adherence among the Older Supplemental Nutritional Assistance Program Population

Abstract

The burdens of chronic diseases such as hypertension and diabetes for older Americans are profound. Yet, data on the population-level prevalence of hypertension and diabetes among the older adult Supplemental Nutritional Assistance Program (SNAP) population and the associated level of medication adherence is lacking despite evidence of the “treat or eat” trade-off in the general population. We used linked administrative data from SNAP and Medicaid between 2006 and 2014 in the state of Missouri to document rates of hypertension or diabetes diagnoses and medication adherence. About 69% of the study sample were found to be diagnosed with a hypertension and 40% with diab etes. Approximately 1 in 4 of those living with hypertension and 1 and 3 of those living with diabetes were nonadherent to antihypertensive or antidiabetic medications each year, on average. Furthermore, medication non-adherence increases with age and is more common among non-White and urban residents.

Changing patterns of SNAP take‐up and participation and the role of out‐of‐pocket medical expenses among older adults

“…These results help us understand the complexity in the connections across social programs and between health, healthcare expenses, and food access. While growing evidence suggests that the older adult SNAP population suffers from high levels of chronic diseases and medication nonadherence (Heflin et al, 2021), we find that changes in access to health insurance did not change the level of estimated SNAP take-up or participation. However, it is possible that the composition or well-being of the caseload on SNAP did change.…”

Medication Adherence in Chronic Prescription Policy: An Analysis of Population-Based Data

“…These three diseases were selected because they are highly prevalent long-term diseases for which medication adherence is essential to improving patient outcomes. 6,7…”

“…These three diseases were selected because they are highly prevalent long-term diseases for which medication adherence is essential to improving patient outcomes. 6,7 The unit of analysis was prescriptions. Full refill rates (%) per year were calculated; the numerator was the total number of refill records in the original medical institution or community pharmacy, and the denominator was the total number of long-term prescriptions.…”

US State Policy Contexts and Population Health

“…SNAP reduces food insecurity, poverty, and the need to decide between nutritious meals and other essentials. Partly as a consequence, it improves adherence to medications and lowers risks of obesity, diabetes, CVD, and working‐age mortality 43,44 . Medicaid expansion has a host of health‐related benefits including lower mortality from drug overdose 45 and cardiometabolic diseases 46,47 .…”

“…Partly as a consequence, it improves adherence to medications and lowers risks of obesity, diabetes, CVD, and working‐age mortality. 43 , 44 Medicaid expansion has a host of health‐related benefits including lower mortality from drug overdose 45 and cardiometabolic diseases. 46 , 47 By reducing the odds that low‐income adults must choose between medical care and other necessities, Medicaid expansion resulted in fewer evictions and unpaid bills.…”