Aging
Food Insecurity, the Supplemental Nutritional Assistance Program, and Physical Functioning in Older Adults Kelley Akiya* Kelley Akiya Akiya Akiya Akiya Institute for Health Policy Studies, University of California San Francisco
Introduction: Food insecurity in older adults is associated with increased functional limitations, a significant barrier to healthy aging. Our study investigates whether the Supplemental Nutrition Assistance Program (SNAP), the largest anti-hunger program in the U.S., protects against the negative impact of food insecurity on aging adults’ functional status. Methods: We used data from the Health and Retirement Study, a large population-based survey of older adults, and included participants ages 50 and older with at least three waves of outcome data (N= 5,507). SNAP receipt (yes/no) and food insecurity were collected in 2013 and functional status outcomes were collected biennially from 2014-2022. Food insecurity was measured with the Household Food Security Survey Module and participants were classified as having high, low, or very low food security. Functional status outcomes included counts of reported limitations with Activities of Daily Living (ADLs) and instrumental activities of daily living (IADLs). We used multilevel negative binomial models with a random intercept and interaction terms between level of food insecurity and SNAP receipt to estimate associations with ADLs and IADLs. Models were adjusted for demographic and socioeconomic confounders. Results: In our sample, 588 (10.7%) participants reported low food security, 454 (8.2%) reported very low food security, and 558 (10.1%) reported receiving SNAP. Very low food security was associated with subsequent ADLs among non-SNAP participants (Incident Rate Ratio [IRR] = 5.24, 95% CI = 3.73, 7.4), while the association was attenuated among SNAP participants (IRR of very low security * SNAP = 0.52, 95%CI = 0.29, 0.93). Results were similar for IADLs and those with low food security, though confidence intervals associated with the low food security * SNAP interaction terms included the null. Conclusion: SNAP participation may reduce functional limitations among food-insecure older adults.