Impact of the supplemental nutritional assistance program on diet-related disease morbidity among older adults

Health Serv Res. 2021 Oct;56(5):854-863. doi: 10.1111/1475-6773.13609. Epub 2021 Jan 24.


Objectives: To examine the health effects of the Supplemental Nutritional Assistance Program (SNAP) and the differential impact of SNAP across race/ethnicity among older adults.

Data source/study setting: 2008-2013 Medical Expenditure Panel Survey, a nationally representative population-based complex sample survey.

Study design: A difference-in-regression-discontinuity (DRD) design is used to assess the impacts of SNAP on diet-related disease morbidity. The primary outcomes were the prevalence rate of hypertension, coronary heart disease, stroke, diabetes, and cancer. We also conducted supplemental analysis to examine potential co-occurring trends in medical utilization.

Data collection/extraction methods: Data are publicly available.

Principal findings: In the full sample, SNAP eligibility was associated with a significant decline in diabetes (-3.71 percentage points [pp]; P < .05). Non-Hispanic (NH) White respondents reported trends similar to the full sample; however, NH Black respondents reported large declines in hypertension (-13.95 pp; P < .01) and Hispanic respondents reported declines in the prevalence of angina (-6.94 pp; P < .05) and stroke (-4.48 pp; P < .05).

Conclusions: Supplemental Nutritional Assistance Program eligibility was associated with the reduced prevalence of diet-related disease among older adults. These observed declines in the prevalence of diet-related disease do not appear to be attributable to increased medical visits or spending on medical services and prescriptions.

Keywords: Supplemental Nutritional Assistance Program; diet-related disease; older adults.

MeSH terms

  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / mortality
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / mortality
  • Diet / statistics & numerical data*
  • Female
  • Food Assistance / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Mortality / ethnology*
  • Neoplasms / ethnology
  • Neoplasms / mortality
  • Poverty / statistics & numerical data*