Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization among Older Adults? the Case of Maryland

Laura J. Samuel, Sarah L. Szanton, Rachel Cahill, Jennifer L. Wolff, Pinchuan Ong, Ginger Zielinskie, Charles Betley

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


This study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged ≥65 years who were dually enrolled in Medicare and Medicaid (2009-2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR = 0.99, 95% CI: 0.99-0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47% of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.

Original languageEnglish (US)
Pages (from-to)88-95
Number of pages8
JournalPopulation health management
Issue number2
StatePublished - Apr 2018


  • food assistance
  • health care utilization
  • hospitalization
  • older adults
  • socioeconomic status

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health


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