For years, we've been hearing public health officials make this argument: If you want to lower health care costs in the long run, you need to make investments in programs that help promote healthful habits.
The argument makes sense, but it can be hard in tight fiscal times to fund a program with the idea that the program's payoff will come years, or maybe decades, down the road.
Which is why we were so intrigued by a recent study from Massachusetts General Hospital looking at the link between the U.S. government's Supplemental Nutrition Assistance Program (SNAP), the program we used to call food stamps, and lowered health care expenditures. (Results of the study were published in November's edition of JAMA Internal Medicine.)
The researchers aimed to explore the links between food insecurity, SNAP and improved health outcomes, as measured in expenditures for health care.
The U.S. Department of Agriculture defines "food insecurity" as "limited or uncertain access to adequate food." In Oregon, estimates are that 14.6 percent of households experienced food insecurity in the three-year period from 2014 to 2016; that's higher than the 12 percent national rate reported in 2016. (Sadly, it is not at all unusual for Oregon to surpass the national average in a number of these hunger statistics.)
Previous research has shown that, considered separately, both food insecurity and SNAP participation were associated with obesity and a lower-quality diet. That's not a surprise, and there are a variety of reasons why that's true, some of which may not be readily apparent: For example, it sometimes can difficult for low-income people to regularly gain access to nutritious food.
Other research has shown that when those two factors (food insecurity and SNAP participation) were considered together, SNAP participation was linked with a lower body mass index and improved nutrition. Again, that stands to reason.
But the most recent study attempts to put a dollar sign to those earlier findings by examining the association between SNAP participation and health care spending.
The results of that study suggest that, to recast a cliche, an apple a day (or similar nutritious food) can keep the doctor (or at least some medical bills) at bay.
Consider some of the findings:
• SNAP enrollees spent an average of $1,409 less on health care per year than those not enrolled.
• The cost savings also were seen in subjects suffering from chronic ailments: For example, SNAP enrollees with hypertension spent, on average, $2,654 less than nonparticipants with the same ailment. SNAP enrollees with coronary heart disease spent $4,109 less than nonparticipants with the same disease.
The researchers suggested that one possible reason for these findings was that SNAP benefits allowed participants to purchase healthier food that allowed them to manage those conditions at least partially through diet. That would be our guess as well.
But here's where the long-term payoff starts to click in: Compare that money saved with the average monthly benefit per person, which in fiscal year 2017 was $125. You can do the math: We're basically recouping all of that $1,500 annually in reduced health care payments. And for someone with a chronic ailment like hypertension or chronic heart disease, we could be coming out thousands of dollars ahead.
These aren't academic questions in Oregon or the mid-valley. Statistics from the state Department of Human Services from January 2015 suggest that 20 percent of Oregon households — 1 in 5 — were accessing SNAP benefits. In Linn County, the number was 25 percent. In Benton County, the number was 11 percent, but that suggests to us that not enough people in the county are accessing the SNAP services to which they're entitled.
SNAP cuts into the hunger that still stalks the mid-valley, and all of America. That's important. This new study suggests that the program also makes sense as a long-term investment in lower health care costs. (mm)