A new study in The American Journal of Medicine investigates to what extent chronically ill adults who are struggling financially are taking less medication than they are prescribed or no medication at all.

The study acknowledges that there is renewed optimism in the economy at present, but it finds that many Americans are still having trouble meeting basic needs. In a 2012 survey, 1 in 5 reported that they were struggling to pay for basic necessities, while 1 in 6 admitted they had no form of health insurance.

"For the chronically ill," The American Journal of Medicine says in a related news release, "the difference between paying rent or putting food on the table may be the cost of their medication."

The new study tested the link between food insecurity (not having consistent access to food due to financial restrictions) and underuse of medication. To do this, the researchers analyzed data from 9,696 chronically ill adults who participated in the National Health Interview Survey (NHIS).

Of these chronically ill adults, 18.8% reported food insecurity and 23.4% admitted that they used their medication less frequently than they are prescribed, as a result of cost. About 11% of this group reported both food insecurity and cost-related medication underuse.

Within the population of chronically ill adults in the NHIS, the study found Hispanic or non-Hispanic black people were more at risk of both medication underuse and food insecurity. These groups were also more likely to have more chronic conditions than other participants.

Current policies leave some groups at risk of food insecurity and medication underuse

Respondents to the NHIS with incomes that are 100-200% above the Federal Poverty Line also reported high rates of food insecurity and medication underuse.

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In 2012, 1 in 5 Americans reported that they were struggling to pay for basic necessities, while 1 in 6 admitted they had no form of health insurance.

People in this income bracket are often not eligible for government assistance, so the researchers think this data could be useful in influencing future policy decisions.

People who reported medication underuse were more likely to not have any health insurance.

Interestingly, however, the study found that if people participated in either Medicaid or the Women, Infants and Children (WIC) food and nutrition service, then they were less likely to report both food insecurity and cost-related medication underuse.

"The observations that Medicaid and WIC participation is associated with lower odds of both food insecurity and cost-related medication underuse suggest that there may be important 'spill-over' effects from programs that target food insecurity or cost-related medication underuse, by freeing up available resources," says lead investigator Dr. Seth A. Berkowitz, from the Division of General Internal Medicine at Massachusetts General Hospital and Harvard Medical School.

Dr. Berkowitz concludes:

"Food insecurity is strongly associated with cost-related medication underuse, and approximately 1 in 3 chronically ill NHIS participants are unable to afford food, medication, or both, despite participation in assistance programs. Interventions targeted to under-resourced groups who may face 'treat or eat' choices could produce substantial health gains for these vulnerable patients."

In late 2013, Medical News Today reported on a Harvard School of Public Health study that suggested the largest federal nutrition program in the US, the Supplemental Nutrition Assistance Program, is not doing enough to prevent food insecurity among low-income families.