In 2010, more than 2.3 million households (7.9 percent) with an elderly member were food insecure and even more reported some difficulties with obtaining adequate resources for food (Coleman-Jensen et al., 2010). It is widely acknowledged that any food insufficiency contributes to poor health and increases the likelihood of diet-related disease. The Supplemental Nutrition Assistance Program (SNAP), formerly the food stamp program, is the primary nutrition assistance program aimed at reducing food-related hardship. Yet, participation rates for the eligible elderly are estimated at 35% (Cunnyngham 2010). Given the fixed incomes, worse health, and high medical needs of the elderly poor and near poor, the low take-up rate is both puzzling and concerning due to the potential for SNAP to improve the well-being of participants (Kreider et al., 2011; Yen et al., 2008; Ratcliffe and McKernan, 2011).

The low take-up rate in SNAP among the elderly and its effects on food insufficiency and diet-related disease is relatively unexplored. This research uses restricted-use Health and Retirement Study (HRS) data to examine the effect of SNAP participation on reported food insufficiency and, in turn, diet-related disease to better understand the health consequences of SNAP participation. To address the endogeneity of SNAP receipt and identify the causal effects of SNAP use on the elderly, we instrument for SNAP participation with state and county-level variables related to SNAP outreach, including radio advertisements, federally awarded outreach grants, and state SNAP rules. Preliminary analysis finds that the causal effect of SNAP participation results in some improved diet-related outcomes but a higher incidence of food distress. 

Given the rapid growth of the elderly population, understanding both the determinants of participation and how SNAP affects this population is of substantial policy importance. Our findings shed light on the effectiveness of targeted outreach on participation decisions of the elderly, as well as the effect of SNAP program rules on participation. We also inform the optimal benefit level of SNAP by examining if SNAP recipients are provided enough financial resources to meet their nutritional needs.