Financial and Food-Related Physical Functional Barriers to Food Security Among Older Adults: Associations With SNAP Participation.

OBJECTIVE: To examine how financial constraints and food-related physical functioning limitations, an underexplored dimension of food insecurity, are associated with Supplemental Nutrition Assistance Program (SNAP) participation among older adults. DESIGN: Cross-sectional analysis of nationally representative survey data. SETTING: US; National Health and Nutrition Examination Survey, 2007-2018. PARTICIPANTS: A total of 4,429 adults aged ≥ 60 years who were income-eligible for SNAP and had complete food security and participation data. MAIN OUTCOME MEASURE: Self-reported SNAP participation in the past 12 months. ANALYSIS: Food insecurity because of financial constraints was assessed using the US Department of Agriculture Adult Food Security Survey Module. Food-related physical functioning insecurity was measured using a validated tool. Participants were categorized as food secure, financially food insecure only, physically food insecure only, or insecure because of both. Weighted logistic regression estimated odds of SNAP participation by food insecurity type, adjusting for sociodemographic and health characteristics. RESULTS: Supplemental Nutrition Assistance Program participants had higher prevalence of financial food insecurity (34.6% vs 15.0%) and combined financial and physical food insecurity (15.6% vs 5.6%) than nonparticipants. In adjusted analyses, financial food insecurity (odds ratio [OR] = 1.74 [95% confidence interval (CI), 1.35-2.26]), physical functioning food insecurity (OR = 1.47 [95% CI, 1.16-1.87]), and combined insecurity (OR = 2.30 [95% CI, 1.70-3.21]) were associated with greater odds of SNAP participation. IMPLICATIONS: Both economic and food-related physical functioning barriers to food access are associated with SNAP participation among income-eligible older adults. Assessments focused solely on financial constraints may overlook important physical functioning barriers. A multidimensional approach to food insecurity may improve food access and support healthy aging.