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Chronically ill poor Americans often must choose food over needed medicine

Harold Mandel's picture
Struggling in poverty

There are Americans who are so poor that they often can not afford needed medications. These Americans are often actually living in fear of not having enough food to eat if they buy certain needed medications. It appears in such cases these people either do not understand the possible welfare programs which could help them, or welfare programs which could benefit them in such a crisis situation are simply not available where they are living. In a nation where billionaires are created overnight in high tech IPOs on Wall Street and where everyone must under the law get an education to make them literate and eligible to train for some type of well paying work, this situation is a disgrace.

Adults suffering from chronic disease are often not able to meet medication and food needs, reports The American Journal of Medicine. Researchers investigated which groups most commonly are confronted with unmet food and medication needs. Cross-sectional data were analyzed from chronically ill participants, dealing with self-reporting of the following conditions at 20 years old:

1: Arthritis

2: Diabetes mellitus

3: Cancer

4: Asthma

5: Chronic obstructive pulmonary disease

6: Stroke

7: Hypertension

8: Coronary heart disease

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9: A psychiatric problem

Out of 9696 adult National Health Interview Survey (NHIS) participants who reported chronic illness, 23.4 percent reported cost associated medication underuse, while 18.8 percent reported food insecurity, and 11 percent reported both. Among adults who reported food insecurity there was a significantly higher likelihood to report cost associated medication underuse. These people were less likely to have public, non-Medicare insurance and to report participation in the Special Supplemental Nutrition Assistance Program for Woman, Infants, and Children.

It was concluded that about 1 in 3 chronically ill NHIS participants are not able to afford food, medications, or both. There was less food insecurity and cost-related medication underuse seen in participants who have WIC and public health insurance.

Many Americans are being forced to choose between food or medicine reports Elsevier Health Science in a discussion of the research published in The American Journal of Medicine. Food insecurity is defined as not having consistent access to food due to lack of financial stability. The researchers found that chronically ill adults who reported food insecurity in their household were significantly more likely to report cost associated medication underuse.

Cost related medication underuse refers to taking less medication than has been prescribed, or not taking the medication at all because of financial concerns. 1 in 5 Americans reported they were having trouble meeting their basic needs in 2012. Furthermore, 1 in 6 of these people reported they had no form of health insurance. Among the chronically ill people many people would not be able to pay their rent and put food on the table if they bought their medications. Overall it was observed that 1 in 3 chronically ill NHIS participants were not able to afford food, medications, or both.

The participants with both medication underuse and food insecurity were more likely to:

1: Be Hispanic or non-Hispanic black

2: Have several chronic conditions

3: Lack insurance

Lead investigator Seth A. Berkowitz, MD, has said, “The high overall prevalence of food insecurity and cost-related medication underuse highlights how difficult successful chronic disease management in the current social environment is.” Residual unmet needs for food-insecure participants have been suggested by these findings with clear implications for health policy. It is suggested that future public policy target groups susceptible to food insecurity and medication underuse.

Berkowitz says the observations that Medicaid and WIC participation is associated with decreased chances of both food insecurity and cost-related medication underuse has suggested that there may be important "spill-over" effects from programs that target food insecurity or cost-related medication underuse, by helping to free up available resources. Overall it was observed that low or no cost sharing prescription drug benefits have been associated with improved health outcomes in a general population, as well as the lowering of socioeconomic disparities in health outcomes.

It appears to me that as suggested by this research food insecurity is strongly linked to cost associated medication underuse. Clearly there should be more interventions to target under-resourced groups who may be confronted with choices between eating well or treating an illness. Vulnerable patients need help with this problem. There is no excuse to allow situations to evolve wherein people have to let their lives pass them by from untreated illness so they can eat well while they are succumbing to the illness.