Do In-Kind Transfers Affect Health? Evidence from the Food Stamp Program
Diabetes currently affects 23.6 million Americans, raising questions about the role of preventive service use and lifestyle modifications to reduce its financial and health burden. In this paper, I examine the role of Food Stamp receipt in health outcomes amongst elderly diabetics. Longitudinal survey data from the Health and Retirement Study from 1995 - 2006 are linked to administrative Medicare records and biomarker data. These data allow me to consider numerous health outcomes and employ several strategies to control for non-random Food Stamp participation. Food Stamp recipients are less healthy and more economically disadvantaged than income-eligible nonrecipients. I find no significant difference in Medicare spending, outpatient utilization, diabetes hospitalizations and glycosylated hemoglobin (HbA1c) levels between recipients and non-recipients after controlling for a rich set of covariates including individual fixed effects and measures of diabetes treatment compliance. Food Stamp diabetics are 7 percentage points more likely to experience an inpatient hospitalization. Food Stamp receipt is associated with a 3 percentage decrease in End-Stage Renal Disease for non-Whites. As one-third of elderly Food Stamp recipients are currently diabetic, greater coordination between the Food Stamp, Medicare, and Medicaid programs may improve health outcomes for this group.
