While Medicaid recipients express similar desires for their health as non-recipients, they are having a more difficult time achieving those outcomes, reporting far higher food insecurity, more health problems and greater stress about their food decisions than the general population.

For the first time in the 13-year history of the International Food Information Council (IFIC) Foundation’s Food and Health Survey, an oversample of Medicaid beneficiaries was conducted in partnership with The Root Cause Coalition to explore the unique health and nutrition issues facing over 66 million Americans covered by the program.

According to the survey, Medicaid recipients experience far greater rates of food insecurity across many indicators compared to the general population. About one-third (32 percent) often purchase less-healthy food options than they otherwise would because of lack of money, more than twice the rate (13 percent) of non-recipients. Similarly, nearly one-third often purchase less food overall (28 percent) because of money, nearly three times the rate (10 percent) of non-recipients. A similar number (27 percent) worry that their food will run out before they get money to buy more, compared to just 7 percent of non-recipients. And 43 percent of Medicaid recipients say they often skip at least one meal a day, compared with 28 percent of non-recipients.

But even though their means may be lacking, Medicaid recipients have similar aspirations for good health as the general population. Among the top health-related benefits Medicaid beneficiaries seek from food and nutrients, 17 percent cite cardiovascular health (compared to 21 percent of non-recipients), 15 percent cite weight loss or management (compared to 21 percent of non-recipients), and 12 percent desire greater energy (compared to 13 percent of non-recipients). Also on the positive side of the ledger, 59 percent of Medicaid recipients report getting information on foods to eat or avoid from their personal healthcare professional—79 percent of whom said they made changes in their eating habits as a result.

But the inability to connect what they eat to the health outcomes they desire appears to be standing in their way: Only 35 percentof Medicaid recipients are able to name a food or nutrient that contributes to their top health concern, compared to a similar amount (42 percent) of non-recipients.

At the same time, Medicaid recipients report more health problems than non-recipients: 66 percent are overweight or obese, according to their self-reported height and weight (vs. 60 percent of non-recipients); 28 percent have high blood pressure (vs. 25 percent of non-recipients); and 27 percent report stress/anxiety/depression (more than double the 9 percent of non-recipients). Only 38 percent of Medicaid recipients rate their health as excellent or good, compared to 58 percent of non-recipients.

Similar numbers of Medicaid recipients (38 percent) and non-recipients (33 percent) both report following a type of specific eating pattern or diet in the past year. Intermittent fasting is the most popular for 12 percent of recipients (vs. 9 percent of non-recipients), followed by 9 percent of recipients who are paleo dieters (vs. 5 percent of non-recipients) and 8 percent who are gluten-free (vs. 5 percent of non-recipients).

The act of grocery shopping itself can have an impact on the mental health of Medicaid recipients. One-third (34 percent) say they often or always experience stress when shopping for food or beverages, triple the rate of non-recipients (11 percent). Among Medicaid recipients who experience stress while shopping, fully two-thirds (67 percent) say the price of food is a reason.

“While Medicaid is a vital lifeline for one in five Americans, tens of millions still face precarious food choices and conditions that exacerbate the health gap between those with fewer means and the rest of the population,” said Joseph Clayton, CEO of the IFIC Foundation. “We’re grateful to The Root Cause Coalition for helping uncover these realities, as well as the pressing need to address them.”

“The Root Cause Coalition is proud to add the results of this survey to our body of knowledge about the broader Medicaid population and the challenges it faces,” said Barbara Petee, Executive Director of The Root Cause Coalition. “Working in collaboration with our estimable partners at the IFIC Foundation has enabled us to shine an even brighter light on the need for cross-sector collaborations to fight food insecurity and promote healthy nutrition.”

Methodology

The results were derived from an online survey of 1,005 Medicaid recipients ages 18 to 80 and was fielded March 12 to March 26, 2018. The results were weighted to ensure that they are reflective of the American population ages 18 to 80, as seen in the 2017 Current Population Survey. Specifically, they were weighted by age, education, gender, race/ethnicity and region. The survey was conducted by Greenwald & Associates, using ResearchNow’s consumer panel.

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About the IFIC Foundation: The mission of International Food Information Council Foundation, a 501(c)(3) nonprofit, is to effectively communicate science-based information on health, food safety and nutrition for the public good. The IFIC Foundation is supported primarily by the broad-based food, beverage and agricultural industries. Visit http://foodinsight.org.

About The Root Cause Coalition: Established in 2015, The Root Cause Coalition is a non-profit, member-driven organization comprised of more than 60 leading health systems, hospital associations, foundations, businesses, national and community nonprofits, health insurers, academic institutions and policy centers. The Coalition works to achieve health equity through cross-sector collaboration in advocacy, education and research. For more information, visit www.rootcausecoalition.org and connect with us on Twitter, Facebook and LinkedIn.

Medicaid Recipients’ Consumption, Trends, Attitudes and Drivers from Food Insight