As we're scrambling to fix health care, food stamps are quietly paying off.

No one should have to choose between food and medicine. For many low-income people with chronic illnesses, however, it's a decision far too familiar.

Seth Berkowitz, a doctor at Massachusetts General Hospital, recalls a woman — a mother — who ended up in the hospital with dangerously high blood pressure. The woman had a prescription for a medication to keep her blood pressure down, but she hadn't filled it because it was nearing the end of the school year and her kids' final tests were coming up. Faced with the option of paying for a prescription she needed or making sure her kids weren’t going into their tests hungry, she chose to feed her kids.

This is not an uncommon dilemma. When Berkowitz conducted a study on the subject back in 2014, he discovered that a third of the chronically ill patients he saw couldn't afford both food and medication.


By skipping medications in favor of paying for food, people and families often end up spending more on health care in the long run. Medical emergencies are expensive — even just a ride in an ambulance can cost several thousands of dollars — and skipping regular checkups or other preventive care can lead to more costly problems further down the line.

Seeing firsthand how food insecurity forces people to make tough decisions, Berkowitz began work on a follow-up study.

Does helping people afford food lower their overall medical bills?

According to a new study published in JAMA Internal Medicine by Berkowitz and colleagues, food assistance through the American government’s Supplemental Nutrition Assistance Program could help low-income individuals and families save on their medical bills.

SNAP — formerly known as food stamps — is a federal program that gives low-income individuals money to spend on food. The exact implementation varies state by state, but overall about 1 in 7 Americans get help through the program.

Though the program may have started with stamps and paper bills, today funds are distributed through government issued EBT cards like this one. Photo by Justin Sullivan/Getty Images.

Berkowitz’s study looked at roughly 4,400 low-income adults, about 40% of whom were on SNAP. When Berkowitz’s team compared how much the average person in each group was spending on health care, they found the SNAP group spent about $1,400 less per year.

For comparison, the average single adult on SNAP receives about $1,500 a year in benefits.

What can we do with this knowledge?

Berkowitz’s study wasn’t able to pinpoint why these savings happen, but they have some ideas. People with SNAP benefits — now better able to feed their families — may be more likely to get their necessary prescriptions and checkups. Being able to afford healthier food might also be a factor.

This market in New York City both accepts SNAP funds and rewards the purchase of fresh fruit and vegetables with vouchers. Photo by Andrew Burton/Getty Images.

This research is especially timely as America is searching for a way to decrease its massive health care bill.

By understanding how social programs help keep people out of the hospital in the first place, studies like this one can help us understand how to keep spending down.

Not to mention how to make sure moms like Berkowitz’s patient can both feed their kids and fill their prescriptions too.

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Courtesy of Macy's

In many ways, 18-year-old Idaho native, Hank Cazier, is like any other teenager you've met. He loves chocolate, pop music, and playing games with his family. He has lofty dreams of modeling for a major clothing company one day. But one thing that sets him apart may also jeopardize his future is his recent battle against a brain tumor.

Cazier was diagnosed in 2015. When he had surgery to remove the tumor, he received trauma to his brain and lost some of his motor functionality. He's been in physical, occupational, and speech therapy ever since. The experience impacted Cazier's confidence and self-esteem, so he's been looking for a way to build himself back up again.

"I wanted to do something that helped me look forward to the future," he says.

Enter Make-A-Wish, a nonprofit organization that grants wishes for children battling critical illnesses, providing them a chance to make the impossible possible. The organization partnered with Macy's to raise awareness and help make those wishes a reality. The hope is that the "wish effect" will improve their quality of life and empower them with the strength they need to overcome these illnesses and look towards the future. That was a particularly big deal for Cazier, who had been feeling like so many of his wishes weren't going to be possible because of his critical illness.

"In the beginning, it was hard to accept that it would be improbable for me to accomplish my previous goals because my illness took away so many of my physical abilities," says Cazier. His wish of becoming a model also seemed out of reach.

But Macy's and Make-A-Wish didn't see it like that. Once they learned about Cazier's wish, they knew he had to make it come true by inviting him to be part of the magical Macy's holiday shoot in New York.

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Make-A-Wish can't fulfill children's wishes without the generosity of donors and partners like Macy's. In fact, since 2003, Macy's has given more than $122 million to Make-A-Wish and impacted the lives of more than 2.9 million people.

Cazier's wish experience was beyond what he could've imagined, and it filled him with so much joy and confidence. "It is like waking up and discovering that you have super powers. It feels amazing!" he exclaims.

One of the best parts about the day for him was the kindness everyone who helped make it happen showed him.

"The employees of Macy's and Make-A-Wish made me feel welcome, warm, and cared for," he says. "I am truly grateful that even though they were busy doing their jobs, they were able to show kindness and compassion towards me in all of the little details."

He also got to spend part of the shoot outdoors, which, as someone who loves climbing, hiking, and scuba-diving but has trouble doing those activities now, was very welcome.

Courtesy of Macy's

Overall, Cazier feels he grew a lot during his modeling wish and is now emboldened to work towards a better quality of life. "I want to acquire skills that help me continue to improve in these circumstances," he says.

You can change the lives of more kids like Cazier just by writing a letter to Santa and dropping it in the big red letterbox at Macy's (you can also write and submit one online). For every letter received before Dec. 24, 2019, Macy's will donate $1 to Make-A-Wish, up to $1 million. By writing a letter to Santa, you can help a child replace fear with confidence, sadness with joy, and anxiety with hope.

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