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.

It is safe to say that the wise words of Muhammad Ali stands the test of time. Widely considered to be the greatest heavyweight boxer the world has ever seen, the legacy of Ali extends far beyond his pugilistic endeavors. Throughout his career, he spoke out about racial issues and injustices. The brash Mohammed Ali (or who we once knew as Cassius Clay) was always on point with his charismatic rhetoric— despite being considered arrogant at times. Even so, he had a perspective that was difficult to argue with.

As a massive boxing fan—and a huge Ali fan—I have never seen him more calm and to the point then in this recently posted BBC video from 1971. Although Ali died in 2016, at 74 years old, his courage inside and outside the ring is legendary. In this excerpt, Ali explained to Michael Parkinson about how he used to ask his mother about white representation. Even though the interview is nearly 50 years old, it shows exactly how far we need to come as a country on the issues of racial inclusion and equality.


Keep Reading Show less