Abstract
Background. Many individuals and families eligible for means-tested social welfare programs do not seek these benefits, and the reasons for this phenomenon are not fully understood. Supplemental Nutrition Assistance Program (SNAP) uptake is preceded by family, health, and economic shocks resulting in sharp increases in food insecurity, and it is followed by moderate decreases in food insecurity. The result in cross-sectional data is that SNAP recipients have higher food insecurity overall than eligible non-recipients. We examined if similar patterns existed for Supplemental Security Income (SSI) recipients and food insecurity. Methods. We compared rates of food insecurity between SSI recipients and eligible non-recipients using nationally representative data from the Survey of Income and Program Participation. We conducted a difference-in-differences analysis comparing SSI recipients and eligible non-recipients at two time points a year apart just before SSI receipt. We also conducted a cross-sectional analysis. Results. In the lead up to SSI uptake, SSI recipients had a statistically significant increase in uninsurance in comparison to eligible non-recipients. In cross-sectional data, SSI recipients and significantly higher levels of food insecurity than eligible non-recipients. Conclusions. Levels of food insecurity among eventual SSI recipients rise prior to SSI receipt. To the extent SSI reduces food insecurity, as with SNAP it does not fully address the rise in food insecurity that occurs prior to the initiation of benefits. Benefit levels may need to be increased to fully alleviate food insecurity among people with disabilities.