Objective: Poverty and material hardship have both been linked to negative health outcomes in later life. Yet, limited research investigates their combined associations with health. We examined the mediating role of material hardship in the association between poverty and self-rated health. <br/><br/>Methods: Using data from the Understanding America Study, we estimated binary and ordered logistic regression models of self-rated health, including indicators of hardship and income-to-poverty ratios for adults aged 50 years or older (N = 2862). <br/><br/>Results: We found that the association between income poverty and self-rated health was mediated by indicators of material hardship among those with incomes between two and four times the official poverty threshold. <br/><br/>Conclusion: Interventions to improve health in later life would benefit from efforts to assess and alleviate hardship, with attention to those in the middle range of the income distribution who have income too high to qualify for needs-based supports while still being at risk of experiencing hardship.