Food Security Among Older Adults Craig Gundersen University of Illinois James P. Ziliak University of Kentucky
Definitions of Categories of Food Insecurity A household is placed into food security categories based on responses to 18 questions on the Core Food Security Module (CFSM) Examples of questions I worried whether our food would run out before we got money to buy more Did you or the other adults in your household ever cut the size of your meals or skip meals because there wasn t enough money for food Were you ever hungry but did not eat because you couldn t afford enough food In the last 12 months did you or other adults in your household ever not eat for a whole day because there wasn t enough money for food?
Definitions of Food Insecurity Categories Marginally food insecure (Threat of hunger) 1 or more affirmative responses to CFSM Food insecure (At-risk of hunger) 3 or more affirmative responses to CFSM Very low food secure (Facing hunger) 8 or more affirmative responses to CFSM (households with children) 6 or more affirmative responses to CFSM (households without children)
Percent Number in Millions Figure 1. Trends in Threat of Senior Hunger 18 10 16 9 14 8 12 7 6 10 5 8 4 6 3 4 2 2 1 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Year 0 Rate under Threat Number under Threat
Table 4. Top Ten States in Terms of the Threat of Senior Hunger in 2013 Arkansas 26.10 Louisiana 24.39 Mississippi 24.34 District of Columbia 20.27 Texas 20.26 Tennessee 19.67 Missouri 19.06 South Carolina 18.77 North Carolina 18.40 Alabama 17.21
Hunger Rates By Income Categories 10 15 20 25 30 35 40 45 marginally food insecure at-risk of hunger hunger 0 5 <50% of PL 50-100% of PL 100-200% of PL >200% of PL
Distribution of Income Groups By Hunger Categories Percent 10 20 30 40 50 <50% of PL 50-100% of PL 100-200% of PL >200% of PL 0 hunger at-risk of hunger marginally food insecure
Hunger Rates By Race Categories Percent 10 15 20 25 30 marginally food insecure at-risk of hunger hunger 0 5 white black
Distribution of Race Categories By Hunger Categories Percent 10 20 30 40 50 60 70 80 white black 0 hunger at-risk of hunger marginally food insecure
Percent Figure 5. Trends in Threat of Senior Hunger by Age 20 18 16 14 12 10 8 6 4 2 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Year 60-69 years old 70-79 years old 80+ years old
Multivariate Regression Models Controlling for other factors we find that food insecurity is more likely among older adults Living at or below the poverty line Without a high school degree Who are African-American or Hispanic Who are divorced or separated Who have a grandchild living in the household Who are younger
Figure 2. Regression-Adjusted Estimates of the Effect of Food Insecurity on Nutrient Intakes of Seniors 60+ (Percent Change Relative to Average of Food Secure Seniors) Energy Protein Vitamin A Vitamin C Thiamin Riboflavin Vitamin B6 Calcium -0.2 Phosphorous Magnesium Iron -4.3-4.9-5 -3.3-3.7-5.1-8.3-7.5-6.7-7.2 Percentages in red are statistically significant at the 1% level; in green at the 5% level; and yellow at the 10% level
Diabetic Excellent Excellent or Very Good Excellent, Very Good, or Good Depression ADL Limitations High Blood Pressure High Cholesterol Congestive Heart Failure Coronary Heart Disease Heart Attack Cancer Chest Pain Gum Disease Gum Health Psoriasis Asthma Figure 3. Regression-Adjusted Estimates of the Effect of Food Insecurity on Health Outcomes of Seniors 60+ (Percent Change Relative to Average of Food Secure Seniors) 60 53 51.8 40 36.9 21.8 21.8 14.5 5.3 5.9 1.7 4.9-8 -10-1.1-21.8-11.5 Percentages in red are statistically significant at the 1% level; in green at the 5% level; and in yellow at the 10% level
What Can be Done? Supplemental Nutrition Assistance Program (SNAP) Primary goals are to alleviate hunger and improve the well-being of poor people By far, largest food assistance program in the United States Benefit levels Size of program Available to all ages Eligibility Criteria Gross income test Not binding for seniors Net income test Net monthly income (after various deductions) less than the poverty line Asset test Less than $3,000 Waived in many states
What Can be Done? SNAP Encourage participation Over 60 Between 40 and 60 Address barriers for grandparents raising grandchildren Entering program Benefit levels Reevaluate minimum benefit levels Reach out to the socially isolated Help those with mobility issues Recognize importance of informal food assistance programs For those receiving SNAP For those ineligible for SNAP
Future Research Directions Why is there a negative age gradient? How do the dynamics of multi-generational households influence food insecurity? How do chronic health conditions influence food insecurity and vice-versa? How might allowing home-delivered meals to be purchased with SNAP benefits influence food insecurity rates?