Be Healthy. Nutrition and Food Security

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Be Healthy Nutrition and Food Security

Texas Health and Human Services HHS oversees the operation of the health and human services system. HHS has responsibility for strategic leadership, administrative oversight of Texas health and human services system programs, and provides direct administration of some programs. HHS oversees: Eligibility Determination System Planning and Evaluation Policy Development and Rule-making Ombudsman Services Aging Programs

Office of Aging Service Coordination Initiatives Age Well Live Well Aging Texas Well Database of Aging Programs Texercise Silver Lining

Age Well Live Well In 2050, Texans aged 65 and over is projected to be 17.4 percent. The Age Well Live Well campaign provides resources and tools to help individuals and local communities meet the needs associated with aging and create opportunities for living well.

Age Well Live Well The Age Well Live Well campaign provides resources, tips, tools and expertise to help Texans: Be Healthy: by improving the physical health of older adults, their families and the community at large. Be Connected: by providing opportunities for Texans to get engaged in local activities and volunteer. Be Informed: by creating awareness of aging-related issues and resources offered through Age Well Live Well partners, HHS and the aging and disability network.

The Changing Face of Texas In 2012, Texas s population was more than 25 million and nearly 4 million (15%) were 60 years or older. It is estimated that by 2030 Texas s 60 plus population will increase to over 6 million (20%). An increase of almost 25% from 2012.

The Changing Face of Texas Baby Boomers

Be Healthy Importance of Physical Activity The Centers for Disease Control and Prevention recommends adults get at least 150 minutes of moderate to vigorous activity per week. Regular physical activity Can help increase your overall health and lower the risk of developing chronic diseases Also assists in promoting stronger and healthier muscles, bones and joints.

The High Cost of Inactivity Cardiovascular diseases are among the 10 most frequent causes of hospitalization of people 45 years and older in Texas More than 1.8 million Texans have diagnosed diabetes and an estimated 440,468 additional Texans with undiagnosed diabetes In 2013, Texans 65 and older: 38 percent were overweight 27.6 percent were obese

The High Cost of Inactivity Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs.

Benefits of Exercise People who participate in physical activity on a regular basis lower their risk of developing a chronic disease by 30 50%.

Be Healthy Nutrition Recommendations Make half your plate fruits and vegetables Focus on whole fruits Vary veggies Make half your grains whole grains Move to low-fat and fat-free dairy Vary protein (chicken, fish, beans, etc.)

Be Healthy Benefits of Eating Healthy Reduces risk of heart disease, stroke, type 2 diabetes, bone loss, hypertension and some kinds of cancer Improves energy level Helps with weight management Improves ability to recover from illness or injury

Food Insecurity What is it? The USDA defines food insecurity as a householdlevel economic and social condition of limited or uncertain access to adequate food.

The High Cost of Food Insecurity In 2014, 5.7 million (9%) Americans over the age of 60 were food insecure. This is projected to increase by 50% in 2025. Texas has the fourth highest rate of senior food insecurity in the nation.

The High Cost of Food Insecurity Food insecure older adults are: 60% more likely to experience depression. 53% more likely to report a heart attack. 40% more likely to experience congestive heart failure. 22% more likely to experience limitations in their Activities of Daily Living.

The High Cost of Food Insecurity Food insecurity significantly increases the risk of malnutrition with up to 1 out of 2 older adults at risk for malnutrition. Hospital costs can be up to 300% greater for individuals who are malnourished. Malnourished hospitalized adults have a five times higher mortality and 50% higher readmission rates.

Malnutrition Malnutrition A deficiency, excess or imbalance in a person s intake of energy and/or nutrients. Covers two broad conditions (undernutrition and overnutrition). Undernutrition can be caused by lack of calories, protein or other nutrients. Overnutrition comes from eating too many calories but not eating enough nutritious foods.

Malnutrition Risk Factors Loss of appetite Oral health Chronic conditions Medication interaction Social isolation Depression Dementia including Alzheimer s Unable to shop, cook or feed oneself

Malnutrition What can be done? Conduct periodic screenings for malnutrition Educate on malnutrition and relevant resources Assist in accessing programs and services Create a plan using the National Blueprint: Achieving Quality Malnutrition Care for Older Adults as a guide

Brainstorm Barriers to food security

Barriers to Food Security Individual Community/ Environment

Barriers to Food Security Individual Mobility Food utilization Chronic disease Oral health Mental health

Mobility Many people experience food insecurity even with adequate transportation due to functional limitations that effect the ability to grocery shop. In 2015, 26.5 million adults 65 or older had one basic actions labeled as difficult or a complex activity limitation. In 2015, 3.4 percent of adults 65-74 years of age needed assistance with personal care from other persons.

Food Utilization Not knowing proper cooking, handling and storing of food can lead many older adults to experience food insecurity as well as at a greater risk for food borne illness. An older person who gets a foodborne illness is likely to be sicker longer. To avoid contracting a foodborne illness, older adults must be especially vigilant when handling, preparing and consuming foods.

Chronic Diseases Many people who have chronic conditions can experience food insecurity due to limited access and ability to prepare foods. 3 out 4 adults 65 and older have a chronic condition. Chronic conditions can result in changes to nutrient intake and ability to use nutrients which can lead to malnutrition.

Oral Health Older adults can experience food insecurity due to poor oral health. A decrease in the ability to chew or swallow can limit foods that can be consumed and greatly impact nutritional status. 1 in 4 older adults have lost all of their teeth. Adequate access to medical and dental care can: Reduce premature morbidity and mortality, Preserve function Enhance overall quality of life

Mental Health Mental health, including dementia and Alzheimer s Disease, can play a role in a person s food security and overall nutrition. Approximately 1 in 5 adults in the U.S. experiences mental illness in a given year. An estimated 5.1 million adults 65 and older have some type of dementia.

What can be done? Identify what is causing food insecurity Periodic malnutrition screenings Support older adults nutrition self-efficacy Educate and provide relevant resources Home delivered meals and congregate meals Medication management Create opportunities Healthy cooking demonstrations

Barriers to Food Security Community/Environment Food deserts Transportation Food prices

Food Deserts Food deserts are defined as parts of the country vapid of fresh fruit, vegetables, and other healthful whole foods, usually found in impoverished areas. This is largely due to a lack of grocery stores, farmers markets, and healthy food providers. Approximately 23.5 million Americans live in areas designated as food deserts, and nearly half are lowincome. In 2012, Texas had the largest grocery gap.

Transportation Transportation is needed to access healthy food options. A poor transportation system limits access to food especially for those who do not own a car or have no access to reliable and/or affordable public transportation. One-fourth of adults 75 years and older do not drive. Continues to be cited as one of the top unmet needs across Texas communities.

Food Prices Food prices are a major determinant of food intake. High food costs can have a negative impact on nutritional status and health. Prices for food items vary with store size, with small stores charging an average of 10% more than supermarkets. On average, low-income households face slightly higher prices than other households for the same food items.

What can be done? Assess food security in your community Plan ways to address food insecurity Research best practices and template policies Create opportunities Start or enhance existing initiatives (e.g. community gardens, Drive a Senior, etc.) Advocate for access to healthy food options Talk with local and state leadership to highlight the issue and enlist their support

Barriers to Food Security Individual and Community/Environment Limited income Social isolation

Limited Income Many older adults who are food insecure routinely face with deciding between purchasing healthy, fresh foods or paying for medications or heat and electricity for their home. 11 percent of adults 65 and older live below the poverty level. In 2014, approximately 75 percent of older adults depended entirely, or almost entirely, on Social Security for their monthly income.

Social Isolation Older adults who live alone are more likely to experience food insecurity than those who live with others. 19% of Americans age 62-91 are lonely. More than 1.2 million (9%) households composed of older adults living alone experience food insecurity.

What can be done? Provide resources and education on eating healthy on a budget Assist with applying for nutrition assistance programs: SNAP Commodity Supplemental Food Program Senior Farmers' Market Nutrition Program Educate on meal services: Congregate meals at senior centers Home delivered meal programs Implement innovative initiatives Lunch Buddy Program

Brainstorm Resources to address food insecurity

Texercise A statewide health promotions initiative, aims to educate and involve individuals and communities in physical activities and proper nutrition. Texercise provides free educational and motivational resources including: Texercise Handbook DVD Fact sheets (12 fitness and 8 nutrition) Website (www.texercise.com)

Area Agencies on Aging The 28 regional agencies help Texans 60 and older, their family members and/or other caregivers receive the information and assistance they need to locate and access community services to help them live with dignity and choice in their homes and communities for as long as possible. Services include: Nutrition Services In-home support services Benefits counseling Care coordination

Aging and Disability Resource Centers Help simplify access to long-term care by providing one point of contact for people. ADRCs cut through the confusing maze of funding sources, multiple intake systems and eligibility processes. ADRCs are key points of access for information on: Person centered long-term services and supports Referral and assistance Long-term care services

2-1-1 A free, anonymous social service hotline available 24/7 that helps Texans connect with the services they need. No matter where you live in Texas you can call 2-1-1 and get information about local services. 2-1-1 provides information on: Aging services Senior centers Food banks/pantries

Meals on Wheels Non-profits with 15 locations in Texas serving older adults through home delivered meals or at congregate meal sites. Meals on Wheels provide: Nutritious meals Friendly visits Other services dependent on location

Texas AgriLife Extension Services Helps improve the lives of people, businesses and communities across Texas through high-quality, community-based education. AgriLIFE programs ensure Texans are better prepared to eat well, stay healthy and manage money. AgriLife programs include: Dinner Tonight Master Wellness Volunteers Master Gardeners Walk Across Texas

Take the Challenge Identify areas you can assist in addressing food insecurity. Research innovative and best practices. Collaborate with other organizations.

Contact Information Holly Riley Aging Services Coordination, Manager 512.438.4293 Holly.Riley@hhsc.state.tx.us Chelsea Couch Texercise Program Coordinator 512.438.3631 Chelsea.Couch@hhsc.state.tx.us