SENIORS, FOOD INSECURITY, HEALTH, AND COMMUNITY PROGRAMMING Hilary Seligman, MD, MAS Senior Medical Advisor and Lead Scientist, Feeding America Associate Professor of Medicine and of Epidemiology & Biostatistics, University of California San Francisco October 29, 2015
5.4 Million SENIORS ARE FOOD INSECURE
Hunger The uneasy or painful sensation caused by a lack of food, or the recurrent and involuntary lack of access to food. (LSRO)
Food insecurity: Household-level economic and social condition of limited or uncertain access to adequate food Food security: access by all people at all times to enough food for an active, healthy life United States Department of Agriculture
Coping Strategies to Avoid Hunger Eating low-cost foods Fewer F&V More fats/carbs Eating highly filling foods Small variety of foods Avoiding food waste Binging when food is available Higher risk of obesity, diabetes, & other chronic, dietsensitive chronic disease Once you are chronically ill, poorer ability to manage it your illness
A Conceptual Framework: Cycle of Food Insecurity & Chronic Disease FOOD INSECURITY HOUSEHOLD INCOME SPENDING TRADEOFFS STRESS COPING STRATEGIES: Dietary Quality Eating Behaviors Bandwidth HEALTH CARE EXPENDITURES FUNCTIONAL STATUS CHRONIC DISEASE
Food Insecurity Episodic Food Availability Eating Behaviors Reduced Diet Quality Food Affordability Bandwidth Stress & Competing Demands Chronic Disease (Obesity & Diabetes) Sub-Optimal Self-Management
Experience of Food Insecurity Among Seniors Reduced food intake: With all of my expenses... sometimes I have to go to bed without eating, [but] I am used to it. Episodic food availability: There were times that if we found [food] for lunch we didn t have [food] for dinner. Sometimes [our daughters] would help us. They would give us a loaf of bread and they would help us with a little bit of food... It is sad and painful. Sometimes we run out of things towards the end of the month. Dietary quality, Competing demands: I buy the medication first. I cook macaroni and put some sauce on it No protein, you know, not enough protein. Wolfe, Community and International Nutrition, 2003
Experience of Food Insecurity Among Seniors Stress: I worry a lot because of nutrition and health. I don t have the money to buy what I need. Coping strategies: Sometimes I don t have anything here and I don t want to tell my children that I am in that situation. I ll go to some of the Sisters apartments from church and they offer me food and that s how I can get something to eat. Wolfe, Community and International Nutrition, 2003
Food Insecure Seniors & Health Compared to their food-secure peers, food-insecure seniors are: 60% 53% 52% 40% MORE LIKELY TO EXPERIENCE DEPRESSION MORE LIKELY TO REPORT A HEART ATTACK MORE LIKELY TO REPORT ASTHMA MORE LIKELY TO REPORT CONGESTIVE HEART FAILURE Food Insecurity Health Care Expenditures
A Conceptual Framework: Cycle of Food Insecurity & Chronic Disease FOOD INSECURITY UPSTREAM COMMUNITY INTERVENTION HOUSEHOLD INCOME SPENDING TRADEOFFS STRESS COPING STRATEGIES: Dietary Quality Eating Behaviors Bandwidth HEALTH CARE EXPENDITURES FUNCTIONAL STATUS HEALTH CARE INTERVENTION CHRONIC DISEASE
Special Notes for Senior Population FOOD INSECURITY FRAIL ELDERLY SOCIAL ISOLATION CHRONIC DISEASE
Targeting Programs for Seniors Not Homebound: Food Pantries Congregate Meal Sites 79% 13% 8% Homebound, Can Cook: Home Delivered Groceries Homebound, Cannot Cook: Home Delivered Meals
Targeting Programs for Seniors Not Homebound: Food Pantries Congregate Meal Sites 79% 13% 8% Homebound, Can Cook: Home Delivered Groceries Homebound, Cannot Cook: Home Delivered Meals Feeding America provides 127 million meals to 7 million adults aged 60 and older annually.
A Conceptual Framework: Cycle of Food Insecurity & Chronic Disease FOOD INSECURITY UPSTREAM COMMUNITY INTERVENTION HOUSEHOLD INCOME SPENDING TRADEOFFS STRESS COPING STRATEGIES: Dietary Quality Eating Behaviors Bandwidth HEALTH CARE EXPENDITURES FUNCTIONAL STATUS HEALTH CARE INTERVENTION CHRONIC DISEASE
Hilary Seligman, MD, MAS Lead Scientist And Senior Medical Advisor, Feeding America Associate Professor Of Medicine & of Epidemiology & Biostatistics, UCSF Hilary.Seligman@ucsf.edu
200 MEMBER 1 NATIONAL OFFICE FOOD BANKS 46M AMERICANS SERVED ANNUALLY 60K FOOD PANTRIES AND MEAL PROGRAMS
The Impact of the Feeding America Network We serve 46 MILLION AMERICANS annually, including 12 million children and 7 million seniors We source and distribute 10 MEALS for each $1 donated We provide 3.3 BILLION MEALS each year to people in need We source 1 BILLION POUNDS of fruits and vegetables by the network We have 200 FOOD BANKS in the Feeding America network 2 MILLION VOLUNTEERS help carry out our vision for a hunger-free America Source: Network Activity Report and Hunger in America 2014