Impact of Food Insecurity and Food Assistance Program Participation on Nutritional Risk Among the Elderly
Research Center: Department of Nutrition at the University of California, Davis
Investigator: Frongillo, Edward A., and Jung Sun Lee
Institution: Cornell University
Edward A. Frongillo, Jr., Ph.D.
Division of Nutritional Sciences
Ithaca, NY 14853
607-225-3153, fax 607-225-1003
The purposes of this study are to examine: 1) the factors
associated with the food insecurity of the elderly
in the United States, 2) the consequences associated
with food insecurity for the nutritional and health status
of the elderly, and 3) the impact of food assistance
programs among the nutritionally needy or food-insecure
elderly on their nutritional and health status.
Frongillo and Lee used data from two cross-sectional
surveys and one longitudinal study: the third National
Health and Nutrition Examination Survey (1988-94),
the Nutrition Survey of the Elderly in New York State
(1994), and the Longitudinal Study of Aging (1984-
1990). Their multiple linear and logistic regression
analyses examined three sets of issues: (1) how health
and physical functioning, as well as sociodemographic
and economic factors, contributed to food insecurity in
the elderly, (2) the extent to which food-insecure elderly
were likely to have lower nutrient intake and skinfold
thickness (a measure of body fat), poorer self-reported
health status, and greater nutritional risk, and
(3) whether food assistance participants differ from
nonparticipants with respect to their nutrient intake,
skinfold thickness, self-reported health status, nutritional
risk, and rates of hospitalization and mortality;
and how these differences compare between food-secure
and food-insecure elderly.
The authors found that low levels of income and education,
minority status, and food assistance program
participation were significantly related to food insecurity.
Functional impairments and lack of social support
were significantly related to food insecurity
among the elderly, even after controlling for those factors.
Food insecurity was significantly associated with
lower intakes of energy, protein, carbohydrates, saturated
fat, niacin, Vitamins B-6, B-2, B-12, magnesium,
iron, and zinc, as well as lower skinfold thickness.
Also, food-insecure elderly were 2.3 times more likely
to report fair or poor health status and had higher
nutritional risk. The authors found poorer nutritional
and health status among food-insecure or needy elderly
than among food-secure elderly across all three data
sets. Among food-insecure or needy elderly, food
assistance participants had lower nutrient intakes and
skinfold thickness, greater nutritional risk, poorer self-reported
health status, and higher rates of hospitalization
and mortality than nonparticipants. Among the
food-secure elderly, however, participants and nonparticipants
had similar nutritional and health status.
Food security in the elderly is associated not only with
limited food affordability, availability, and accessibility,
but also with inadequate food utilization. Food-insecure
elderly are those with multiple problems that
prevent them from achieving nutritional well-being,
and lead them to seek food assistance programs.
Food-insecure elderly have poorer nutritional and
health status than do food-secure elderly.
The results of this study imply that both program efficacy
and the need status of participants are playing
roles in determining the impact of food assistance programs.
The authors conclude that better theoretical
and empirical knowledge of how the needs of this population
are dynamically related to food assistance program
delivery is essential to determining program
impact and to make food assistance programs more
effective and beneficial for needy elderly.