WTP Webinar: Barriers to Food Access Experiences by Older Adults

Wisdom Tooth Project Webinar Series

Barriers to Food Access: Experiences by Older Adults

Tuesday, July 26th, 2016

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Question and Answer Session • Questions are welcome! This session will be at the end of the presentation • May last for 10-15 minutes.

• Write your questions in your control panel on the upper right hand of your screen.

• Submit questions at any time.

Barriers to Food Access: Experiences by Older Adults Presentation By:

Marie C. Gualtieri, M.A. North Carolina State University

Outline • Introduction • Demographics • What Are Some Barriers?

• • • • •

Causes of Food Insecurity Preparing Meals Nutrition Barriers to Food Access Programs Measurement Issues

• Conclusion

Introduction What is food insecurity?

• Food insecurity is limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.1 • • • •

High food security Marginal food security Low food security Very low food security

1 from

the Life Sciences Research Office, S.A. Andersen, ed., "Core Indicators of Nutritional State for Difficult to Sample Populations," The Journal of Nutrition 120:1557S-1600S, 1990.

Introduction (cont.)

What is the current issue? • Approximately 9.6 million Americans over the age of 60, roughly 15.5% of the total senior population in the United States, are food insecure.2 • Services have been created to help provide meals to older adults.

2 Ziliak, J.P. & Gundersen, C. (2015). State of senior hunger in America 2013: An annual report. Prepared for the

National Foundation to End Senior Hunger (NFESH).

Introduction (cont.)

What are future projections? • In 2040 there will be 79.7 million older adults, more than twice as many as in 2000.3 • The number of seniors experiencing food insecurity is anticipated to increase by 50% by 2025.4

3

U.S. Department of Health and Human Services, Administration on Aging. (2012). A profile of Older Americans: 2012.

4

Ziliak, J.P. & Gundersen, C. (2009). Senior hunger in the United States: Differences across states and rural and urban areas. Prepared for the National Foundation to End Senior Hunger (NFESH).

Demographics • Physical and mental disability • Gender • Age • Race • Living with grandchildren • Poverty line

What Are Some Barriers?

• Causes of Food Insecurity • Preparing Meals • Nutrition • Social Support • Barriers Food Access Programs • Measurement Issues

Causes of Food Insecurity Income • Currently, food insecurity is associated mainly with income.

• This income is in the form of Social Security checks, retirement, pensions, payment from temporary side jobs, payment from Veteran’s Affairs, etc.

• Being married does not mean you are better off.

Quotes “You run out of things. You don’t like to, but you do. I grew up during the Great Depression, and I have four sisters. We never went hungry, my mother made a lot of casseroles, but they were very frugal and meticulous with money. So I grew up in a thrifty environment. You just make it stretch.”5 - Barbara, 91* “Most of my medications are expensive, and I have to choose between food and getting my medications. And I find out I choose medication over food.

And I need to take food with my medication. I try to balance, but I’m in between a hammer and a hard place. I would love to have food, and I would love to have my medication. But I have to make a decision.”

- Robert, 64 5

Gualtieri, M.C. & Donley, A.M. (2016). Senior hunger: The importance of quality assessment tools in determining need. Journal of Applied Social Science 10(1), 8- 21. *Pseudonyms are used to maintain confidentiality.

Causes of Food Insecurity (cont.)

Mobility and Transportation • Transportation can be an issue due to physical and cognitive ability issues.

• Even if seniors have cars, they can have issues using their cars to go to the grocery stores.

• Cognitive impairments also play a role.

Preparing Meals • Preparing meals can be challenging seniors, mainly due to health and mobility issues. • Using appliances, such as the stove can be difficult, which also impacts the types of food these seniors can prepare.

Nutrition • In a national study of older adults aged 50 and older (with a majority of the sample aged 60 and older: 66%), respondents reported:6 – – – –

6 AARP

wanting assistance in how to read nutrition labels wanting to know more recipes having more time to cook and better cooking skills having transportation to be able to shop at different locations to diversify their foods for consumption(depending on affordability for some respondents)

Foundation. (2016). Securing the essentials: Findings on nutrition knowledge and food insecurity among older adults. Washington, DC: AARP Foundation. Retrieved from http://pdf.aarpfoundation.org/i/455086-aarpfoundation-findings-on-nutrition-knowledge-and-food-insecurity-among-older-adults.

Nutrition (cont.) • There seems to be a disconnect between seniors reporting that they believe that they eat nutritious, well-balanced meals and what they actually eat.

Quotes Breakfast: oatmeal Lunch: a slice of toast Dinner: baked potato Marcy, 88 Breakfast: smoothie made with random food products, oatmeal, milk Lunch: leftovers Dinner: cheese and crackers Robert, 64

Social Support • Seniors many have a strong dependence on their sources for support, and find themselves in a bind if their neighbors, friends or relatives are unavailable.

Quotes “My neighbor is reliable but has commitments himself. He’s retired, and we’ve been neighbors for over 50 years, and he has appointments and he and his wife visits their son for a couple a weeks at a time. Sometimes my sister will help, but her husband is an invalid, so she has her hands full. She can’t leave him alone. So I cannot rely on her. My other sister is a crossing guard and is not available because of her work schedule. She’s also not able to drive at night, so she cannot really help. My other sister lives kind of far away and is not available.”

-Barbara, 91 “He [his neighbor] is hard to do without.”

-Ron, 76

Barriers to Food Access Programs • Eligibility requirements • Being present • Filing paperwork • Participation requirements • Waiting lists

Measurement Issues • Assessment questions • The USDA measurement of household food insecurity focuses on income.

• What seniors report might not be accurate, and therefore, follow up questions are needed.

• Issues with priority.

Conclusion • Home-delivered meals programs are a solution to seniors experiencing food insecurity. • There are many different home-delivered meals programs throughout the United States that use different delivery models to try and meet the demand for the services, which includes delivering meals every day versus once a week. 7

7

Thomas, K.S., Akobundu, U., & Dosa, D. (2015a). More than a meal? A randomized control trial comparing the effects of home-delivered meals programs on participants’ feelings of loneliness.

Journal of Gerontology Series B: Psychological Sciences & Social Sciences, 0, 1-10.

Conclusion (cont.) • Even though both groups receive meals, findings suggest that those who received meal delivery everyday were more likely to express that participating in the program improved their feelings of loneliness when compared to the group only receiving meal delivery once a week. 7 • In terms of seniors on the waiting list, which is the population in the current study, scholars have found that this population is more prone to falling in their homes, and express feelings of depression and anxiety. 8

8

Thomas, K.S., Smego, R., Akobundu, U., & Dosa, D. (2015b). Characteristics of older adults on waiting lists for meals on wheels: Identifying areas for intervention. Journal of Applied Gerontology doi: 0733464815614918.

Conclusion (cont.) • Due to medical advancements making it feasible for seniors to live longer, and because the Baby Boomer generation is aging, the number of seniors experiencing food insecurity is expected to increase.

• However, budget cuts and lack of federal funds have food assistance programs establishing waiting lists as the demand for such services far surpasses the supply. • Because this issue is projected to get worse for seniors, hopefully food access will become a pertinent topic of conversation among policymakers.

Thank you!

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