No One Should Go Hungry by Yinyin Liu

SENIOR HUNGER IN SAN FRANCISCO BY YINYIN LIU

WHAT IF YOU DON’T HAVE ENOUGH MONEY TO EAT IN A RESTAURANT?

WHAT IF YOU DON’T HAVE ENOUGH MONEY TO EVEN BUY YOUR BASIC FOODS?

WHAT IF YOU HAD TO CHOOSE BETWEEN FOOD AND MEDICINE?

SO, YOU THINK HUNGER IS ONLY A PROBLEM OF HOMELESS PEOPLE?

NO, IT’S ABOUT OUR PARENTS AND GRANDPARENTS.

Designed by: Yinyin Liu yinyin409@gmail.com 804-787-3283 Instructors: Phillip Hamlett and Jeremy Stout ESL Supporters: Amy Shipley and Jill Ballard Academy of Art University MFA Graphic Design Typeface: Univers 57 Condensed and Minion Pro Paper: Red River Matte Printed: Epson 3880 Binded: Yinyin Liu

NO ONE SHOULD GO HUNGRY SENIOR HUNGER IN SAN FRANCISCO by Yinyin Liu

LUNCH PARTY FOR SENIOR HUNGER Date: October 30th, Tuesday Location: 660 California Street Duration: 12pm-12:45pm Activities: Lunch + Discussion

HOST

Yinyin

Hi, I’m Yinyin— I was born and grew up in Beijing, China. I came to San Francisco to study graphic design, and I’m always wondering why I see so many homeless people in the city, in this most rich country— the USA. After some research, I found out that the issue is far more than just homeless people. Often seniors have been working their whole life but have ended living on a minimal fixed income, and struggling to feed themselves in their “golden years”. In order to dive into this subject and figure out the reasons behind it, I’m going to hold a lunch party to discuss this issue with a group of varied people.

PARTICIPANTS

Bruce I’m Taiwanese, 28 years old, student, loves sports and drawing.

Bob I am 59, and working for the Groceries for Seniors Program. I’m in charge of deliveries.

Elena I’m 44 years old, a mother of two, and a housewife, enjoys cooking.

Sylvette I’m a French immigrant, a housewife and 64 years old. I take care of my 83-yearsold mother at home.

Nancy I’m retired, 75 years old. I’ve been living in San Francisco my whole life.

Robert I’m 73 years old, retired and volunteering in the foodbank every week from Monday to Thursday.

TABLE OF CONTENTS FORWARD

1. SENIOR HUNGER

2. THE CAUSES

3. HELPING HUNGRY SENIORS

1.1 Food Security vs. Food Insecurity 1.2 Senior Hunger Facts 1.3 Senior Hunger Groups 1.4 Senior Hunger Effects

2.1 Expensive Living Costs in San Francisco 2.2 Senior Outreach Barriers 2.3 Bad Food Distribution 2.4 Wrong Social Attitude

FORWORD Yinyin

The impact of not being able to access quality and nutritious food spans beyond the palpable effects on health, such as obesity and under-nutrition, as hunger can also lead to depression for affected individuals, premature displacement from the community, and inflict excessive burdens on the general health care system. With the substantial expansion of the senior population in the recent and coming years and escalating health care costs in the U.S., the impetus to be proactive in addressing elderly hunger and, thus, preventable health care utilization now and in the future, is both urgent and essential.

SENIOR HUNGER

1.1 FOOD SECURITY VS FOOD INSECURITY Food security is the measure of the ability ensure access to essential nutrition. It refers to a household’s or country’s ability to provide future physical and economic access to sufficient, safe, and nutritious food that fulfills the dietary needs and food preferences of that household for living an active and healthy life.1

The recognition of food insecurity—commonly known as hunger—has been at the forefront of public dialogue as the nation struggles to recover from rising unemployment rates, mass foreclosures, and rising prices. Food insecurity, is observed along a continuum, ranging from (a) having to rely on socially unacceptable methods of acquiring food, such as stealing, scavenging, or obtaining the services of food pantries and soup kitchens; (b) feeling anxious about or deprived of nutritious food due to access limitations; to (c) exhibiting involuntary, recurrent, or prolonged disrupted eating patterns because the household lacks the necessary resources for food.2

The impact of senior hunger is ultimately felt by everyone: Malnutrition costs. It costs older people by exacerbating disease, by increasing disability, by decreasing their resistance to infection, and by extending their hospital stays. It costs caregivers by increasing worry and caregiving demands. The entire country pays health care costs related to this increase in complication rates, increasing hospital stays, and increasing mortality rates. Malnutrition costs people and it costs dollars (S7-S8).3

FAO Agricultural and Development Economics Division (June 2006). Food Security. Retrieved June 8, 2012.

Holben, D.H. “The concept and definition of hunger and its relationship to food insecurity” at http://www7.nationalacademies.org/cnstat/Concept_ and_Definition_of_Hunger_Paper.pdf for further explanation of this topic and the measurement of food insecurity for different purposes.

Torres-Gil, F.M. (1996). “Malnutrition and Hunger in the Elderly.” Nutrition Reviews, 54 (1), S7-S8.

United States Department of Agriculture “ The (UDSA) uses the term “food insecurity” to

Yinyin

describe the condition of a household facing food scarcity intermittently. This terminology replaced the phrase “hunger,” which, though applicable, is more apt for describing the physical pain and health deficiencies resulting from an individual’s experience of prolonged food scarcity due to a lack of resources.4

”

FOUR MEASUREMENT 5 As of 2006, the USDA has replaced its usage of the term “hunger” with “food insecurity,” thus acknowledging the causes and effects that the availability of food can have on households: 6 HIGH FOOD SECURITY—Households had no problems, or anxiety about, consistently accessing adequate food.

VERY LOW FOOD SECURITY—At times during the year, eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food.

MARGINAL FOOD SECURITY—Households had problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of their food intake were not substantially reduced. LOW FOOD SECURITY/AT RISK FOR HUNGER— Households reduced the quality, variety, and desirability of their diets, but the quantity of food intake and normal eating patterns were not substantially disrupted.

4,5

Meisha McDaniel. [Considering the Costs of Senior Hunger and the Benefits of Federal Nutrition Programs in Washington, D.C.][Why Investment in Senior Food Programs Is More Important Now Than Ever ].<Considering-the-Costs-and-Benefits-of-Federal-Nutrition-Programs-in-WashingtonDC-McDaniel.pdf>

ERS/USDA. (2009). “Food Security in the United States: Measuring Household Food Security” http://www.ers.usda.gov/Briefing/FoodSecurity/ measurement.htm.

1.2 SENIOR HUNGER FACTS

About 20% of the seniors in San Francisco and Marin face the threat of hunger. Many of them find that after working hard all their lives, living on a small fixed income presents impossible choices: Do I pay the rent, or buy food? Medicine, or food? They simply canâ&#x20AC;&#x2122;t afford all of their basic needs. When health problems keep seniors homebound, the problem becomes even more complicated.7

Seniors, San Francisco and Marin Food Banks. web. 29. Nov. <http://www.sffoodbank.org/program/seniors>

SF SENIORS AS PERCENT OF TOTAL POPULATION 14%

19%

60+

65+

85+

SF SENIOR HUNGER FACTS

27% 18% 5%

73%

TOTAL SENIOR: 148,148 TOTAL LOW-INCOME SENIORS 40,000 (27%) 2005-2009 American Community Survey 5-Year Estimates

TOTAL LIVING BELOW FEDERAL POVERTY LINE: 27,159 (18%)

TOTAL LIVING AT/BELOW 150% POVERTY LINE: 8432 (5%)

In an age of rapid technological innovation and disease eradication, life expectancy rates for people in the United States have been steadily increasing, as men and women have the potential to live an average of at least 20 years longer than people born 100 years ago. However, for the millions of older people struggling to acquire food that satisfies their nutritional needs, the fruits of aging are difficult to reap. As of 2005, over five million U.S. citizens ages 60 and older have experienced some form of food insecurity or have been at-risk of this in their later years. Considering the prevalence of health problems among this cohort, coupled with increasing fuel, food, and housing costs, many elderly people, especially those living on fixed incomes, are struggling to meet the demands of the rising costs of living. The impact of not being able to access quality and nutritious food spans beyond the palpable effects on health, such as obesity and under-nutrition, as hunger can also lead to depression for affected individuals, premature displacement from the community, and inflict excessive burdens on the general health care system. Older adults make up a significant proportion of emergency food recipients but have been historically underrepresented in Food Stamp Program.8

SENIOR TRENDS9 In many states, the anticipated expansion of the elderly population is expected to exceed the growth of other age groups, and, nationally, the number of people ages 65 and older in 2030 will double what was recorded in the year 2000. This means that, in the not so distant future, one in every five people in the U.S. will be an older adult.10 Contemporary seniors, with access to the advantages of recent medical and technological innovations, have the opportunity to participate fully in society as community-dwelling citizens throughout their lives. SENIOR(60+) TRENDS IN FOOD INSECURITY 2005-201111 8% 6% 4% 2% 0 2005

2006

2007

2008

2009

2010

8, 9

Meisha McDaniel. [Considering the Costs of Senior Hunger and the Benefits of Federal Nutrition Programs in Washington, D.C.][Why Investment in Senior Food Programs Is More Important Now Than Ever].<Considering-the-Costs-and-Benefits-of-Federal-Nutrition-Programs-in-WashingtonDC-McDaniel.pdf>

“The Maturing of America—Getting Communities on Track for an Aging Population” Web. 29. Nov. <http://www.aginginplaceinitiative.org/index. php?option=com_content&task=view&id=19&Itemid=48.>

San Francisco Human Services Agency. Demographic and Poverty Trends in San Francisco. <SF_demographics_6.11.pdf >

2011

GROWTH IN SAN FRANCISCO SENIOR POPULATION(60+)

26,951

29,190

78,429

76,921

32,368

30,258

1990

2000

34,681

75,161

185,418

44,888

2010

2020 PROJECTED

SENIOR AGE 80+ SENIOR AGE 65-79 SENIOR AGE 60-64 PROJECTED TOTAL POPULATION

2000-2010 From census and american community survey ; 2011-2020 projections from CA Dept of Finance.

SAN FRANCISCO BY ETHNICITY AND POVERTY STATUS, 2006-2008

33%

WHITE

OTHERS

30%

ASIAN/PI

NATIVE AMERICAN

14% 14%

LATINO

AFRICAN-AMERICAN

TOTAL POOR POPULATION: 97,570 WHITE: 34,872 AFRICAN-AMERICAN: 16,420 ASIAN/PI: 29,512 NATIVE AMERICAN: 673 LATINO: 15,882 OTHER: 211 Source: IPUMS, 2006‐2008 American Community Survey 3‐year Estimate * Income < 100 Federal Poverty Level

1.3 SENIOR HUNGER GROUPS

What Characteristics Put Seniors at-Risk for Being Food Insecure? Nationally, most food insecure seniors are white, Non-Hispanic, under age 70, women, retired or disabled, live in metro areas, do not receive Food Stamps, and do not have a grandchild living within the home. All other factors remaining constant,

the risk of hunger among seniors increases for people with the following attributes: ages 60-64, living below the poverty line, African-American or Latino, never completed high school, disabled or unemployed, divorced or separated, renting, living with a grandchild, socially isolated, holds less than $25,000 in liquid wealth, and has a net worth less than $50,000. However, the risk of hunger is not unique to these groups and tends to be evident across demographic categories. These factors are significant when considering the barriers facing national and local anti-hunger organizations who wish to target seniors with unpredictable access to nutritious food.12 Food insecurity remains a problem that cuts across race, gender and age among San Franciscans. Seniors are a population that is at high risk for hunger in San Francisco. One in four of San Francisco’s 107,000 seniors faces the threat of hunger daily. Recently, the Meals on Wheels Association of America funded a study to look at seniors and hunger entitled “The Causes, Consequences, and Future of Senior Hunger in America.” The study found that those seniors at higher risk for food insecurity tend to be: Low-income; Younger seniors; Minority; Living alone.13

Ziliak, J.P.: Gundersen, C.; Haist, M. The Causes, Consequences, and Future of Senior Hunger in America. Web: <http://216.235.203.153/ Document. Doc?id=13>

1.4 SENIOR HUNGER EFFECTS Poverty can lead to hunger, and hunger can impact the physical, emotional and social lives of seniors. Hunger and the lack of access to nutritious foods compromise seniors health. Hunger deteriorates seniors’ mental and physical well being. Chronic illnesses worsen with hunger and leave seniors at risk for increased long-term care and hospitalization.14 It’s fair to say that many seniors expected their “golden years” to be just that...golden. But the retirement years have not been troublefree for all—some simply can’t make ends meet. Millions of seniors are living in poverty or are facing financial hardship because of high medical costs and rising living expenses. Silently suffering, too many of America’s oldest citizens are making tough choices— not taking their medications as prescribed, not adjusting the thermostat for heating or cooling, or skipping meals. While hunger in itself is a serious problem, not eating healthy meals often makes existing health conditions worse.15 PHYSICAL16 – Seniors may experience weakness, poor balance, lack of energy and more pronounced symptoms of diseases such as diabetes, dementia, heart disease, stroke, high blood pressure, high cholesterol and vision loss, all due to the lower intakes of nutrients.

A healthy diet can slow the onset of many diseases and help seniors manage the symptoms and impact of disease on lifestyle and longevity, but seniors may experience a loss of appetite from changing senses of taste and smell caused by aging, medication and disease. Seniors who experience hunger are more likely to experience poor overall health and have more limitations with regard to daily activities. EMOTIONAL17 – Worry and the physical manifestations of hunger can cause emotional problems for seniors. While it’s regularly unrecognized and untreated in older adults, depression affects as many as 6 million Americans over 65. The following situations can impact the emotional health of seniors: grief, loneliness, isolation, failing health, retirement, lack of mobility, concurrent illnesses such as Parkinson’s disease, cancer or diabetes, medications, and malnutrition itself, which makes depression worse.

Ziliak, J.P.: Gundersen, C.; Haist, M. The Causes, Consequences, and Future of Senior Hunger in America. Web. 28. Nov.< http://216.235.203.153/ Document.Doc?id=13>

USDA SNAP / Engaging Special Populations / Senior Outreach / <senior_outreach.pdf>

16, 17 The effect of poverty and hunger on seniors, <FactSheet-EffectsPoverty-Seniors.pdf>

SIC

THE HUNGER CYCLE

POOR

THREE MAIN HEALTH ISSUES AS A RESULT OF SENIOR HUNGER

1 2 3

WEIGHT GAIN Those who are eating less or skipping meals to stretch food budgets may overeat when food does become available, resulting in chronic ups and downs in food intake that can contribute to weight gain18. Cycles of food restriction or deprivation also can lead to an unhealthy preoccupation with food and metabolic changes that promote fat storage â&#x20AC;&#x201C; all the worse when in combination with overeating19. Unfortunately, overconsumption is even easier given the availability of cheap, energy-dense foods in low-income communities20.

MALNUTRITION Poor nutrition leads to increased utilization of health care services, early nursing home or other long-term care placements, and an increased risk of death. Further, it is estimated that 50 percent of all diseases impacting older Americans are directly connected to lack of appropriate nutrient intake.21

MENTAL HEALTH Several psychosocial effects, such as apathy, depression, anxiety, and selfneglect, are reported with greater frequency among the malnourished elderly. Without the meals they receive to sustain them at home, these older Americans may require placement in less desirable and much more costly institutional settings.22

Dammann & Smith, 2010; Ma et al., 2003; Olson et al., 2007; Smith & Richards, 2008.Â

Alaimo et al., 2001; Dietz, 1995; Polivy, 1996.

Paul Ash. Potato chips beckon as food prices rise. Web. 29. Nov.<http://www.sfgate.com/health/article/Potato-chips-beckon-as-food-prices-rise-3210628 php#ixzz2BUQPuZgf>

21, 22

Senior Huger The Human Toll and Budget Consequences. <SeniorHungerReport.pdf>

For older Americans especially, hunger and malnutrition can completely undo any investments or advances. You don’t have to be a doctor to understand that proper nutrition is the bedrock of all health, and nowhere are the medical consequences of malnutrition more devastating than in our older population. 23

— Mark Lachs24

Unknown author. Senior Huger The Human Toll and Budget Consequences. <SeniorHungerReport.pdf>

Mark Lachs is the Director of Geriatrics for the New York Presbyterian Health System, Professor of Medicine at the Weill Medical College of Cornell University, and the author of “Treat Me Not My Age.”

THE CAUSES

2.1 EXPENSIVE LIVING COSTS IN SAN FRANCISCO

San Francisco ain’t cheap—it’s official. The City by the Bay has been found to be one of the most expensive places in the country to live, according to a new study by the Council for Community and Economic Research. The council’s Cost of Living Index found San Francisco’s cost of living to be 61 percent above the national average. 25

Sajid Farooq. San Francisco Is Expensive—Officially. Web. 29. Nov. <http://www.nbcbayarea.com/news/local/San-Francisco-Is-Expensive---Officially-135271068.>html

MOST EXPENSIVE URBAN AREAS COST OF LIVING INDEX,THIRD QUARTER 2011

NEW YORK (MANHATTAN), N.Y

223.9

NEW YORK (BROOKLYN), N.Y

185.5

HONOLULU, HAWAII

167.1

SAN FRANCISCO, CALIF.

161.3

NEW YORK, (QUEENS), N.Y.

154.4

SAN JOSE, CALIF.

152.4

STAMFORD, CONN. NATIONAL AVERAGE FOR 309 URBAN AREAS=100

148.4 100

“San Francisco Near Top in Cost of Living Ranking ” The Wall Street Journal. Web.05 Noverber 2012. < http://online.wsj.com/article/SB1 0001424052970204012004577072921778341642.html>.

I am a native San Franciscan—I’ve been “ living in the city for my whole life. I love

the city, but I have to say San Francisco is very expensive to live in.

”

Nancy

IN GENERAL26

THE PRICE OF FOOD27

Dramatic Increases in Cost of Food, Gas and Rental Housing. The entire nation is facing increases—yet San Francisco is experiencing some of the highest inflation across the country:

Grocery prices rose by more than 1 1/2 times the overall rate of inflation in 2010, according to government statistics, and economists predict that it will be even worse this year. For months consumers have grappled with higher prices at the supermarket, while restaurateurs pulled out every kitchen trick they could to absorb food inflation costs.

•

Rental prices in San Francisco have risen 12% in the past 6 months.

•

Over the past year, flour has gone up 37%, bread 16%, eggs 35%, milk 30% and pasta 19%.

•

San Francisco has the third highest gas prices in the nation.

•

Prices for utility gas service jumped 21% since February.

As a City, San Francisco has a higher proportion of older adults than all other California counties living on a fixed income who are vulnerable to rent increases and inflation, who now have less to spend for food. It may be hard to fathom, but the face of hunger in San Francisco isn’t just a homeless man on Sixth Street.

Food is often the first item to be slashed in a lowincome senior’s budget as they struggle to meet other “non-negotiable” costs like rent, utilities, and transportation. In addition to being forced to buy a smaller quantity of food, the quality of food purchases may also suffer. The price gap between energy-dense foods and nutrient-rich ones is rapidly widening: potato chips are now seven times cheaper per calorie than apples. This trend is forcing low-income seniors to increase calories by purchasing less expensive, processed foods that are high in unhealthy fats – and which can lead to diet-related illnesses. Adding to the problem is that California’s food stamp process is so complex and difficult that only half of eligible people even apply. Increasingly, those who face food insecurity are turning to the city’s nonprofit food providers.

SF foodbank

Stacy Finz , Many restaurants expecting to raise prices , SFGate. Web. 28. Nov.<http://www.sfgate.com/business/article/Many-restaurants-expecting-to-raiseprices-2376358.php>

So, what has been causing the increase of food price? The alarming trend related to food prices is the cost of gasoline, which, according the Consumer Price Index for All Urban Customers (CPI-U) climbed 53.5 percent in 2009, well in excess of the moderate 43.1 percent decline in 2008.

In the United States, a meal travels approximately 13,000 miles on average before reaching the dinner table.29

Aside from the distance many food products have to travel before reaching the shelf, consumer food access is similarly compromised by escalating transportation costs due to the inequitable distribution of markets throughout the District, an issue referred to as a “grocery gap.” Both nationally and within the District, research has suggested that the deficiency of supermarkets, which offer a wide selection of food choices at affordable prices, is related to the prevalence of obesity, diabetes, and other nutrition-related diseases. The affected areas, often called “food deserts,” predominately affect lower-income neighborhoods and disproportionately impact people of color.28

Onorato Launches “Allegheny Grows” Initiative to Promote Urban Farming and Community Gardening.< http://www.alleghenycounty.us/ news/2010/20100325.aspx>

THE BREAKDOWN OF OUR FOOD (FOR EVERY DOLLAR WE SPEND ON FOOD)

$1 16¢ 84¢ GOES TO “MARKETING”

TRANSPORTATION

DIESEL

TRUCK

DRIVER

THE MILL/ THE FACTORY

PACKAGING

STORING

WORKER

←

GOES TO FARMER

←

MORE PACKAGING REQUIRED

RISING GAS PRICE

Tracie McMillan. Where does your grocery money go? Mostly not to the farmers. Web. 29. Nov. <http://eatocracy.cnn.com/2012/08/08/ where-does-your-grocery-money-go-mostly-not-to-the-farmer/>

EXPENSIVE HOUSING30 It isn’t exactly a secret that San Francisco is an expensive place to live. Among seniors, home ownership is the single most important nonfinancial asset. Some 70 percent of all seniors are homeowners who live in housing that meets or exceeds standards of adequacy, suitability and affordability. Conversely, most low-income seniors (two of every three households) are renters, and only a minority have subsidized rent. According to a report released this week by the National Low Income Housing Coalition, San Francisco is the most expensive place in the country to rent housing. The average rent on a two-bedroom property in the the city is $1,905 per month. The report finds that someone would need to make at least $76,000 a year (or $36.63 per hour) to be able to afford rent without spending over one-third of his or her income on rent. It would take the salaries of 4.6 full-time jobs at San Francisco’s highest-in-the-nation minimum wage to afford a two-bedroom. While the city’s median family income of about $103,000 is well above what’s needed to afford to live in San Francisco, high rents have the effect

of pricing people on the lower side of the economic spectrum out of the market almost entirely. Rent increases have kicked into overdrive in recent years, as many of the region’s outlying bedroom communities were among the hardest hit in the nation by the foreclosure crisis with throngs of people losing their homes. Both low-income homeowners and renters spent, on average, just over $5,000 annually on housing, which shows the significance of property tax, maintenance and fuel costs for senior homeowners. The situation appears to be most acute for those living in urban areas where housing costs are higher.

According to Yahoo! Homes, not only does San Francisco already have the highest median home price of any major American metro area, but home prices in the city are increasing at a faster rate than any other large urban area in the country. 31

San Francisco Rents The Highest Of Any City In Country web. 27. Nov. <http://www.huffingtonpost.com/2012/03/14/san-francisco-rents-the-highest-innation_n_1345275.html>

Ilyce R. Glink. Top 10 cities where home prices are on the rise. web. 28.Nov. <http://homes.yahoo.com/news/top-10-cities-where-home-prices-are-on-therise.html>

2.2 SENIOR OUTREACH BARRIERS

COMPLICATED APPLICATION PROCESS AND RULES32 Older Americans are a diverse group, but on the whole they are vulnerable relative to other age groups, particularly in terms of health and financial security. A number of public and private programs provide financial assistance to older low-income seniors, yet sizable proportions of potentially eligible individuals do not participate. The two major barriers to enrollment in public benefit programs among older individuals are lack of knowledge about the programs and the complexity of the application and enrollment processes. Other factors that may affect enrollment are reluctance to provide personal information, or seniorsâ&#x20AC;&#x2122; calculation that the value of the benefit is not great enough to warrant their participation in a confusing or difficult application process. Older Americans with limited incomes are faced not only with a multiplicity of programs that potentially will provide needed assistance, but also with multiple sets of complex eligibility rules and enrollment procedures that may differ from program to program and state to state.

Unfamiliarity with Programs 33 34 35 Studies of the MSPs conclude that not knowing that programs exist is the leading barrier to enrollment. A national survey of Medicare beneficiaries, conducted in 2003, indicated that 79 percent of eligible beneficiaries who were not participating in the MSPs had never heard of the programs. Research also shows that some Medicaid eligibility workers and counselors are not aware of available programs. State officials in Arizona and Maine report that despite policy changes to expand eligibility for the MSPs, enrollment did not increase substantially because Medicare beneficiaries were not familiar with the programs or the expansions. A national survey of seniors indicates that lack of awareness about LIS benefits is a significant factor in low participation rates, particularly among low-income seniors of color. A survey of Medicare beneficiary counselors across the country shows that the most common reasons beneficiaries do not apply for the LIS are that they do not have the information they need;

Increasing Participation In Benefit Programs For Low-Income Seniors. <1266_Summer_increasing_particip_benefit_progs_v3.pdf>

Susan G. Haber, Walter Adamache, Edith G. Walsh et al., Evaluation of Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB) Programs (Baltimore: Centers for Medicare and Medicaid Services, Oct. 1, 2003); Laura Summer and Emily Ihara, Simplifying Enrollment in Medicaid and Medicare Savings Programs for the Elderly and Individuals with Disabilities (Washington, DC: AARP Public Policy Institute, Dec. 2005).

Haber et al., Evaluation of QMB and SLMB Programs.

Kim Glaun, Medicaid Programs to Assist Low-Income Medicare Beneficiaries: Medicare Saving Programs Case Study Findings (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, Dec. 2002); MedPAC, Medicare Payment Policy.

they are not aware that a subsidy is available, they do not know how to apply for the subsidy, or they think they are ineligible for financial reasons.36 Misperceptions Regarding Who Qualifies for Benefits 37 38 Confusion related to eligibility rules can pose barriers to enrollment, as can lack of knowledge or understanding about program benefits. Some seniors conclude that the transaction costs associated with applying for benefits are too high relative to the difficulty of applying. It may be difficult, for example, to arrange for transportation to apply in person, or to obtain the documents needed to verify financial information, such as the value of a life insurance policy. The reluctance of older individuals to ask for help or to share personal financial information also has been documented.

Complex or unfamiliar Application and Enrollment Processes39 40 Confusion related to complex or unfamiliar application and enrollment processes can occur among potential beneficiaries, particularly among applicants who have limited English proficiency. Confusion among eligibility workers has also been documented. Seniors in focus groups say they sometimes do not understand what is being asked, and they are fearful of making mistakes on MSP application forms. Some Medicare beneficiaries are also confused about the two-step process required for low-income beneficiaries to enroll in a Medicare Part D drug plan and apply for the LIS. A study of enrollment in State Pharmacy Assistance Programs concluded that wellestablished older programs and those that have the fewest restrictions on enrollment tend to have the highest enrollment rates.

Laura Summer, Patricia Nemore, and Jeanne Finberg, Medicare Part D: How Do Vulnerable Beneficiaries Fare? (New York: The Commonwealth Fund, April 2008).

JoAnn Lamphere and Margo L. Rosenbach, “Promises Unfulfilled: Implementation of Expanded Coverage for the Elderly Poor,” Health Services Research, April 2000 35(1) pt. 2:207–17; Margo L. Rosenbach and JoAnn Lamphere, Bridging the Gaps Between Medicare and Medicaid: The Case of QMBs and SLMBs (Washington, D.C.: American Association of Retired Persons Public Policy Institute, Jan. 1999); Todd E. Elder and Elizabeth T. Powers, Public Health Insurance and SSI Participation Among the Aged, Working Paper 2006-117, University of Michigan Retirement Research Center, May 2006.

Rosenbach and Lamphere, Bridging the Gaps; Elder and Powers, SSI For the Aged and the Problem of Take-Up; GAO, Means-Tested Programs. Information on Program Access. 43

they are not aware that a subsidy is available, they do not know how to apply for the subsidy, or they think they are ineligible for financial reasons. Misperceptions Regarding Who Qualifies for Benefits Confusion related to eligibility rules can pose barriers to enrollment, as can lack of knowledge or understanding about program benefits. Some seniors conclude that the transaction costs associated with applying for benefits are too high relative to the difficulty of applying. It may be difficult, for example, to arrange for transportation to apply in person, or to obtain the documents needed to verify financial information, such as the value of a life insurance policy. The reluctance of older individuals to ask for help or to share personal financial information also has been documented. Complex or unfamiliar Application and Enrollment Processes 41 42 Confusion related to complex or unfamiliar application and enrollment processes can occur among potential beneficiaries, particularly among applicants who have limited English proficiency. Confusion among eligibility workers has also been documented. Seniors in focus

groups say they sometimes do not understand what is being asked, and they are fearful of making mistakes on MSP application forms. Some Medicare beneficiaries are also confused about the two-step process required for lowincome beneficiaries to enroll in a Medicare Part D drug plan and apply for the LIS. A study of enrollment in State Pharmacy Assistance Programs concluded that well-established older programs and those that have the fewest restrictions on enrollment tend to have the highest enrollment rates. One source of complexity related to the application process is the resource or asset test. Beneficiaries may not understand what information they must provide, they may have difficulty obtaining the information needed to apply, or they may be wary of sharing detailed information about their finances. The need to verify this information also complicates the process for program staff. Recent federal legislation exempts the value of life insurance policies from resource calculations for the LIS. This exemption will simplify the application process somewhat, but it would be even simpler without a resource test.

Lamphere and Rosenbach, â&#x20AC;&#x153;Promises Unfulfilledâ&#x20AC;?; Rosenbach and Lamphere, Bridging the Gaps; GAO, Means-Tested Programs. Information on Program Access; Stephen Crystal, Thomas Trail, Kimberly Fox et al., Enrolling Eligible Persons in Pharmacy Assistance Programs: How States Do It (New York: The Commonwealth Fund, Sept. 2003); Kim Glaun, Karen Davenport, and Andrea Cohen, The Medicare Low Income Drug Subsidy: Strategies to Maximize Participation (New York: Medicare Rights Center, Jan. 2005).

Perry et al., Barriers to Medicaid Enrollment.

Debra J. Lipson, Allison Barrett, Angela Merrill, and Noelle Denny-Brown, Doors to Extra Help: Boosting Enrollment in the Medicare Part D Low-Income Subsidy. (AARP Public Policy Institute, Sept. 2007).

Crystal et al., Enrolling Eligible Persons in Pharmacy Assistance Programs. 45

don’t want to be called a senior—I don’t “ Ineed people’s sympathy. I am perfectly fine

by myself most of the time. I do need helps at times for sure, but I just don’t feel comfortable when I burden other people.

”

Nancy

SENIORS RESIST TO THE OUTSIDE CARE43 Resistance is at the root of many senior-care issues. Why? Some seniors believe admitting they need help brings their independence into question. Some seniors believe once they acknowledge the need for help, they will lose control of their affairs. They are trying to maintain dignity. Unless they feel they can trust someone, they often resist change. It’s the fear life as they’ve known it will be taken away from them. Seniors needing control over their life is the primary reason that seniors resist change. They have been making their own decisions their whole life and they still want to be in charge. But now you and their family are trying to push them into decisions they aren’t ready to make. Include the senior in the decision-making process by listening to and respecting their ideas. Dependence generates anger, shame, defiance. It’s acceptable only for the very young; among adults, it’s not merely an uncomfortable personal reality, it’s unAmerican. We are all supposed to be able to take care of ourselves, apparently forever.

Seniors are harder to reach because they are more isolated, often live alone, and don’t have anyone to help them navigate the SNAP enrollment process. They are also more mistrustful of giving out personal information and are potentially too proud to ask for government assistance. —Celia Hagert44

Increasing Participation In Benefit Programs For Low-Income Seniors. <1266_Summer_increasing_particip_benefit_progs_v3.pdf>

Celia Hagert, Senior Policy Analyst, Center for Public Policy Priorities. <senior_outreach.pdf >

have large amount of immigrant seniors “ We who need help, but they don’t even speak English. So, even when there are a lot of help programs out there, they don’t know about them or cannot ask for help.

”

Bob

MINORITY’S BARRIERS45 Our Nation has experienced a cultural shift. San Francisco is famous for its diversed citizen proportion. There are key differences, however, between individuals who migrated to America decades ago and more recent arrivals. Members of the Silent Generation typically speak English at home and at work, and more than likely have changed some of their behaviors to fit in. They are generally more comfortable interacting with government agencies and organizations, both inside and outside their community. In contrast, recent immigrants, even when documented, may hesitate to seek services from government agencies. They tend to hold officials in high regard or with suspicion, in turn suppressing their own views. Seniors from other minority backgrounds may function in similar ways.

SAN FRANCISCO POPULATION BY ETHNICITY 2006-200846 ASIAN/PI AFRICAN AMERICAN WHITE

32%

LATINO

NATIVE

<1% AMERICAN

14%

44%

USDA SNAP / Engaging Special Populations / Senior Outreach / <senior_outreach.pdf>

IPUMS, American Community Survey 3‐year estimate

OTHER

SENIOR(60+)PERCENTAGE OF SF POPULATION BY ETHNICITY AND AGE GROUP, 2006-2008

50 45 40 35 30 25 20 15 10 5 0 WHITE

AFRICAN-AMERICAN

TOTAL POPULATION (798,185) SENIOR AGE 60+ (154,920)

IPUMS, American Community Survey 3‐year estimate

ASIAN/PI

LATINO

lot seniors do not have assess to the “ AInternet, or they are stuck at home, or they don’t know how to access help programs. Many of these programs are Internet focused. This is definitely a senior senior outreach problem.

Sylvette

”

SENIORS’ PREFERED TRADITIONAL MEDIA ARE:

NEWS

feel the community used to be much closer “ Ibefore—everyone knew each other. But now

people are getting spread out, and I don’t even know the people next door. And as a senior myself, I don’t feel comfortable asking help from strangers.

”

Nancy

SENIOR DISCONNECT: MILLIONS ARE LOSING BILLIONS IN BENEFITS47 In addition to the core food program SNAP,48 there are numerous other public and private benefits that offer free or discounted services to low-income seniors, including respite care, tax relief, transportation, legal assistance, and in-home care. One of the key priorities for an aging America is to enable older adults to live independently in their homes and communities for as long as possible. For those with limited income and resources, benefits—whether public or private—can be a critical resource to receive support to attain this goal and avoid costly institutionalization. Benefits provide recipients with access to healthy food, needed medical care and prescriptions, and a safe living environment, as well as other supportive services. They also provide community economic stimulus, as benefits are spent locally in pharmacies, grocery stores, utility companies, and health care providers.

understanding who may be eligible.50 Likewise, those who already receive one benefit may not realize that they may be eligible to receive further support from other programs. In San Francisco, millions of hungry seniors don’t have the Internet at home, especially those who are disabled. They have lost touch with their communities—they’re isolated and don’t trust strangers or ne helpers. Lowincome seniors’ preferred media are traditional media: TV, telephone, word-of-mouth, post mail, newspapers, and radio.

However, many seniors49 are missing out on these benefits. The reasons are varied: lack of awareness about benefits, perceived (real or otherwise) complexity of applications, stigma associated with receiving entitlements, and not

The Senior Disconnect: Millions are Losing Billions in Benefits. <You-Gave-Now-Save-data-brief.pdf>

The Supplemental Nutrition Assistance Program, or SNAP.

This brief contains data pertaining to the older adult population, especially those with Medicare, however, many of the benefits described herein are also available to younger adults (aged 21–64) with disabilities who have Medicare.

For more on the policy and programmatic barriers that impede benefits access, please see the NCOA white paper, Closing the Loop: Coordination of Benefits for Seniors and People with Disabilities, forthcoming at www.ncoa.org.

2.3 BAD FOOD DISTRIBUTION

WASTED FOOD51 52 53 Food is simply too good to waste. Even the most sustainably farmed food does us no good if the food is never eaten. Getting food to our tables eats up 10 percent 12 of the total U.S.energy budget, uses 50 percent of U.S.land, and swallows 80 percent of freshwater consumed in the United States. Yet, 40 percent of food in the United States today goes uneaten. That is more than 20 pounds of food per person every month. Not only does this mean that Americans are throwing out the equivalent of $165 billion each year, but also 25 percent of all freshwateri and huge amounts of unnecessary chemicals, energy, and land. Moreover, almost all of that uneaten food ends up rotting in landfills where it accounts for almost 25 percent of U.S. methane emissions. Nutrition is also lost in the mix—food saved by reducing losses by just 15 percent could feed more than 25 million Americans every year at a time when one in six Americans lack a secure supply of food to their tables. Given all the resources demanded

for food production, it is critical to make sure that the least amount possible is needlessly squandered on its journey to our plates.

40% of food in the United States today goes uneaten. The average American consumer wastes 10 times as much food as someone in Southeast Asia.54

A. Coleman-Jensen, M. Nord, M. Andrews, and S. Carlson, United States Department of Agriculture, “Household Food Security in the United States in 2010,” September 2011.

U.N. FAO, “Global Food Losses and Food Waste,” 2011, www.fao.org/ag/ags/ags-division/publications/publication/en/?dyna_ fef%5Buid%5D=74045.

K.D. Hall, J. Guo, M. Dore, C.C. Chow, National Institute of Diabetes and Digestive and Kidney Diseases, “The Progressive Increase of Food Waste in America and Its environmental Impact,” PLoS ONE 4(11):e7940, 2009.

Dana Gunders . Wasted: How America Is Losing Up to 40 Percent of Its Food from Farm to Fork to Landfill< wasted-food-IP.pdf>

FOOD LOSSES AT EACH STEP IN THE SUPPLY CHAIN

PRODUCTION LOSSES

POSTHARVEST, HANDLING AND STORAGE LOSSES

PROCESSING AND PACKAGING LOSSES

DISTRUBUTION AND RETAIL LOSSES

CONSUMER LOSSES** **Includes out-of-home consumption

Source: Food and Agriculture Organization 2011

GRAIN PRODUCTS SEAFOOD FRUITS & VEGETABLES MEAT MILK

2% .5% 3% 2% .25%

GRAIN PRODUCTS SEAFOOD FRUITS & VEGETABLES MEAT MILK

5% 1% 4% .5%

GRAIN PRODUCTS SEAFOOD FRUITS & VEGETABLES MEAT MILK

11% 20% 3% 3%

10%

2% 9.5% 12% 4% .25%

27% 33% 28% 12% 17%

Senior hunger is about poverty. Also in a larger sense, it’s the way that food is set up. There’s more than enough food in America for everybody, but people still go hungry because it’s not well distributed. In hotels and restaurants, food is wasted each day, all over the city. — John Meehan55

John Meehan: The executive director of the groceries for seniors program. Irish immigrant, and have been serving in the food bank for more than 15 years. John has received numerous awards and recognitions, including the prestigious Bank of America Local Hero Award in 2005.

Losses in distribution56 Proper transport and handling of food are critical throughout the supply chain, particularly with perishable goods that require cold conditions. Inconsistent refrigeration is less of a problem today than in the past, but it still occurs when trucks malfunction or are involved in accidents. Other handling problems occur when produce is kept at improper temperatures, such as when it sits too long on loading docks. Imported products can wait days at the ports for testing, significantly reducing their shelf life.

Even food banks sometimes reject these loads because they cannot use them in the quantities being shipped, for instance a truckload of beets. Distribution centers can also find themselves with surplus product when individual stores don’t require what they had forecasted.

About 10 percent of the U.S. Energy budget goes to bringing food to our tables.57

A larger problem that occurs at the distribution stage is that of rejected shipments. Rejected perishable shipments can be dumped if another buyer cannot be found in time. If these perishables do make it to a store, they have a shorter shelf life by the time they get there. Sometimes they are brought to food banks if the food banks have the capacity to take them.

Dana Gunders . Wasted: How America Is Losing Up to 40 Percent of Its Food from Farm to Fork to Landfill.<wasted-food-IP.pdf>

Webber, Michael, “How to Make the Food System More Energy Efficient,” Scientific American, December 29, 2011.

Losses in retail58 59 60 In-store food losses in the United States totaled an estimated 43 billion pounds in 2008, equivalent to 10 percent of the total food supply at the retail level. But that doesn’t tell the whole story. Through their influence both up and down the supply chain, retailers actually are responsible, at least in part, for a much bigger proportion of total losses. Most of the loss in retail operations is in perishables—baked goods, produce, meat, seafood, and, increasingly, ready-made foods. The USDA estimates that supermarkets lose $15 billion annually in unsold fruits and vegetables alone. Unfortunately, the retail model views waste as a part of doing business. According to a former President of Trader Joe’s, “the reality as a regional grocery manager is, if you see a store that has really low waste in its perishables, you are worried. If a store has low waste numbers it can be a sign that they aren’t

fully in stock and that the customer experience is suffering.” Industry executives and managers view appropriate waste as a sign that a store is meeting quality control and full-shelf standards, meaning that blemished items are removed and shelves are fully stocked. In 2005 and 2006, annual supermarket losses averaged 11.4 percent for fresh fruit and 9.7 percent for vegetables, with losses varying from 0.6 percent for sweet corn to as high as 63 percent for mustard greens.

One industry consultant estimates that up to one in seven truckloads of perishables delivered to supermarkets is thrown away.

J.C. Buzby et al., “The Value of Retail- and Consumer-Level Fruit and Vegetable Losses in the United States,” The Journal of Consumer Affairs, Fall (2011):492-515

J. Alvarez and R. Johnson, “Doug Rauch: Solving the American Food Paradox,” Harvard Business Review N9-012-022, November 2011.

J.C. Buzby, H.F. Wells, B. Axtman, and J. Mickey, USDA, economic Research Service, “Supermarket Loss estimates for Fresh Fruit, Vegetables, Meat, Poultry, and Seafood and Their Use in the eRS Loss- Adjusted Food Availability Data,” eIB-44, March 2009.

Some of the main drivers for in-store retail losses include: Overstocked product displays. Most retail stores operate under the assumption that customers buy more from brimming, fully stocked displays, preferring to choose their apples from a towering pile rather than from a scantly filled bin. This leads to overstocking and overhandling by both staff and customers and damage to items on the bottom from the accumulated weight. Expectation of cosmetic perfection. Many customers select stores based on the quality of perishables, and therefore retailers feel compelled to have only produce of perfect shape, size, and color—leading to much of the culling discussed above. Pack sizes that are too large. Produce arrives in preset quantities according to case size. This limits the flexibility for produce buyers to

Bloom, American Wasteland, 175.

Timothy Jones, “Analyzing Retail Food Loss”, BioCycle (December 2005).

purchase exactly the amount needed. For example, if a grocer wants 50 grapefruit but they come in cases of 80, the store is then stuck with 30 extras. Availability of fresh, ready food until closing. Stores are increasingly offering more prepared, ready-made food in their delicatessens and buffets. On the one hand, this can be a good way to make use of marginally damaged or nearly expired products if the labor is available to do so. However, as with produce, store managers often feel compelled that displays of ready-made items remain fresh and fully stocked instead of letting shelves hold fewer items as they run out. Rotisserie chickens, for instance, might be thrown away and replaced after four hours on display. One grocer estimated that his store threw away a full 50 percent of the rotisserie chickens that were prepared, many of those from the last batch of the day.61 Ready-made food makes up a large portion of food lost at convenience stores, which discard approximately 25 percent of their food products.62

Losses in food service According to the USDA, households and food service operations (restaurants, cafeterias, fast food, and caterers) together lost 86 billion pounds of food in 2008, or 19 percent of the total U.S. retail-level food supply.63 Another significant portion is served but never eaten. Other drivers of waste in food service include large portions, inflexibility of chain-store management, and pressure to maintain enough food supply to offer extensive menu choices at all times.64 In addition, staff behavior and kitchen culture can contribute to food waste.

the average chicken caesar salad doubled in calories, and the average chocolate chip cookie quadrupled. Today, portion sizes can be two to eight times larger than USDA or FDA standard serving sizes.65

Approximately 4 to 10 percent of food purchased by restaurants becomes kitchen loss, both edible and inedible, before reaching the consumer.66

Plate waste is a significant contributor to losses in food service, resulting primarily from large portions and undesired accompaniments. Portion sizes have increased significantly over the past 30 years. From 1982 to 2002, the average pizza slice grew 70 percent in calories,

J.C. Buzby et al., “The Value of Retail- and Consumer-Level Fruit and Vegetable Losses in the United States,” The Journal of Consumer Affairs, Fall (2011):492-515.

L. Kantor, K. Lipton, A. Manchester, and V. Oliveira, “estimating and Addressing America’s Food Losses,” USDA Food Review January-April 1997, p. 2-12.

Bloom, American Wasteland, 125. 60 Bloom, American Wasteland, 143.

LeanPath. <Short Guide to Food Waste Management Best Practices>. 2008, <www.leanpath.com/docs/Waste_Guide_o.pdf>

I eat out quite often. Honestly, I don’t “ Well, take out my leftovers all the time. Though, I don’t see what I do would really affect hungry seniors.

”

Bruce

Extensive menu choices make it challenging to achieve proper inventory management because large menus require more inventory to be on hand at all times. Unexpected sales fluctuations also make planning difficult. Particularly wasteful are large buffets, which cannot reuse or even donate most of what is put out because of health code restrictions. Centralized chain-restaurant management can also make it harder to manage waste because although chain restaurants have advanced software for inventory planning, there is often a lack of flexibility at the individual restaurant level that prevents local managers from reusing food in creative ways. In addition, fast-food outlets often must adhere to time limits. For example, McDonald’s fries must be thrown out after seven minutes and burgers after 20 minutes. These time limits cause approximately 10 percent of all fast food to be discarded.67

Bloom, American Wasteland, 122.

67,68

Bloom, American Wasteland, 125.

Bloom, American Wasteland, 143.

On average, diners leave 17 percent of meals uneaten and 55 percent of these potential leftovers are not taken home.68 69

$1,350 TO $2,275

I throw food away when it’s gone “ Well, past the expiration date, because I mind my families’ health. That would happen mostly because I would buy more food when it’s on sale in the supermarket. I just can’t help putting things into my shopping cart.

”

Elena

Losses in households American families throw out approximately 25 percent of the food and beverages they buy.70 The cost estimate for the average family of four is $1,365 to $2,275 annually.71 Consumer food waste also has serious implications for wasted energy. A McKinsey study reports that household losses are responsible for eight times the energy waste of post-harvest losses on average due to the energy used along the supply chain and in food preparation.72 In the United Kingdom, about twothirds of household waste is due to food spoilage from not being used in time, whereas the other one-third is caused by people cooking or serving too much.73 However this ratio is unknown for the United States.

losses, followed closely by dairy, and meat/ poultry/fish (see: Total Food Loss from Retail, Food Service and Households). Note that loss numbers are based on mass and include loss in mass due to cooking but exclude inedible portions such as bones and peels. Again, data of this nature for losses from farm to retail are not available.

For the average u.S. Household of four, food waste translates into an estimated $1,350 to $2,275 in annual losses.74

At the retail and end-consumer stages of the supply chain, perishables make up the majority of food losses due to the high volume of consumption and the food’s tendency to spoil. In terms of total mass, fresh fruits and vegetables account for the largest

70, 71

Bloom, American Wasteland, 187. The author reports a 15 percent loss in homes, with potentially an additional 10 percent loss in liquid products.

R. Dobbs et al., “Resource Revolution: Meeting the World’s energy, Materials, Food, and Water Needs,” McKinsey Global Institute, November 2011.

WRAP, “New estimates for Household Food and Drink Waste in the U.K.,” 2011, www.wrap.org.U.K./downloads/New_estimates_ for_household_ food_and_drink_waste_in_the_U.K._FINAL_ v2.110a9ba6.11460.pdf.

Bloom, American Wasteland, 187. Another report using updated USDA consumer loss numbers and 2011 prices estimates $1,600 in annual losses per household of four: Clean Metrics, “The Climate Change and Economic Impacts of Food Waste in the United States,” http://www. cleanmetrics. com/pages/ClimateChangeImpactofUSFoodWaste.pdf. 67

always has a certain class of those people, who think “ There other people don’t have stuff, because they are lazy. But they don’t take into account those who might have lost their job, and they might have had a pretty good job but end up with a serious disease. So they come from wealth but turn out to be very poor—it can happen pretty easy in a city like San Francisco, and in a bad economic time.

”

Robert

2.4 WRONG SOCIAL ATTITUDE Hunger is only a problem of poor people. It’s a myth that for most of people, we would think hunger is only a problem for poor people. But the truth is a Yes and No. Yes, it’s about money, while low-income seniors often suffer more, and often have to make disquieting choices between purchasing medication or food, but we should correct our thoughts that even though money is the principal barrier to eating nutritious meals for food insecure seniors. It is also a problem of access and care: we have quite amount of seniors who have different levels of disablities that potentially affect their daily life. Food insecure seniors sometimes had enough money to purchase food but did not have the resources to access or prepare food due to lack of transportation, functional limitations, or health problems. And for those who live in areas that are more difficult to access.

It’s also a culture thing in the United States—that the younger generation doesn’t take care their parents or grandparent as much as some of the other cultural groups. They don’t know or think seniors are going hungry because they don’t hear from older generation, or they don’t visit them as often as they should. HEALTH STATUS FAIR TO POOR AMONG SF RESIDENTS BY AGE GROUP AND INCOME76 NON-LOW INCOME LOW INCOME

51%

31%

12% 12%

24-29

31%

12%

50-64

65+

Senior Hunger In America: Shocking Facts Vs. Popular Myths. Web. 27. Nov. 2012< http://www.huffingtonpost.com/enid-borden/senior-hungerin-america-_b_900233.html >

Source: 2005 & 2007 California Health Interview Survey (http://www.chis.ucla.edu/) Low-income = 200% Federal Poverty Level

For some people who haven’t experienced it, they don’t understand it—and they won’t understand it unless it happens to them. But for those who say they don’t understand it, they really don’t care. They don’t. They just think people are poor because they are lazy. — Bob Johnson

Bob Johnson: the paid stuff of the groceries for senior program. In charge of delivery. He sees and knows a lot about the current situations.

ANY DISABILITY

16,191

HEARING

VISION

COGNITIVE

9,196

14,533

MOBILITY

SELF-CARE

INDEPENDENCE

15,978

SAN FRANCISCO DISABILITY POPULATION ESTIMATES BY AGE 65+

43,916

31,048

27,330

Source: 2009 American Community Survey 1-year estimates

The government will take care of it. Well, even you now know our seniors are in hunger, and it’s not all about money. You might questioning isn’t the government taking care of the seniors? There are so many service out there to help. Actually, they haven’t so far and they could do a lot more. Unfortunately, the reality is that the federal share of funding that goes towards addressing Senior Hunger is so small relative to the impact and savings that would result with more funding. How’s that? Approximately 50 percent of all health concerns affecting older Americans are directly connected to a lack of nutrients. The cost of a year’s worth of nutritious home-delivered meals that could sustain the health and nutrition of our seniors is roughly equal to the cost of just one day in the hospital. That’s a serious savings! But ironically enough, in the name of saving federal dollars, as the Older Americans Act is up for reauthorization, there is a serious risk of policy makers cutting funding on a program that could save us much more in the short and long term.78

90 percent of low-in-come seniors without sufficient resources to buy food do not receive any meals under the federal meals programs.79 Nearly 80 percent of aging agencies report an increased demand for home-delivered meals, yet more than 1 in 5 report that they are unable to serve all who request them.80

Senior Hunger In America: Shocking Facts Vs. Popular Myths. Web. 27. Nov. 2012< http://www.huffingtonpost.com/enid-borden/senior-hunger-in-america_b_900233.html >

79, 80

James P. Ziliak,Gatton Endowed, and Margaret Haist, The Causes, Consequences, and Future of Senior Hunger in America.<SeniorHungerStudy.pdf >

IN 2011, THE GOVERNMENT FUNDING ON SNAP

AVERAGE HOUSEHOLD RECEIVING

BILLION

PER MONTH

$37

$287

PARTICIPATION IN SNAP SINCE 2007

+70% THE SNATE HAS PROPOSED IN CUTS TO SNAP.

AVERAGE HOUSEHOLD RECEIVING

-$4.5 -$90 BILLION

PER MONTH

“Democrats Not Trying To Prevent Food Stamp Cuts, Breaking Promise ” HUFF POSTl. Web.05 Noverber 2012. <http://www.huffingtonpost. com/2012/06/21/democrats-not-trying-to-p_n_1614248.htmll>.

should be aware that in time they will “ People be old too. They should know that the future is

Sylvette

This issue doesn’t affect you.81 This issue does affect you in one way or another. You could care because as a San Franciscian: according to the San Francisco Food Bank estimates that 1 in 5 adults in San Francisco struggle each day to feed themselves and their families. Food often becomes a “nonessential” item—if a person with a limited income must choose between paying a fixed expense, like rent, and buying food, he or she will likely pay the fixed expense. If not, whether it is your grandparent, mother, father, brother, sister, or friend, chances are someone you care about is over the age of 60. What if your loved ones lacked access to regular meals and you couldn’t help them? And sorry to burst your bubble my friend, but everyone gets old, including you and I. Are you sure you will get the care and nutrition you need in your later years? You are not as removed from the problem of senior hunger as you think.

unpredictable and that seniors require special needs. When people are young they do not think about those things, but they should put themselves in their shoes to understand that with not many years left to live, senior citizens need extra care.

”

The following trends will impact the future of food insecurity and hunger in San Francisco. • An aging senior population. Given that this population is highly vulnerable to poverty and hunger, growth of this group will put heavy strain on the local support system. • High current and projected unemployment. A study forecasted that the metro area of San Francisco, Oakland, and Fremont will have lost approximately 119,000 jobs by the end of the recession and will not return to pre-recession job levels until after 2012.82 As long as a steady income is absent, many San Franciscans will have less or no money for food. • Large Supplemental Security Income (SSI) population. SSI recipients in California do not receive food stamps, which makes them more susceptible to food insecurity.

Danielle Boulé and Paula Jones. Hunger and food insecurity on the rise in San Francisco. < 2010FSTFAnnualReportfinal.pdf >

Drewnowski, A. and Darmon, N. (2005). The Economics of Obesity: Dietary Energy Density and Energy Cost. American Journal of Clinical Nutrition 82(1 Suppl), 265S-273S.

In addition, since the SSI population in San Francisco is comprised mainly of the city’s growing senior population, the SSI- reliant population will grow. • Growing budget deficit at the local level. As budget deficits continue to grow every year, it is increasingly challenging to preserve and expand funding for nutrition services and other resources necessary to address food insecurity in San Francisco. • Growing budget deficit at the state level. Similarly, with state funding reductions, organizations and institutions are facing mounting deficits. The noteworthy achievements the school district has made with providing healthy meals and snacks to children may be threatened by the district’s fiscal challenges. • Large immigrant population. Poverty is high among families of recent immigrants because immigrants tend to have lower incomes. Also, immigrants without documentation do not qualify for many benefits and, although many American-born children do qualify, their parents are often reluctant to apply.

• Growing Income Inequality. Higher poverty rates in California are linked to growth in income inequality.83 The Bay Area, and San Francisco County in particular, has some of the highest income disparities in the state of California. The San Francisco household with earnings at the 80th percentile earns over 5.4 times more than the household at the 20th percentile. ($114,119 vs. $21,175).84 If low-income families’ financial growth remains lower than middle and high-income families, a larger population will be susceptible to food insecurity. • Increased costs for food, transportation and housing. As these costs increase, the already high cost of living in San Francisco will continue to swell and put additional stress on low-income residents. All of the trends mentioned above will put additional strain on publicly funded programs and community based organizations, all of which are already well over capacity. It is crucial to prepare for the future by examining imminent need, leveraging available resources to their fullest potential, and thinking strategically to create solutions that will meet the rising demand.

VI Reed, D. Poverty in California, Moving Beyond the Federal Measure. California Counts. Vol. 7, Number 4. May 2006.

Seligman, H.K., Bindman, A.B., Vittinghoff, E., Kanaya, A.M., and Kushel, M.B. (2007a). Food Insecurity is Associated with Diabetes Mellitus: Results from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. Journal of Internal Medicine 22(7), 1018-23.

HELPING HUNGRY SENIORS

Food is one issue that cannot be solved person by personâ&#x20AC;&#x201D; we have to stand together. â&#x20AC;&#x201D; Josette Sheeran

Josette Sheeran: The Eleventh Executive Driector of the United Nations World Food Programme.

WHAT CAN WE DO? While most of the people already know about the senior hunger issue, few understand the depth of the situation, and many are left wondering: â&#x20AC;&#x153;What can I do?â&#x20AC;?

Yinyin

Well, besides helping make financial donations, which are resisted by a lot of people. We actually can help in various different ways.

WHAT WE DO AFFECT HUNGRY SENIORS. TOGETHER WE CAN HELP.

Yinyin

EDUCATIONAL LECTURES IN COLLEGES + SCHOOL VOLUNTEER OPPORTUNITIES

PROBLEM Most food banks and programs don’t have as many social and educational events as they need. And the young generation will be the mainstream of the society in the next decade or two. Their viewpoint about senior hunger, poverty and non-profit organizations determines whether or not they will care about the issue and help to improve it. It’s important to encourage young people to know more about the issue and its truth. SOLUTION We can educate college students to be open-minded and warm-hearted about the issue of senior hunger. Because hungry seniors might even be their loved ones, they can learn to care about others who may face the same issue in the future. I would like to collaborate with colleges to discuss the senior hunger issue in classes, thus those who already aware of the problem can learn more about it, and whose who don’t know the problem can be informed the serious problem. More importantly, we can better solve the problem by standing together. MATERIALS Game card, E-book, Visual book, Poster, etc.

PUBLIC FEAST EVENTS Yinyin

PROBLEM People misunderstand poverty, hunger, and how nonprofit organizations work with this population. They might not know that their parents have hunger issues, and they often feel too many organizations are asking for their money so they donâ&#x20AC;&#x2122;t want to help this issue. SOLUTION We can hold a outside feast event as a monthly basis. In the event, we could not only talk about the issue, but we will also design an experience to show the attendees that there is enough food but they will be served differently by the time they arrive at the event. This helps highlight how important food distribution plays a role in the senior hunger issue, and hopefully this event will create changes in the social attitude about the issue. In addition, the event will persuade people to call their parents and other seniors they know more often, to make sure the seniors are doing okay and create a more interconnected senior community. MATERIALS Posters, flyers, brochures, etc.

Yinyin

A DIRECT MAIL INFOMATION WITH A LIST OF FOOD HELP PROGRAMS & A RESOURCE MAP (IN MULTI-LANGUAGES) PROBLEM Most seniors in San Francisco are immigrants, and they do not speak English. So when they are under the threat of hunger, they often don’t know where to get help or even where to ask for help. SOLUTION We can use traditional media (direct-maiL) to give seniors targeted information about local current food help programs as well as a Food Resource Map—all materials in their native languages. MATERIALS Direct mail pieces, Posters, etc.