Senior Hunger

Linda Netterville, MA, RD, LDContractor, Nutrition Program, DADS

Objectives

Definition Incidence Causes Consequences Community Roles

Definition

Hunger

-a craving or urgent need for food or a specific nutrient

-an uneasy sensation occasioned by the lack of food

-a weakened condition brought about by prolonged lack of food

Malnutrition

-faulty nutrition due to inadequate or unbalanced intake of nutrients or their impaired assimilation or utilization

Definitions- USDA

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 -Households reduced the quality, variety, and desirability of their diets, but the quantity of food intake and normal eating patterns were not substantially disrupted.

Very low food security -Eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food.

Definitions

Term Used USDA Terminology # of CSFM Answered(Core Food Security Module) 10 questions if no children

High Food Security No to all questions

Threat of Hunger Marginal Food Security At least one yes

Risk of Hunger Low Food Security At least 3 yes

Facing Hunger Very Low Food Security At least 6 yes

Survey Questions Used by USDA to Assess Household Food Security

1. "We worried whether our food would run out before we got money to buy more." Was that often, sometimes, or never true for you in the last 12 months?

2. "The food that we bought just didn't last and we didn't have money to get more." Was that often, sometimes, or never true for you in the last 12 months?

3. "We couldn't afford to eat balanced meals." Was that often, sometimes, or never true for you in the last 12 months?

4. In the last 12 months, did you or other adults in the household ever cut the size of your meals or skip meals because there wasn't enough money for food? (Yes/No)

5. (If yes to question 4) How often did this happen--almost every month, some months but not every month, or in only 1 or 2 months?

Survey Questions Used by USDA to Assess Household Food Security

6. In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money for food? (Yes/No)

7. In the last 12 months, were you ever hungry, but didn't eat, because there wasn't enough money for food? (Yes/No)

8. In the last 12 months, did you lose weight because there wasn't enough money for food? (Yes/No)

9. In the last 12 months did you or other adults in your household ever not eat for a whole day because there wasn't enough money for food? (Yes/No)

10. (If yes to question 9) How often did this happen--almost every month, some months but not every month, or in only 1 or 2 months?

Top Ten Hunger States

1. Mississippi

2. New Mexico

3. Arkansas

4. Texas

5. Tennessee

6. Alabama

7. Georgia

8. South Carolina

9. Florida

10.Nevada

US Senior Hunger 2010

1 in 7 face the “Threat of Senior Hunger”

Increased from 2001 to 2010 by 78%

Increased from 2006 to 2010 by 34%

Senior Hunger in Texas

% of Texas Seniors Approximate Number of Texas Seniors

Threat of Hunger

18.14% 685,000

Risk of Hunger

10.62% 401,000

Facing Hunger

4.23% 160,000

Face of Senior Hunger

African American or Hispanic Populations At poverty or near poverty Under age 70 (specifically age 60-64) Unmarried (divorced or separated) Renters Living with grandchildren Less than 12 years of formal education

Face of Senior Hunger

“Food Insecurity- Obesity Paradox”› Obesity

› Weight related disability

Face of Senior Hunger 2010

Near poor Whites Widows Non-metro Retired Women Households with no grandchildren

Consequences of Hunger

At Risk Of Hunger Increased ADLs

Disparity between chronological and

physical age

Consequences of a Poor Diet

Age Related Conditions

•Hearing loss •Macular Degeneration•Oral Health Problems•Sarcopenia•Cognition

Consequences of a Poor Diet

Chronic Diseases

•Heart Disease•Hypertension•Diabetes•Osteoporosis•Some cancers•COPD•Renal Disease

Consequences of a Poor Diet

Acute Conditions

•Dehydration•Pressure Ulcers•Infections•Pneumonia•Fractures•Gum Disease

Consequences of a Poor Diet

Increased Healthcare Costs• Re-Admissions• Longer Stays• Slower Recovery• Premature Institutionalization

Consequences of a Poor Diet

Reduced QOL/Independence • Decreased Mobility• Depression/Anxiety• Sleep Disturbance• Poor Appetite• Increased Morbidity• Increased Mortality

Threatens Independence--Reduces Quality of Life--Increases Healthcare Costs

Limits Muscle StrengthReduces Stamina

Prevents Physical Activity

Decreases ability to:Perform ADLs & IADLs:

Eat, Walk, Grocery Shop, Prepare MealsGrip Items & Lift Heavy Objects

Increases Dependency Increases Need for Caregiver Assistance

Increases Risk for Falls & Fractures

Consequences of Poor Diet on Functionality

Community Role

Strategic Planning

Target Services

Interventions

Collaborate and Coordinate

Referrals

Strategic Planning:

Assess› Demographics-Risk Factors› Community Hunger and Food Insecurity› Community Need› Partners› Resources

Develop interventions to address

Strategic Planning:

Develop interventions to address› Access › Referral › Education› Advocacy› Partnerships

Target Services

Prioritize to high risk groups

Offer services in geographical areas with high need (ie, rural, food deserts, food swamps)

Offer services in low income housing

Demographics

Texas Population% of 60+

Below Poverty 10.6%

African American 8.9%

Hispanic 21.4%

Mobility Limitations 23.6%

Demographics

Texas Population% of 60+

Age 60-64 31.2%

Age 65-74 39%

Age 75-84 21.7%

85+ 8.1%

Purpose: OAA Nutrition Services

To reduce hunger and food insecurity Promote socialization Promote the health and well-being of

older individuals

OAA Nutrition ServicesSections 331, 336, 339

Services required to be provided› Meals, nutrition education

Services that may be provided› Nutrition assessment and counseling, as appropriate

Services that may not be funded › Vitamin/mineral supplements› Dietary supplements

OAA Nutrition Targeting

Poverty Minority Live alone0%

10%

20%

30%

40%

50%

60%

39%

25%

52%

26%23%

39%

10%

22%

30% MOWCongregateUS Pop

National Survey of OAA Participants, December, 2011

OAA Nutrition TargetingCongregate

17%

3 or more IADL

72%

Need Help Going Outside Home

National Survey of OAA Participants, December, 2011

OAA Nutrition TargetingHome Delivered

55%45

3 or more IADL

84%

Need Help Going Outside Home

National Survey of OAA Participants, December, 2011

Characteristic % Congregate Participants

% Home Delivered Participants

Meal enabled living at home 60 92

Eat healthier foods as a result of the program

78 83

Eating meals improves health 78 87

Meals help feel better 85 90

National Survey of OAA Participants, December, 2011

OAA Nutrition ServicesValue Perceived Benefits

OAA Nutrition Services

Provide nutritious, appealing meals› Meet preferences, special needs for therapeutic,

religious reasons› Food components that can be eaten later

Increase number of meals› Holiday Meals› Emergency Meals› Second Meals› More than five days

Supportive Community Services

Nutrition education on low cost food management

Menu planning and shopping assistance Assist in a access/transportation to

grocery stores Grocery delivery Individualized nutrition counseling Cooking classes

USDA Food Assistance Programs

Community Partner Recruitment Initiative

Use the online SNAP application to help families apply

www.YourTexas Benefits.com

USDA Food Assistance Programs› Senior Farmer’s Market Nutrition

Program› TEFAP› CSFP› CACFP› SNAP-ED

Food Assistance Programs

Food Banks Food Pantries Soup Kitchens

Community Food Programs

Mobile Markets Community Gardens

Collaborate and Coordinate

Hunger network organizations and advocacy groups› Texas Hunger Initiative (Baylor University Based) › The Texas Hunger Research Project › Texas Food Bank Network

Home and Community Based Systems (HCBS) network

Aging and Disability Resource Centers (ADRC)

Faith-based organizations

Assessing Hunger and Nutrition Risk

o Community nutrition assessments for planning services› HCBS uniform assessment forms› I & R or ADRC screenings› Identify appropriate referrals

Train all staff: nutrition, case managers, I & R staff about food insecurity

Include outcome and impact measures about food insecurity on evaluations

Future of Senior Hunger

Prediction 2025› 75% more will experience food

insecurity› 33% more suffer hunger

What Can You Do?

References

National Foundation to End Senior Hunger www.nfesh.org

The Causes, Consequences, and Future of Senior Hunger in America, Ziliak, J., C. Gundersen and M. Haist, 2008

Senior Hunger in the United States: Differences across States and Rural and Urban Areas, Ziliak, J. and C. Gundersen, 2009

Senior Hunger in America 2010: An Annual Report, Ziliak, J. and C. Gundersen, 2010

References

Position of the Academy of Nutrition and Dietetics: Food and Nutrition for Older Adults: Promoting Health and Wellness. J Acad Nutr Diet. 2012;112:1255-1277.

Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and Nutrition Programs for Community-Residing Older Adults. J Am Diet Assoc. 2010;110:463-472.

References

USDA Community Food Security Assessment Toolkit

http://www.ers.usda.gov/media/327699/efan02013_1_.pdf

ACL/AOAhttp://www.aoa.gov/AoARoot/AoA_Programs/OAA/index.aspx

USDA ERS-Food Securityhttp://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/measurement.aspx#survey

References

Hunger and Nutrition in America: What’s at Stake for Children, Families and Older Adults - Generations United (2012)

Five Factors that Move the Needle on Reducing Food Insecurity- ConAgra Foods Foundation, Craig Gunderson (2012)

Contact:

Linda Netterville› Linda@mowaa.org