The Nutrition Services Incentive Program (NSIP) is a
Federal program that provides incentives for State
agencies to provide meals to older adults. The program
is administered by the U.S. Department of Health and
Human Services (HHS), and States may obtain
commodity foods from USDA.3 The NSIP provides
funding and commodities for the provision of home-delivered
meals to adults over age 60 in a number of
States. The NSIP does not allow State agencies to set
income limits for the receipt of home-delivered meals.
However, the NSIP is not an entitlement program, and
a number of applicants may be placed on a waiting list
if the State does not have sufficient resources to
provide meals for all applicants. This study examined
a population of older adults who have been placed on
a waiting list for home-delivered meals in five counties
in North Carolina to assess their functional ability,
nutritional status, and strategies to obtain food.
The authors conducted telephone interviews with 110
people who had been assessed as eligible and placed on
the waiting list for home-delivered meals in one Area
Agency on Aging (AAA) Region in North Carolina.
They found that those on the waiting list were about
the same age as those who began receiving home-delivered
meals in 2001, about as likely to be female,
and somewhat more likely to be African-American and
to live alone. Almost half of those on the waiting list
lived in households with incomes below the poverty
line. Survey respondents were asked whether they
needed assistance with nine standard activities of daily
living, such as getting dressed and transferring from
bed to chair. About 20 percent reported that they did
not require the help of another person for any of the
nine activities. Those on the waiting list were less
likely to report needing help getting dressed and transferring
from bed to chair than those who began
receiving home-delivered meals in 2001.
Almost all of those on the waiting list were at high
nutritional risk, based on an index used by the HHS
Administration on Aging. More than a third reported
that they had neither eaten fruit nor drunk fruit juice
the day before the interview, over 40 percent had eaten
no nonstarchy vegetables, less than 15 percent had
eaten neither fruits nor vegetables, and over 40 percent
had neither drunk milk nor eaten calcium-rich products.
While many on the waiting list were at high
nutritional risk, very few were underweight. In fact,
more than half were overweight.
Those on the waiting list to receive home-delivered
meals relied on a variety of sources for their meals.
Seven in 10 reported that they had someone bring
them prepared meals, which accounted for an average
of 3.2 of their meals each week. Almost two-thirds had
someone bring them groceries, which provided a
weekly average of almost 16 meals. The respondent’s
adult children were the most likely to bring prepared
meals or groceries. Almost 10 percent of respondents
did not receive prepared meals or groceries or the help
of someone coming to their home to cook for them.
Almost half of the survey respondents reported that
they did not always have enough money (or food
stamps) for food. However, only 15 percent reported
that they were receiving food stamps.
The study results indicate that almost all of those on
the waiting list to receive home-delivered meals are at
high nutritional risk. However, there is some variation
in their access to an informal support network to help
provide them with meals, which suggests a need to
focus resources on applicants who do not have