Impact of Food Insecurity and Food Assistance Program Participation on Nutritional Risk Among the Elderly

Year: 1999

Research Center: Department of Nutrition at the University of California, Davis

Investigator: Frongillo, Edward A., and Jung Sun Lee

Institution: Cornell University

Project Contact:
Edward A. Frongillo, Jr., Ph.D.
Division of Nutritional Sciences
Cornell University
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.