Conceptualizing Food Insecurity Among Older Adults: Development of a Summary Indicator in the National Health and Aging Trends Study

Abstract Objectives Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was...

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Published in:The journals of gerontology. Series B, Psychological sciences and social sciences Psychological sciences and social sciences, 2021-11, Vol.76 (10), p.2063-2072
Main Authors: Tucher, Emma L, Keeney, Tamra, Cohen, Alicia J, Thomas, Kali S
Format: Article
Language:English
Subjects:
Aged
Cross-Sectional Studies
Female
Financial Stress - epidemiology
Food Insecurity - economics
Frail Elderly - statistics & numerical data
Health Status Disparities
Homebound Persons - psychology
Homebound Persons - statistics & numerical data
Humans
Independent Living - statistics & numerical data
Male
Nutrition Surveys
Nutritional Status
Prevalence
Risk Factors
Social Determinants of Health
Social Support
THE JOURNAL OF GERONTOLOGY: Social Sciences
United States - epidemiology
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Summary:Abstract Objectives Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was to construct a summary indicator of food insecurity incorporating these domains. Methods We used nationally representative survey data from Round 5 of the National Health and Aging Trends Study (NHATS; n = 7,070). We constructed a summary indicator of food insecurity using factors within the following three domains: functional, social support, and financial limitations. First, we identified the prevalence of food insecurity among the sample as defined by the new summary indicator. Then, we estimated unadjusted and adjusted logistic regression models to assess the association between the expanded measure of food insecurity and biopsychosocial factors. Results In 2015, 4.3% (95% confidence interval [CI] 3.75–4.94) of community-dwelling older adults, approximately 1,673,775 million people, were characterized as having food insecurity. Multivariable-adjusted regression models identified that being homebound (odds ratio [OR] 3.49, 95% CI 2.03, 6.00), frail (OR 9.50, 95% CI 4.92–18.37), and experiencing community disability (OR 5.19, 95% CI 3.90–6.90) was associated with food insecurity. Discussion Food insecurity among older adults is broader than lacking adequate financial resources to obtain food; it is also associated with social and functional limitations. A more comprehensive conceptualization will aid future study on the impact of food insecurity on health status, utilization, and outcomes to inform senior nutrition program targeting and services.
ISSN:1079-5014
1758-5368
DOI:10.1093/geronb/gbaa147