Food Insecurity in African American Elders

Food insecurity occurs when the availability of nutritionally adequate and safe foods or the ability to acquire them in socially acceptable ways is limited or uncertain. It is a growing problem in older adults (Sengupta, 2016). Nine percent of older persons who live alone are food insecure, and about 15 percent are at risk. This issue is particularly concerning in African American older adults who are at a greater risk compared to their Hispanic and non-Hispanic white counterparts (16.66%, 13.26%, and 4.4%, respectively) (Ziliak & Gundersen, 2013).

Several factors are associated with food insecurity in older adults (Sengupta, 2016), and the social ecological model provides an appropriate theoretical framework to examine them (Goldberg & Mawn, 2014; Schroeder & Smaldone, 2015).

The model posits that numerous factors and multiple interconnecting levels influence a given health issue (Sallis, Owen, & Fisher, 2008). The complex interplay between the factors within the individual, interpersonal, organizational, community, and public policy spheres is considered.

At the individual level, food insecurity in older adults has been associated with poverty (Coleman-Jensen et al., 2016; Homenko, Morin, Eimicke, Teresi, & Weinstock, 2010), racial/ethnic minority status (Goldberg & Mawn, 2014), perceived racial discrimination (Dean, Sharkey, & Johnson, 2011), and low educational attainment (Goldberg & Mawn, 2014). Other factors include poor quality of life, health status, and dietary intake (Goldberg & Mawn, 2014; Sengupta, 2016). Limitations in activities of daily living (Silverstein, 2016) and lack of private health insurance (Goldberg & Mawn, 2014) are also linked to food insecurity in older adults.

At the interpersonal (relationship) level, food insecurity in older adults has been associated with limited social capital including low social support, lack of financial help from other persons (Goldberg & Mawn, 2014), and being without a spouse/partner. Social disconnectedness and perceived isolation are associated factors in older adults (Cornwell & Waite, 2009). Conversely, social relations beyond the family, such as church affiliations and membership in community organizations, decrease the likelihood of food insecurity.

Community-level factors associated with food insecurity in older adults include high medication costs (Sattler & Lee, 2013) and limited availability of community support services (Nguyen, Sarkari, MacNeil, Cowan, & Rankin, 2013). Within the public policy sphere, food security has improved with the advent of programs such as the USDA's Supplemental Nutrition Assistance Program and the Administration on Aging's Congregate Nutrition Services and Home-Delivered Nutrition Services programs (Lee, Johnson, & Brown, 2011a). However, food insecurity persists in older adults who use such services (Goldberg & Mawn, 2014; Lee et al., 2011a).

Food insecurity remains a complex public health problem that has not been fully explored (Sengupta, 2016). Special attention to disparities in racial and ethnic minorities is especially needed. The purpose of this study was to increase understanding of food insecurity in African Americans.

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