Hunger and Food Insecurity in the Elderly

Abstract

To better understand the nature of food insecurity in the elderly and to improve its measurement, in-depth interviews were conducted with 41 urban Black and rural White elderly in 35 households, followed by telephone administration of commonly used measures of food insecurity in 24 of these elderly. Elderly food insecurity appears to follow a progression of severity, beginning with compromised diet quality, followed by food anxiety, socially unacceptable meals, use of emergency food strategies, and finally actual hunger. The five quantitative measures tested were compared to each elderly person's food insecurity status based on the in-depth interview. All measures had reasonable specificity, and good sensitivity for those experiencing severe food insecurity. However, the Cornell-Radimer, Community Childhood Hunger Identification Project (CCHIP) and Nutrition Screening Initiative (NSI) measures appeared more sensitive than the USDA food sufficiency or Urban Institute measures in correctly identifying those in the lesser stages of food insecurity.

The Prevalence and Effects of Hunger in an Emergency Department Patient Population

“…Indeed, at least one study of hunger in elders reported that in-depth interviews revealed that many elders are likely to underreport their hunger and food insecurity. 13 Unlike the questions about hunger and food insecurity, our questions about choices between food and medicine and health effects had not been previously validated.…”

Less Money Less Food: Voices From Women in Urban Poor Families in Thailand

“…Decreased dietary intake is reported in relationship to food insecurity (Piaseu, 2003;Tarasuk, 2001). The association between hunger and food insecurity is widely documented (Hamilton et al, 1997;Wolfe, Olson, Kendall, & Frongillo, 1998). Malnutrition resulting from chronic insufficient intake may lead to clinical manifestations.…”

“…Moreover, a consequence of food insecurity is psychosocial dysfunction Murphy et al, 1998). Anxiety and stress frequently are reported in relation to food insecurity (Ahluwalia, Dodds, & Baligh, 1998;Weinreb et al, 2002;Wolfe et al, 1998). It is clear that food insecurity is associated with health (Campbell, 1991;McIntyre, Connor, & Warren, 2000;Pheley, Holben, Graham, & Simpson, 2002;Tarasuk, 2001;Vozoris & Tarasuk, 2003).…”

Food Anxiety Is Associated with Poor Health Status Among Recently Hospital-Discharged Older Adults

“…Through in-depth interviews with older adults, Wolfe characterized the progression of food insecurity in the following increasingly severe stages: (1) compromised diet quality and variety and a limited ability to obtain foods recommended for health problems; (2) anxiety or uncertainty of food resources and food management strategies; (3) having to eat meals that are not socially acceptable or eating less; and (4) having to use emergency food management strategies, such as borrowing money. They found that this feeling of anxiety was especially prevalent in those who had physical disabilities and were dependent on others for food acquisition and preparation (27). By asking participants if they were worried about getting enough food, we intended to capture this feeling of anxiety as an early warning signal for the possibility of progression to food insecurity.…”