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Mills CM. Food Insecurity in Older Adults in Canada and the United States: A Concept Analysis. CAN J DIET PRACT RES 2021; 82:200-208. [PMID: 34286614 DOI: 10.3148/cjdpr-2021-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A concept analysis using the method of Walker and Avant was undertaken to clarify the concept of food insecurity in older adults in Canada and the United States. A literature review was undertaken to conduct a concept analysis of food insecurity in older people. Food insecurity is associated with multiple negative health outcomes and may be experienced differently by older adults as compared to younger adults. It is therefore important to understand the concept of food insecurity as is relates to older adults. Four defining attributes of food insecurity in older adults in Canada and the United States were identified: (i) inability to acquire or prepare enough food, (ii) compromising on food quality or preference, (iii) uncertainty or anxiety around the ability to acquire or prepare food, and (iv) socially unacceptable or non-normative practices. These attributes may allow for improved policies and programs aimed at addressing food insecurity in older adults by better meeting the needs of older individuals. Additional research into food insecurity as experienced by Canadian and American older adults could help to further clarify the concept.
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Affiliation(s)
- Christine Marie Mills
- School of Rehabilitation Therapy, Aging and Health, Queen's University, Kingston, ON
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Aguila E, López-Ortega M, Gutiérrez Robledo LM. Non-contributory pension programs and frailty of older adults: Evidence from Mexico. PLoS One 2018; 13:e0206792. [PMID: 30388177 PMCID: PMC6214535 DOI: 10.1371/journal.pone.0206792] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/20/2018] [Indexed: 11/19/2022] Open
Abstract
Non-contributory pension programs in the developing world seek to provide older adults with an income that may improve their health and wellbeing in old age by enabling access to health care and better nutrition. There is no previous evidence of the effects of non-contributory pensions on frailty, a comprehensive measure of health and well-being of the oldest old. We aimed to estimate the effects of non-contributory pension programs on frailty of older adults in the state of Yucatan, Mexico. We use rich panel data, including objective markers and self-reported assessments of health and well-being, for 944 adults at least 70 years of age in two communities of Yucatan, Mexico. The first wave was collected in 2008; the second wave was collected in 2010, 18 months after implementation of a monthly state pension in one community and 12 months after a federal pension paid every two months in the other. We found the state pension led to a statistically significant decrease in the severity of frailty for women, but the federal pension was associated with an increase. We found no statistically significant change in the frailty index for men in either community. Among explanations for these findings are monthly payments being more likely to be spent on health care, medicines, and more regular food expenditures, enabling women who previously lacked independent means of support to increase their longer-term health. The federal program paid every two months led to irregular patterns of food expenditure and increased ownership of durable goods but had no effects on health care utilization, subsequently leading to deterioration in longer-term health for women.
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Affiliation(s)
- Emma Aguila
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, United States of America
- RAND, Santa Monica, CA, United States of America
- * E-mail:
| | - Mariana López-Ortega
- Research Department, National Institute of Geriatrics, National Institutes of Health, Mexico City, Mexico
| | - Luis Miguel Gutiérrez Robledo
- Office of the Director General, National Institute of Geriatrics, National Institutes of Health, Mexico City, Mexico
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Preliminary validation and piloting of a comprehensive measure of household food security in Australia. Public Health Nutr 2017; 21:526-534. [PMID: 29125096 DOI: 10.1017/s1368980017003007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the psychometric properties, validity and reliability of a newly developed measure of food insecurity, the Household Food and Nutrition Security Survey (HFNSS), among an Australian population. DESIGN Cross-sectional study. SETTING Metropolitan areas of Melbourne, Australia, identified as very high, high or medium vulnerability in the 2008 Vulnerability Assessment for Mortgage, Petrol and Inflation Risks and Expenditure index. SUBJECTS A convenience sample of 134 adults (117 females and fifteen males, aged over 18 years). RESULTS Rasch modelling and factor analysis identified four items for exclusion. The remaining items yielded excellent reliability among the current sample and assessed three underlying components: the adult experience of food insecurity (component one), initial/periodic changes to children's food intakes (component two) and progressive/persistent decreases in children's food intakes (component three). Compared with the widely used US Department of Agriculture Food Security Survey Module, the HFNSS identified a significantly higher proportion of food insecurity; this is likely due to the HFNSS's identification of food insecurity due to reasons other than (and including) limited financial access. CONCLUSIONS The HFNSS may be a valid and reliable tool for the assessment of food insecurity among the Australian population and provides a means of assessing multiple barriers to food security beyond poor financial access (which has been identified as a limitation of other existing tools). Future research should explore the validity and reliability of the tool among a more representative sample, as well as specifically among vulnerable population subgroups.
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Vilar-Compte M, Gaitán-Rossi P, Pérez-Escamilla R. Food insecurity measurement among older adults: Implications for policy and food security governance. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2017. [DOI: 10.1016/j.gfs.2017.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cheng Y, Rosenberg M, Yu J, Zhang H. Food security for community-living elderly people in Beijing, China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:747-757. [PMID: 26094641 DOI: 10.1111/hsc.12255] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 06/04/2023]
Abstract
Food security has been identified as an important issue for elderly people's quality of life and ageing in place. A food security index composed of three indicators (food intake, food quality and food affordability) was developed to measure the food security status of community-living elderly people. Food security was then examined among community-living elderly in the central urban districts of Beijing, China. Data were collected by a questionnaire survey in the summer of 2013 and the response rate was 78.5%. Descriptive statistics and binary logistic regression were applied to analyse food security and the associations between food security and demographic and socioeconomic factors. The results showed that 54.2% of the surveyed elderly experienced food security. Participants with better education (OR = 1.68) and better health (OR = 1.47) were more likely to experience food security. The young-old were less likely to experience food security than the older old (OR = 0.94). Elderly people who lived with their children were less likely to experience food security than those who lived alone (OR = 0.43). The results of impact factors on food security highlight both similarities with studies from more developed countries and the unique challenges faced in a rapidly changing China with its unique social, cultural and political systems. The food security index we developed in this study is a simple and effective measure of food security status, which can be used in surveys for evaluating the food security status of elderly people in the future.
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Affiliation(s)
- Yang Cheng
- School of Geography, Beijing Normal University, Beijing, China.
| | - Mark Rosenberg
- Department of Geography, Queen's University, Kingston, Ontario, Canada
| | - Jie Yu
- Department of Geography, Queen's University, Kingston, Ontario, Canada
| | - Hua Zhang
- School of Geography, Beijing Normal University, Beijing, China
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Oemichen M, Smith C. Investigation of the Food Choice, Promoters and Barriers to Food Access Issues, and Food Insecurity Among Low-Income, Free-Living Minnesotan Seniors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:397-404.e1. [PMID: 27062230 DOI: 10.1016/j.jneb.2016.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Investigate food choice, food access, and food insecurity among seniors. METHODS Eight focus groups were conducted in 2 counties with high and low Supplemental Nutrition Assistance Program (SNAP) participation rates. A total of 62 seniors (aged ≥ 60 years) were recruited and each attended 1 focus group at a community center. The sample was 79% female and most were Caucasian (91%), similar to state demographics. The focus group themes of how seniors make food choices and access food, and food insecurity perceptions among this population were identified based on discussion commonalities. For quantitative data, P < .05 was significant. RESULTS Five themes emerged: (1) former experiences affecting eating behaviors; (2) financial and food security driving use of food assistance programs; (3) food access strategies: restaurants, retail markets, and alternative sources; (4) physical changes associated with aging influencing food access and intake; and (5) social influences that play a role in decision making. CONCLUSIONS AND IMPLICATIONS Both SNAP and congregate dining offer food assistance to seniors, but SNAP use was considered unacceptable by some seniors living in county 1 because of the negative stigma attached to the program or because they lacked program knowledge about income criteria. More effort needs to be made to educate seniors about SNAP. It is important to gain insight into how food insecurity affects their food choices.
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Affiliation(s)
- Megan Oemichen
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN
| | - Chery Smith
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN.
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Measurement of the dimensions of food insecurity in developed countries: a systematic literature review. Public Health Nutr 2016; 19:2887-2896. [PMID: 27217202 DOI: 10.1017/s1368980016001166] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Food insecurity is a salient health issue comprised of four dimensions - food access, availability, utilization and stability over time. The aim of the present study was to conduct a systematic literature review to identify all multi-item tools that measure food insecurity and explore which of the dimensions they assess. DESIGN Five databases were searched (CENTRAL, CINAHL plus, EMBASE, MEDLINE, TRIP) for studies published in English since 1999. Inclusion criteria included human studies using multi-item tools to measure food security and studies conducted in developed countries. Manuscripts describing the US Department of Agriculture Food Security Survey Module, that measures 'food access', were excluded due to wide acceptance of the validity and reliability of this instrument. Two authors extracted data and assessed the quality of the included studies. Data were summarized against the dimensions of food insecurity. SETTING A systematic review of the literature. SUBJECTS The majority of tools were developed in the USA and had been used in different age groups and cultures. RESULTS Eight multi-item tools were identified. All of the tools assessed the 'food access' dimension and two partially assessed the dimensions 'food utilization' and 'stability over time', respectively. 'Food availability' was not assessed by existing tools. CONCLUSIONS Current tools available for measuring food insecurity are subjective, limited in scope, with a majority assessing only one dimension of food insecurity (access). To more accurately assess the true burden of food insecurity, tools should be adapted or developed to assess all four dimensions of food insecurity.
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Hong SA, Kim K. Factors contributing to participation in food assistance programs in the elderly population. Nutr Res Pract 2014; 8:425-31. [PMID: 25110563 PMCID: PMC4122715 DOI: 10.4162/nrp.2014.8.4.425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 02/12/2014] [Accepted: 03/13/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES The study objectives were to examine the participation rate in food assistance programs and explore the factors that contribute to such participation among the Korean elderly population. SUBJECTS/METHODS The study sample comprised 3,932 respondents aged 65 years or older who were selected from a secondary data set, the fourth Korean Welfare Panel Study (KoWePS). The factors, related to participation in programs were examined based on the predisposing, enabling and need factors of the help-seeking behavior model. Multiple logistic regression analysis was used to select the best contributors among the factors related to program participation. RESULTS The predisposing rate in food assistance programs was 8.5% (7.1% for men and 10.4% for women). When all variables were included in the model, living without spouse, no formal education, low income, having social security benefits and food insecurity in elderly men, and age, low income, having social security benefits and feeling poor in elderly women were significantly related to a higher tendency to program participation. CONCLUSIONS The predisposing and need factors, such as living without spouse, low education level, food insecurity and feeling poor were important for program participation, as well as enabling factors, such as household income and social security benefits. A comprehensive approach considering these factors to identify the target population for food assistance programs is needed to increase the effectiveness and target population penetration of these programs.
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Affiliation(s)
- Seo Ah Hong
- ASEAN Institute for Health Development, Mahidol University, Salaya, 73170 Nakhonpathom, Thailand
| | - Kirang Kim
- Department of Food Science and Nutrition, College of Natural Science, Dankook University, 119 Dandae-ro, Dangnam-gu, Cheonan-si, Chungnam 330-714, Korea
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Hannum E, Liu J, Frongillo E. Poverty, Food Insecurity and Nutritional Deprivation in Rural China: Implications for Children's Literacy Achievement. INTERNATIONAL JOURNAL OF EDUCATIONAL DEVELOPMENT 2014; 34:90-97. [PMID: 26609194 PMCID: PMC4655325 DOI: 10.1016/j.ijedudev.2012.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Emily Hannum
- Department of Sociology, 3718 Locust Walk, Philadelphia PA 19104
| | - Jihong Liu
- Arnold School of Public Health, University of South Carolina, Health Sciences Building, 208B, 800 Sumter Street, Columbia, SC 29208,
| | - Edward Frongillo
- Arnold School of Public Health, University of South Carolina, Health Sciences Building, 216B, 800 Sumter Street, Columbia, SC 29208,
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Food Access Patterns and Barriers among Midlife and Older Adults with Mobility Disabilities. J Aging Res 2012; 2012:231489. [PMID: 23056944 PMCID: PMC3463949 DOI: 10.1155/2012/231489] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/16/2012] [Indexed: 11/18/2022] Open
Abstract
We examined where midlife and older adults with a mobility disability accessed food outside the home in King County, Washington, USA, how they travelled to these food destinations, and facilitators and barriers to food access using qualitative interviews. Thirty-five adults aged ≥50 years with a mobility disability (defined as use of an assistive device for mobility) were interviewed. Supplemental objective information was obtained from a Global Positioning System device worn by participants for 3 days. Participants primarily accessed food at grocery stores, restaurants, and coffee shops/cafés. The most common transportation modes were walking, obtaining a ride from friends, motorized chair/scooter, and public transit. Location and proximity of food destinations were factors affecting participants' ability to access these destinations. Adequate space, ease of entry, available amenities such as restrooms, and helpful people were facilitators for participants to access food outside the home.
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Samuel LJ, Szanton SL, Weiss CO, Thorpe RJ, Semba RD, Fried LP. Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women. EPIDEMIOLOGY RESEARCH INTERNATIONAL 2012; 2012:696518. [PMID: 24163772 PMCID: PMC3806140 DOI: 10.1155/2012/696518] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examined the relationship between financial strain, or difficulty acquiring necessities, and malnutrition risk in a community dwelling sample of frail and nonfrail women aged 70-79 in the Women's Health and Aging Study (n = 679). Malnutrition risk was measured with a modified version of the Mini-Nutritional Assessment Short Form (MNA-SF) and defined as a score <11, financial strain was measured by (1) sufficiency of money on a monthly basis and (2) adequacy of income for food, and income was measured by ordinal categories. Mean (SD) modified MNA-SF score was 12.2 (1.80), and 14.7% of women had malnutrition risk. Women who usually did not have enough money to make ends meet had more than four-fold increased odds of malnutrition risk (OR = 4.54; 95% CI: 2.26, 9.14) compared to their counterparts who had some money left over each month. This was only slightly attenuated after control for income and education, (OR = 4.08; 95% CI: 1.95, 8.52) remaining robust. These results show an association between financial strain and malnutrition risk, independent of income, in older women. Self-reported financial strain may be preferable to income as a screener for malnutrition risk in older adults in clinical and research settings.
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Affiliation(s)
- Laura J. Samuel
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Sarah L. Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Carlos O. Weiss
- Division of Geriatric Medicine and Gerontology, Johns Hopkins Medicine, Baltimore, MD 21205, USA
| | - Roland J. Thorpe
- Department of Health Policy and Management, Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Richard D. Semba
- Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Linda P. Fried
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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Lee JS, Johnson MA, Brown A. Older Americans Act Nutrition Program improves participants' food security in Georgia. J Nutr Gerontol Geriatr 2011; 30:122-39. [PMID: 21598162 DOI: 10.1080/21551197.2011.566526] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
It is critical to use convincing research methodology to demonstrate the benefits of nutrition assistance programs targeted to vulnerable older adults. We examined the impact of Older Americans Act Nutrition Program (OAANP) participation on food security in participants and waitlisted people in Georgia using two waves of self-administered mail surveys conducted 4 months apart (n = 717, mean age 74.6 ± 9.5, 70.9% female, 33.2% black). At baseline, 54% of the sample was food insecure. Waitlisted people reported higher levels of persistent food insecurity (45.9%) or becoming food insecure (10.0%) than participants (29.3% and 7.1%, respectively) over 4 months. While considering potential confounders, the estimated odds of achieving food security were 1.65 times (95% CI: 1.10-2.48) higher in participants than in waitlisted people over 4 months. Our data suggest the feasibility of using food insecurity measures to detect the benefits of OAANP participation as well as the need to increase the capacity of OAANP.
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Affiliation(s)
- Jung Sun Lee
- Department of Foods and Nutrition, University of Georgia, Athens, Georgia 30602, USA.
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Frongillo EA, Wolfe WS. Impact of participation in Home-Delivered Meals on nutrient intake, dietary patterns, and food insecurity of older persons in New York state. ACTA ACUST UNITED AC 2010; 29:293-310. [PMID: 20711924 DOI: 10.1080/01639366.2010.499094] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to determine if (1) participation in Home-Delivered Meals (HDM) results in improved dietary patterns and nutrient intake, lower food insecurity, and reduced loss of weight; (2) subgroups of older persons are more likely to benefit; and (3) nutritional indicators of impact other than nutrient intake may be useful. The design used was quasi-experimental, with longitudinal assessment of individuals on HDM at baseline (before receipt of services), 6, and 12 months, and comparison to non-randomized group receiving other services. Outcomes included measured weight and height, 24-hour dietary recall, and food insecurity. Paired t test, multiple linear regression, and selection models using multiple logistic regression were performed. All older persons in three New York State counties referred for aging services over a 5-month period were asked to participate (n = 456), and 212 agreed (171 on HDM). At 6 months, the sample size was 101 (34 discharged, 42 hospital/died/moved, 26 chose not to continue), and at 12 months it was 68 (similar reasons). After receiving meals for 6 and 12 months, participants showed greater improvement in most dietary intake variables than either a non-HDM comparison group or HDM participants who ate no HDM meal on the day of assessment. Compared to initial values, participants improved significantly in some variables for dietary patterns, nutrient intake, and nutrient density, and were less likely to be food insecure. Furthermore, HDM was more likely to impact those living alone and those with poorer initial status. This study provides strong evidence that HDM has a positive impact on the nutritional well-being of older persons. Food insecurity and dietary patterns are useful nutritional indicators of impact.
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Affiliation(s)
- Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina 29208, USA.
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Patterns of food insecurity and participation in food assistance programmes over time in the elderly. Public Health Nutr 2009; 12:2113-9. [PMID: 19371452 DOI: 10.1017/s1368980009005357] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The present study aimed to understand the relationship between need and help-seeking behaviour in older adults by examining the patterns of food insecurity and participation in food assistance programmes (FAP), i.e. the Food Stamp Program and home-delivered meals. DESIGN Data from two longitudinal studies were used. The studies were designed to obtain nationally representative information on health, insurance coverage, financial status, family support systems, labour market status and retirement planning, every two years: the Health and Retirement Study (HRS, 1996-2002) and Asset and Health Dynamics Among the Oldest Old (AHEAD, 1995-2002). SETTING USA. SUBJECTS There were 7623 participants for HRS and 3378 for AHEAD. RESULTS The older adults appeared to have persistent patterns between food insecurity and participation in FAP, especially in the Food Stamp Program. More persistently food-insecure older adults had higher participation in FAP (P < 0.001). Food-insecure older adults at one time were more likely to shift from non-participation to participation in FAP the next time than food-secure older adults (P < 0.001). Regardless of previous food insecurity status, previous participants in FAP were more likely to participate subsequently. CONCLUSIONS The relationship between need and help-seeking behaviour in older adults was found to follow a persistent positive pattern, determined by looking at the patterns of food insecurity and participation in FAP. Although food insecurity as a need is a good predictor of participation in FAP, it is not enough to fully predict participation in FAP. Help-seeking behaviour (i.e. previous programme participation) is also important in predicting participation in FAP.
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Bocock MA, Keller HH, Brauer PM. Defining malnutrition risk for older home care clients. CAN J DIET PRACT RES 2009; 69:171-6. [PMID: 19063806 DOI: 10.3148/69.4.2008.171] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE The Resident Assessment Instrument-Home Care (RAI-HC) is widely used to assess needs of home care clients and includes five items used to screen for malnutrition. This study involved defining malnutrition risk and identifying other items within the RAI-HC that might improve malnutrition screening among adults aged 65 or older receiving home care. METHODS A literature review, three focus groups of community care access centre case managers (n=29), and five key informant interviews with registered dietitians were used to identify malnutrition risk factors and indicators. A nominal group (n=5) was used to rank RAI-HC malnutrition risk items. Data were charted and integrated to create the final list of potential risk factors. RESULTS Seven malnutrition indicators (dietary intake, appetite, dysphagia, nutrition support, end-stage disease, weight status, and fluid intake) and seven risk factors (health status, functional ability, self-reported poor health, mood status, social function, cognitive performance, and trade-offs) were considered important concepts in the construct of malnutrition for older home care clients. CONCLUSIONS These items identified through divergent methods form the basis for developing a screening-for-malnutrition-risk tool for home care.
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Affiliation(s)
- Mary Ann Bocock
- Department of Family Relations and Applied Human Nutrition, University of Guelph, Guelph, Ontario, Canada
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Abstract
OBJECTIVES During the past two decades, food deprivation and hunger have been recognized to be not just the concerns of only underdeveloped or developing countries, but as problems for many affluent Western nations as well. Many countries have made numerous efforts to define and measure the extent of these problems. Based on these efforts, the theory and practice of food security studies has significantly evolved during the last decades. Thus, this study aims to provide a comprehensive review of the concept and measurement of food security. METHODS AND RESULTS In this review, we introduce the definition and background of food security, we describe the impact of food insecurity on nutrition and health, we provide its measurements and operational instruments and we discuss its applications and implications. Some practical information for the use of the food security index in South Korea is also presented. CONCLUSIONS Food security is an essential element in achieving a good nutritional and health status and it has an influence to reduce poverty. The information about the current understanding of food security can help scientists, policy makers and program practitioners conduct research and maintain outreach programs that address the issues of poverty and the promotion of food security.
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Affiliation(s)
- Kirang Kim
- Department of Preventive Medicine, Hanyang University, College of Medicine.
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Food Insecurity Is Associated with Health Status of Older Adults Participating in the Commodity Supplemental Food Program in a Rural Appalachian Ohio County. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2008. [DOI: 10.1300/j477v01n02_06] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Frongillo EA, Jyoti DF, Jones SJ. Food Stamp Program participation is associated with better academic learning among school children. J Nutr 2006; 136:1077-80. [PMID: 16549482 DOI: 10.1093/jn/136.4.1077] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Household food insecurity is associated with multiple adverse outcomes in children and adolescents, including poor school performance. U.S. federal food assistance programs such as the Food Stamp Program (FSP) aim to help prevent household food insecurity and its outcomes. Program participation may act as a resource either to counteract the effects of constraints such as food insecurity or to modify the effects of food insecurity on outcomes. This study aimed to determine whether FSP participation was associated with child reading and mathematics learning, weight gain, and social skills and whether these associations depended on degree of estimated need for the program. Data used were from the Early Childhood Longitudinal Study-Kindergarten cohort, a large nationally representative sample. A difference (i.e., fixed-effects) model was used to minimize bias in the estimation of association resulting from unmeasured covariates. Starting FSP participation during the 4 years from K to third grade was associated with about a 3-point greater improvement in reading and mathematics score as compared with stopping FSP participation during that period. But it was for female students only that this association was large and significant. Children in households starting FSP participation had slightly but not significantly less weight gain compared with children in households stopping FSP participation. This study provides the strongest evidence to date that FSP participation plausibly has beneficial effects for children on nonnutritional outcomes, specifically academic learning. The mechanisms for this relationship are not well understood and may be through both dietary intake and stress.
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Affiliation(s)
- Edward A Frongillo
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301, USA.
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Jyoti DF, Frongillo EA, Jones SJ. Food insecurity affects school children's academic performance, weight gain, and social skills. J Nutr 2005; 135:2831-9. [PMID: 16317128 DOI: 10.1093/jn/135.12.2831] [Citation(s) in RCA: 414] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Food insecurity has been associated with diverse developmental consequences for U.S. children primarily from cross-sectional studies. We used longitudinal data to investigate how food insecurity over time related to changes in reading and mathematics test performance, weight and BMI, and social skills in children. Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort, a prospective sample of approximately 21,000 nationally representative children entering kindergarten in 1998 and followed through 3rd grade. Food insecurity was measured by parent interview using a modification of the USDA module in which households were classified as food insecure if they reported > or =1 affirmative response in the past year. Households were grouped into 4 categories based on the temporal occurrence of food insecurity in kindergarten and 3rd grade. Children's academic performance, height, and weight were assessed directly. Children's social skills were reported by teachers. Analyses examined the effects of modified food insecurity on changes in child outcomes using lagged, dynamic, and difference (i.e., fixed-effects) models and controlling for child and household contextual variables. In lagged models, food insecurity was predictive of poor developmental trajectories in children before controlling for other variables. Food insecurity thus serves as an important marker for identifying children who fare worse in terms of subsequent development. In all models with controls, food insecurity was associated with outcomes, and associations differed by gender. This study provides the strongest empirical evidence to date that food insecurity is linked to specific developmental consequences for children, and that these consequences may be both nutritional and nonnutritional.
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Affiliation(s)
- Diana F Jyoti
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301, USA
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Frongillo EA. Understanding obesity and program participation in the context of poverty and food insecurity. J Nutr 2003; 133:2117-8. [PMID: 12840164 DOI: 10.1093/jn/133.7.2117] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Edward A Frongillo
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301, USA.
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