definition incidence causes consequences community roles
TRANSCRIPT
Senior Hunger
Linda Netterville, MA, RD, LDContractor, Nutrition Program, DADS
Objectives
Definition Incidence Causes Consequences Community Roles
Definition
Hunger
-a craving or urgent need for food or a specific nutrient
-an uneasy sensation occasioned by the lack of food
-a weakened condition brought about by prolonged lack of food
Malnutrition
-faulty nutrition due to inadequate or unbalanced intake of nutrients or their impaired assimilation or utilization
Definitions- USDA
Marginal food security -Households had problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of their food intake were not substantially reduced.
Low food security -Households reduced the quality, variety, and desirability of their diets, but the quantity of food intake and normal eating patterns were not substantially disrupted.
Very low food security -Eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food.
Definitions
Term Used USDA Terminology # of CSFM Answered(Core Food Security Module) 10 questions if no children
High Food Security No to all questions
Threat of Hunger Marginal Food Security At least one yes
Risk of Hunger Low Food Security At least 3 yes
Facing Hunger Very Low Food Security At least 6 yes
Survey Questions Used by USDA to Assess Household Food Security
1. "We worried whether our food would run out before we got money to buy more." Was that often, sometimes, or never true for you in the last 12 months?
2. "The food that we bought just didn't last and we didn't have money to get more." Was that often, sometimes, or never true for you in the last 12 months?
3. "We couldn't afford to eat balanced meals." Was that often, sometimes, or never true for you in the last 12 months?
4. In the last 12 months, did you or other adults in the household ever cut the size of your meals or skip meals because there wasn't enough money for food? (Yes/No)
5. (If yes to question 4) How often did this happen--almost every month, some months but not every month, or in only 1 or 2 months?
Survey Questions Used by USDA to Assess Household Food Security
6. In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money for food? (Yes/No)
7. In the last 12 months, were you ever hungry, but didn't eat, because there wasn't enough money for food? (Yes/No)
8. In the last 12 months, did you lose weight because there wasn't enough money for food? (Yes/No)
9. In the last 12 months did you or other adults in your household ever not eat for a whole day because there wasn't enough money for food? (Yes/No)
10. (If yes to question 9) How often did this happen--almost every month, some months but not every month, or in only 1 or 2 months?
Top Ten Hunger States
1. Mississippi
2. New Mexico
3. Arkansas
4. Texas
5. Tennessee
6. Alabama
7. Georgia
8. South Carolina
9. Florida
10.Nevada
US Senior Hunger 2010
1 in 7 face the “Threat of Senior Hunger”
Increased from 2001 to 2010 by 78%
Increased from 2006 to 2010 by 34%
Senior Hunger in Texas
% of Texas Seniors Approximate Number of Texas Seniors
Threat of Hunger
18.14% 685,000
Risk of Hunger
10.62% 401,000
Facing Hunger
4.23% 160,000
Face of Senior Hunger
African American or Hispanic Populations At poverty or near poverty Under age 70 (specifically age 60-64) Unmarried (divorced or separated) Renters Living with grandchildren Less than 12 years of formal education
Face of Senior Hunger
“Food Insecurity- Obesity Paradox”› Obesity
› Weight related disability
Face of Senior Hunger 2010
Near poor Whites Widows Non-metro Retired Women Households with no grandchildren
Consequences of Hunger
At Risk Of Hunger Increased ADLs
Disparity between chronological and
physical age
Consequences of a Poor Diet
Age Related Conditions
•Hearing loss •Macular Degeneration•Oral Health Problems•Sarcopenia•Cognition
Consequences of a Poor Diet
Chronic Diseases
•Heart Disease•Hypertension•Diabetes•Osteoporosis•Some cancers•COPD•Renal Disease
Consequences of a Poor Diet
Acute Conditions
•Dehydration•Pressure Ulcers•Infections•Pneumonia•Fractures•Gum Disease
Consequences of a Poor Diet
Increased Healthcare Costs• Re-Admissions• Longer Stays• Slower Recovery• Premature Institutionalization
Consequences of a Poor Diet
Reduced QOL/Independence • Decreased Mobility• Depression/Anxiety• Sleep Disturbance• Poor Appetite• Increased Morbidity• Increased Mortality
Threatens Independence--Reduces Quality of Life--Increases Healthcare Costs
Limits Muscle StrengthReduces Stamina
Prevents Physical Activity
Decreases ability to:Perform ADLs & IADLs:
Eat, Walk, Grocery Shop, Prepare MealsGrip Items & Lift Heavy Objects
Increases Dependency Increases Need for Caregiver Assistance
Increases Risk for Falls & Fractures
Consequences of Poor Diet on Functionality
Community Role
Strategic Planning
Target Services
Interventions
Collaborate and Coordinate
Referrals
Strategic Planning:
Assess› Demographics-Risk Factors› Community Hunger and Food Insecurity› Community Need› Partners› Resources
Develop interventions to address
Strategic Planning:
Develop interventions to address› Access › Referral › Education› Advocacy› Partnerships
Target Services
Prioritize to high risk groups
Offer services in geographical areas with high need (ie, rural, food deserts, food swamps)
Offer services in low income housing
Demographics
Texas Population% of 60+
Below Poverty 10.6%
African American 8.9%
Hispanic 21.4%
Mobility Limitations 23.6%
Demographics
Texas Population% of 60+
Age 60-64 31.2%
Age 65-74 39%
Age 75-84 21.7%
85+ 8.1%
Purpose: OAA Nutrition Services
To reduce hunger and food insecurity Promote socialization Promote the health and well-being of
older individuals
OAA Nutrition ServicesSections 331, 336, 339
Services required to be provided› Meals, nutrition education
Services that may be provided› Nutrition assessment and counseling, as appropriate
Services that may not be funded › Vitamin/mineral supplements› Dietary supplements
OAA Nutrition Targeting
Poverty Minority Live alone0%
10%
20%
30%
40%
50%
60%
39%
25%
52%
26%23%
39%
10%
22%
30% MOWCongregateUS Pop
National Survey of OAA Participants, December, 2011
OAA Nutrition TargetingCongregate
17%
3 or more IADL
72%
Need Help Going Outside Home
National Survey of OAA Participants, December, 2011
OAA Nutrition TargetingHome Delivered
55%45
3 or more IADL
84%
Need Help Going Outside Home
National Survey of OAA Participants, December, 2011
Characteristic % Congregate Participants
% Home Delivered Participants
Meal enabled living at home 60 92
Eat healthier foods as a result of the program
78 83
Eating meals improves health 78 87
Meals help feel better 85 90
National Survey of OAA Participants, December, 2011
OAA Nutrition ServicesValue Perceived Benefits
OAA Nutrition Services
Provide nutritious, appealing meals› Meet preferences, special needs for therapeutic,
religious reasons› Food components that can be eaten later
Increase number of meals› Holiday Meals› Emergency Meals› Second Meals› More than five days
Supportive Community Services
Nutrition education on low cost food management
Menu planning and shopping assistance Assist in a access/transportation to
grocery stores Grocery delivery Individualized nutrition counseling Cooking classes
USDA Food Assistance Programs
Community Partner Recruitment Initiative
Use the online SNAP application to help families apply
www.YourTexas Benefits.com
USDA Food Assistance Programs› Senior Farmer’s Market Nutrition
Program› TEFAP› CSFP› CACFP› SNAP-ED
Food Assistance Programs
Food Banks Food Pantries Soup Kitchens
Community Food Programs
Mobile Markets Community Gardens
Collaborate and Coordinate
Hunger network organizations and advocacy groups› Texas Hunger Initiative (Baylor University Based) › The Texas Hunger Research Project › Texas Food Bank Network
Home and Community Based Systems (HCBS) network
Aging and Disability Resource Centers (ADRC)
Faith-based organizations
Assessing Hunger and Nutrition Risk
o Community nutrition assessments for planning services› HCBS uniform assessment forms› I & R or ADRC screenings› Identify appropriate referrals
Train all staff: nutrition, case managers, I & R staff about food insecurity
Include outcome and impact measures about food insecurity on evaluations
Future of Senior Hunger
Prediction 2025› 75% more will experience food
insecurity› 33% more suffer hunger
What Can You Do?
References
National Foundation to End Senior Hunger www.nfesh.org
The Causes, Consequences, and Future of Senior Hunger in America, Ziliak, J., C. Gundersen and M. Haist, 2008
Senior Hunger in the United States: Differences across States and Rural and Urban Areas, Ziliak, J. and C. Gundersen, 2009
Senior Hunger in America 2010: An Annual Report, Ziliak, J. and C. Gundersen, 2010
References
Position of the Academy of Nutrition and Dietetics: Food and Nutrition for Older Adults: Promoting Health and Wellness. J Acad Nutr Diet. 2012;112:1255-1277.
Position of the American Dietetic Association, American Society for Nutrition, and Society for Nutrition Education: Food and Nutrition Programs for Community-Residing Older Adults. J Am Diet Assoc. 2010;110:463-472.
References
USDA Community Food Security Assessment Toolkit
http://www.ers.usda.gov/media/327699/efan02013_1_.pdf
ACL/AOAhttp://www.aoa.gov/AoARoot/AoA_Programs/OAA/index.aspx
USDA ERS-Food Securityhttp://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/measurement.aspx#survey
References
Hunger and Nutrition in America: What’s at Stake for Children, Families and Older Adults - Generations United (2012)
Five Factors that Move the Needle on Reducing Food Insecurity- ConAgra Foods Foundation, Craig Gunderson (2012)
