Food Insecurity and Depressive Symptoms of Older Adults Living Alone in South Korea

Background and Purpose: Older adults living alone are at great risks of poor health, economic insecurity, social isolation, or self-neglect. Past research also documents that older adults living alone are more likely to experience depressive symptoms, compared to those with a spouse or family. The number of older adults living alone is rapidly increasing with the growth of aging population, and their financial strain and associated risks for depression are alarming in South Korea. However, limited empirical evidence is known on food insecurity and depression of older adults living alone despite the fact that they have high prevalence of food insecurity and tend to seek food assistance. This study aims to examine whether food insecurity is likely to lead to depression in Korean older adults living alone. Also, this study examines whether the relationship between food insecurity and depressive symptoms varies by low income status.

Methods: We employed data from the Korea Welfare Panel Study collected from a large-scale national sample in South Korea. Our sample consisted of 815 elderly age 65 or older who lived alone. The dependent variable was depressive symptoms measured in 2009 by a Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D). The independent variable was food insecurity measured in 2008 using six questions adapted from the USDA’s Food Security Scale. We classified those with two or more affirmative responses out of six as food insecure (=1) and with less than two affirmative responses as food secure (=0). Conducting OLS regression analyses, we tested the main effect of food insecurity on depression and the interaction effect of food insecurity and low income. Covariates included socioeconomic and health characteristics of the study respondents that may be associated with depressive symptoms.

Results: The mean of the depressive symptoms was 8.2 (SD=6.0). About 15% of the sample reported experiencing food insecurity. Food insecure older adults showed higher levels of depressive symptoms by more than three points at the both waves (t = -5.83, p < .001). We found that the relationship between food insecurity and depressive symptoms differed by low income status (b = 6.27, p = .047). The association was significant only in the low income group (b = 1.37, p= .04).

Discussion and Implications: The findings agree with previous studies conducted in other countries in that food insecurity is a risk factor of depressive symptoms of older adults and the association is more concerning in older adults with constrained economic resources. Recognizing the significant link between food insecurity and depressive symptoms is important for many other countries as well as Korea to mitigate adverse consequences in rapidly aging society. Protecting access to food may be a promising strategy to lessen depressive symptoms associated with financial strain among older adults living alone.