Food Insecurity and Depression of Korean Older Adults: Examination By Subgroups

Background and Objective: In South Korea, the incidence of depression among older adults and the rapid aging of the population highlight the importance of examining the association of financial strain and depression among older adults. A recent report reveals that Korean older adults are the poorest among OECD countries: about 49% of older adults live with low income. Moreover, the suicide rate of older adults in Korea is the highest among OECD countries, and one of the main reasons for suicide is economic stress. Likewise, Korean older adults appear more vulnerable to food insecurity compared to the entire population and to younger groups, which is different from findings in other developed countries. Food insecurity is an important predictor of mental health but has not been examined as a contributor to depression among older adults in Korea. This study aims to investigate whether food insecurity explains depression in Korean older adults. Especially, we compare similarities and differences across subgroups.   

Methods: We employed data from the Korea Welfare Panel Study (KOWEPS) collected in 2008 and 2009 from a large-scale national sample in South Korea. Our analysis sample consisted of 2,111 elderly householders age 65 or older. The dependent variable was depression as measured by a Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D). The independent variable was food insecurity measured using six questions adapted from the USDA’s Food Security Scale. We conducted OLS regression analyses to estimate the association between food insecurity and depression in the full sample (Model 1) and in four subgroups. The four subgroups included (1) those who ever received food services in the past year (Model 2), (2) those who did not receive food services (Model 3), (3) low income older-adults (Model 4), and (4) those living alone (Model 5).        

Results: The mean of the depressive symptoms was 6.50 (SD=5.73). The mean level of food insecurity was .42 (SD=.98), and about 9.4% of the sample reported experiencing food insecurity. Food insecurity was more prevalent for some subgroups. Food insecure older adults comprised 23.2% of those who received any food services in the past year (n=155), 12.05% of those who lived with low-income (n=1,526), and 15.4% of those living alone (n=820). Food insecurity was significantly associated with depression in the full sample and in three subgroups (those who did not receive food services, those with low income, and those living alone). However, food insecurity did not account for variance in depression among those who had received food services in the past year. 

Discussion and Implications: Our study confirms that food insecurity predicts depression in older adults in Korea. Protecting access to food may be a promising strategy to lessen financial strain and associated psychological stress in older adults. Social work practitioners and policy makers should identify older adults with emergent needs for food and consider intervention strategies to ensure access to healthy food, notably, those in low-income or living alone. We also discuss recommendations for future research (e.g., evaluation of food assistance policy and program).