Food Insecurity and Health Outcomes of Older Adults: Implications for Practice

Background: Prior evidence has suggested that food insecurity is as strong a predictor of decreased health in later life. Older adults in the United States are already at greater risk for worsening health status than younger age cohorts due to the increased prevalence of multiple chronic disease found in the older adult population. Approximately 65% of older adults are living with two or more chronic conditions such as heart disease, cancer, respiratory disease, and diabetes. Social workers employed the medical setting often encounter older patients with multiple co-morbidities and are responsible for connecting these older adults with various healthcare, government, and community-based social services. Due to the relationship between food insecurity and health status, social workers working in geriatric care should consider providing certain patient populations with resources to navigate food access and affordability barriers. This scoping review aimed to identify what health conditions are more commonly associated with food insecurity among older adults.

Methods: A scoping review was performed to locate original research and reports examining the relationship between food-insecure older adults, age 60 and over, and health outcomes. The review was performed between September – December 2016 through EBSCOhost, PubMed, Google Scholar, and ProQuest databases. An internet-based search engine provided access to public reports from the American Association of Retired Persons (AARP), the Center for Disease Control (CDC), and the National Foundation to End Senior Hunger. The following terms were used during record searches: food insecurity, food security, hunger, food insufficiency, food access, food deserts, older adults, elderly, aged, seniors, geriatric, aging, health, wellness, depression, and well-being. Finally, a manual search was performed to locate original studies referenced in research articles. Search efforts identified a total of 317 articles related to the health outcomes of food-insecure older adults. After abstracts were evaluated, 19 articles remained and were included in the present scoping review.

Results: Review findings indicated that food insecurity was associated with various physical health conditions, mental health disorders, and functional impairments specific to older adults. Physical health conditions included malnutrition, diabetes, osteoporosis, and cardiovascular disease. Disease-associated malnutrition among older adults also has been associated with over $50 billion in annual health care costs. Mental health disorders related to food insecurity included depression, substance use, and cognitive decline. Older adults who identified as having a physical impairment also indicated difficulty with food-related activities such as shopping, preparing, or cooking meals, all of which have influenced nutrient intake.

Conclusions: The results of this scoping review suggest that older adults with certain health conditions may be at an increased risk of food insecurity. Social workers in the medical field may consider screening these older patient populations to determine if they experience food access and affordability barriers. After identifying older patients at high risk for food insecurity, social workers would be better equipped to connect them with appropriate government or community-based programs designed to provide nutrition-based services to at-risk older adults. Utilization of these services may lead older adults to experience improved health outcomes and increased quality of life.