Food Insecurity and Depression Among the Older Adults Poor: A Longitudinal Study Focusing on Moderating Effects of Social Service Usage in South Korea

Food insecurity is recognized as a serious social problem, even in developed countries such as South Korea. In particular, older adults appear to be a group that is critically vulnerable to food insecurity. As both age and income are known to be major variables influencing food purchase and consumption, social intervention targeting the older adults poor is a significant issue that requires immediate response. Furthermore, researchers have recently begun to pay attention to this issue because findings indicate that food insecurity is a critically important explanatory variable for depression. Specifically, some studies have already reported that the Supplemental Nutrition Assistance Program in the U.S. (commonly known as “food stamps”) has had a positive effect on the relationship between the two variables. The purpose of this study is to investigate how food insecurity longitudinally affects depression among the older adults poor, while testing the moderating effects of social service usage in South Korea.

This study used five waves of longitudinal data from the Korea Welfare Panel Study (KWPS, 2011-2015), which is collected by the Korea Institute of Health and Social Affairs, a national research think-tank. The data are collected nationally using random sampling. Data from a total of 2,217 older adults poor aged 65 or older were analyzed for this study.

Depression was measured using the Korean version of the Center for Epidemiologic Studies Depression Scale. However, KWPS used a short version with 11 questions. For food insecurity, it was measured using the “Six-item Short Form Household Food Security Survey Module” of U.S. Regarding social service usage variables, there are “free meal service,”, “meal delivery service”, “home helper service,”, “basic pension”, “commodity support”, and “voucher service”.

First, the proportion of the older adults poor who were experiencing food insecurity decreased from 10.05% in 2011 to 6.99% in 2015. On the other hand, the incidence of severe food insecurity with hunger increased from 12.41% in 2011 to 15.7% in 2015. Second, food insecurity appeared as a variable affecting depression among the older adults (B = 1.550, p < .001), even after controlling for variables such as age, income, education, gender, etc. Third, the free meal service (a social service program) was found to have a moderating effect on the relationship between food insecurity and depression (B = 0.781, p < .1).

This study indicates that food insecurity significantly affects depression among the older adults, while the free meal service has a moderating effect on the relationship between food insecurity and depression. In the case of South Korea, this finding is very meaningful because there has been little discussion and studies about food insecurity. Moreover, for a country like South Korea that has high rates of suicide and depression among the older adults, this study provides a reason why we should pay attention to food insecurity and supports development of more proactive programs to tackle this issue among the older adults.