Aging in Place: The Relationship between Social Connectedness and Food Insecurity Among Older Subsidized Housing Residents

Background: Findings on the prevalence and impacts of loneliness and social isolation on the lives of older adults have led to the lack of social connectedness being viewed as a major public health issue. Although an understudied population, emerging evidence suggests that for the nearly 3 million older low-income adults living in subsidized housing the impacts of lack of social connection may be especially profound. From a life course perspective, cumulative economic disadvantage, if combined with a cumulative connectedness disadvantage, may heighten exposure to health risk factors and negative health outcomes. Addressing social risk factors in this population thus may have the potential to reduce health disparities as well as improve quality of life. Epidemiological studies have found that poverty and food insecurity are associated with poorer health in later life. Yet, although housing is recognized as a social determinant of health, relatively little research has explored food insecurity in the marginalized population of older subsidized housing residents. The lack of investigation may reflect an assumption that because subsidized housing residents generally pay 30 percent of their monthly adjusted gross income for rent and utilities they should be food secure. In this study we sought to address this knowledge gap through an examination of factors associated with food insecurity with a particularly emphasis on how social connectedness was associated with food insecurity. Specifically we hypothesized that social connection measures (i.e., loneliness, sense of community belonging), independent of sociodemographic, health, and food program participation variables, would contribute to food insecurity.

Methods: The data are from in person interviews, conducted in English or Spanish, with 216 of the 300 tenants age 55-plus living in a large subsidized housing development in a predominately minority neighborhood of a Northeastern city (a 72% response rate). Approximately 50% of the participants identified as Black and 45% identified as Latino. Food insecurity was measured using the 6-item USDA Household Food Security Survey, loneliness was assessed with the Revised UCLA Loneliness Scale-8 Item Short Form (RULS-8) and sense of belonging was measured with the three-item community membership subscale of the Sense of Community Index. Multivariate logistic regression models were used to determine if the social risk factors were related to food insecurity even after other factors were controlled.

Results: Food insecurity was prevalent in the studied population; 40% for residents ages 55-69 and 20% for those ages 70-plus. Additionally, 34% expressed a strong sense of loneliness, and 40% reported little sense of community belonging. Food insecurity was positively correlated with loneliness. Importantly, multivariate logistic regression models revealed that loneliness was significantly related to food insecurity (increased the odds ratio) even after other factors were controlled.

Conclusions and Implications: The findings underscore that food insecurity and loneliness are serious issues among older adults living in subsidized housing developments. Furthermore, the results revealed that food insecurity involves many underlying determinants, including psychosocial factors. For a significant number of older subsidized housing residents hunger and loneliness co-exist; thus, future interventions might adopt the twin objectives of food security and social integration.