Associations between Basic Needs and Mental Health Among Economically Disadvantaged Older Adults in Flint, MI

Background: Many older adults living in Flint, MI have faced years of increased neighborhood crime, few transportation options and access to grocery stores. Living in a food desert imposes barriers to obtain nutrition and proper meals, and lack of access to healthy food increases health disparities. In addition, older Flint residents have experienced traumatic events such as the Flint water crisis. Much has been written about the Flint water crisis and how it impacted families with young children; however, less focus has been on Flint’s older adult population. While the connection between physical hardships and mental status is not new, its association may be stronger among those who are in economically and environmentally challenged situations. This exploratory study examines associations between basic needs and life stressors among older adults in Flint, MI.

Methods:Surveys were distributed to 642 Flint households who received weekly delivery services from a nonprofit community outreach center in early March 2020. 106 surveys were returned (16.5%). Respondents indicated if they were currently receiving assistance from governments, neighborhood, or family and friends for following needs: financial, food, healthcare, housing, utility bill, and transportation. We considered those who marked yes on specific items having needs in those areas. Respondents indicated their stress (Cohen et al., 1983) and mental illness (Kessler et al., 2002). Demographics included gender, race, education, and age. We used t-test and general linear regression to examine the associations among receiving assistance, stress, and mental illness.

Results: Among 78 residents aged 55 or older, the majority were female (71.8%), African American (75.6%), and had not completed high school (57.7%). They were 67.7 years old (SD=10.6) on average. Ten respondents (12.8%) were receiving financial assistance, 59 (75.6%) food, 58 (74.4%) healthcare, 12 (15.4%) housing, 21 (26.9%) utility, and 22 (28.2%) transportation. Independent t-test showed that those with food assistance had higher stress than counterparts, t(76)=2.24, p=0.028. Those with utility assistance had higher stress than counterparts, t(76)=2.11, p=0.038. The general linear model confirmed the negative association between receiving food assistance and stress (b=3.6, p=0.025) after controlling age, race, gender, and education. Mental illness was not related to assistance.

Conclusions: The findings showed higher levels of stress among those who received food assistance, which indicates a few possibilities: 1) The food assistance available in the Flint community may not be enough to meet residents’ needs, or 2) The procedures or requirements to obtain food may create stress among older adults. Improving neighborhood infrastructure as well as community support systems in regards to food insecurity will address the challenges that older adults have regarding nutritional assistance. Though we found the associations between food needs and stress, it did not capture resident’s experiences.When considering historical contexts and environmental challenges in Flint, older adult’s life stress may be too complex to explain simply by food assistance and related needs, which requires further research.