Meeting the Dietary Needs of Older Adults Exploring the Impact of the Physical, Social, and Cultural Environment: Workshop Summary (2016) / Chapter Skim
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3 Emerging Insights (Ecological)
3 Emerging Insights (Ecological)
Pages 45-64
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From page 45... ...
, opened her talk by showing several models that can be used to understand the dimensions of food security, the stages of nutritional risk, and the multiplicity of influences and factors at various levels that affect the food choices and behaviors of older adults. The World Health Organization (WHO)
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SOURCES: Presented by Julie Locher on October 28, 2015 (Locher et al., 2008, 2009)
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. Locher described factors influencing food choices at various levels (see Box 3-1)
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Locher concluded her presentation by noting that insights from behavioral economics may be very useful in designing intervention studies in nutrition and aging. FOOD SECURITY AMONG OLDER ADULTS Craig Gundersen, Soybean Industry Endowed Professor in Agricultural Strategy in the Department of Agricultural and Consumer Economics at the University of Illinois, opened his presentation with the official definition
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This is to be expected, but in fact, almost 30 percent of food insecure households have incomes above 20 percent of the poverty line. Gundersen stated that this needs to be considered when policies and interventions to address food insecurity are developed.
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, formerly known as the Food Stamp Program, and that data show that food insecurity rates are less among SNAP participants compared to eligible nonparticipants. Unlike other federal nutrition programs, SNAP is available across the entire age spectrum, and the eligibility criteria are lower for seniors.
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SPECIAL CONSIDERATIONS FOR MEETING THE DIETARY NEEDS OF VULNERABLE GROUPS Joseph Sharkey is a Professor in the Department of Health Promotion and Community Health Sciences and Founding Director of the Program for Research and Outreach-Engagement on Nutrition and Health Disparities Solutions at the Texas A&M School of Public Health. He began his presentation by defining vulnerable populations as including underrepresented groups, underserved communities, racial and ethnic minorities, immigrant groups, and refugees.
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A traditional approach to thinking about resources can include economic resources (e.g., employment, income sources, benefits) , community resources (e.g., transportation systems, neighbors, access to and availability of different types of food stores and food places, access to and use of nutrition assistance programs)
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Sharkey concluded by saying that they provide invaluable observational insights and environmental knowledge and have been key to the work he has done in South Texas and Arizona. Some of the projects Sharkey and his colleagues have conducted over the past several years include a survey of 140 seniors in two communities in South Texas to get the resident perspective, a household and resource survey of 548 people, and 14 focus groups of older adults to understand food access, food availability, and where help is needed most.
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Sharkey explained that these findings helped identify a need to develop sustainable training and education activities to reduce the risk and presence of hunger using community collaborations that integrate place, services, and population health. The driving force was to improve not only knowledge, but skills in the context of where people live.
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She explained that in this field, when people think about built environment, they mean the man-made, physical attributes of the surroundings, including structural conditions that affect walkability and recreation. The availability of health-promoting resources (food stores and playgrounds)
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Segregation, Neighborhood Poverty, and Diet Yen then presented the results of research on racial and ethnic residential segregation, neighborhood poverty, and diet biomarkers to make the point that built and social environments have effects on food intakes and that improving social environments can have positive effects on the built environments and therefore on older adults' access to healthy food (Yi et al., 2014)
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Using the Nutrition Screening Initiative's DETERMINE checklist, the nutritional risk assessment included questions about their appetite, the regularity of meals, frequency of alcoholic drinks, problems with teeth, mouth, or swallowing, difficulty paying for basics needs, the number of medications used, living alone, unexplained weight loss of 10 pounds or more, and difficulty eating, preparing meals, or shopping. The participants had a wide spectrum of social and economic 2 Independent life-space levels are levels that a person could achieve without help from another person or use of assistive equipment.
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, 16 percent had a score of 5 or greater on the Geriatric Depression Scale (indicating declines in cognitive abilities and increased depressive symptoms) , and 20 percent had no physical activity.
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75.3 ± 6.7 African American 50% Female 50% Rural Residence 51% Married 51% Education <12th Grade 20% Education >12th Grade 50% Income <$8,000/year 23% Income >$40,000/year 12% Prevalence of Common Conditions Among UAB Study Sample Hypertension 71% Arthritis/Gout 49% Gastrointestinal Disease 26% Diabetes 25% Cancer History (not including skin) 18% Cardiac Arrhythmia 14% COPD/Asthma 14% Heart Failure 13% NOTE: COPD = chronic obstructive pulmonary disease; SD = standard deviation.
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had higher baseline life-space scores. Additionally, unintentional weight loss was associated with lower baseline life-space and an accelerated decline in community mobility, independent of other factors.
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Sharkey concluded by suggesting that the biggest assets are community, neighborhoods, and families and that researchers and policy makers have a responsibility to help the community have a better situation by building on their strengths. To a question about how behavioral economics might affect food choices if preferences are established at such an early age, Locher replied that she was referring to multiple spaces, ranging from the home environment to the larger community environment as well as things that policymakers and industry do.
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Gundersen believes that these policies are another way to contribute to the debasement and marginalization of poor people. As a sociologist, Gundersen recognizes that people consume food for many reasons other than just physical nourishment, such as nourishment for the soul or as a way to express their cultural identity.
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2012. Children's very low food security is associated with increased dietary intakes in energy, fat, and added sugar among Mexican-origin children (6-11 y)
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2014. The state of senior hunger in America 2012: An annual report.
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