Hungry Seniors in Washington: An Update

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Hungry Seniors in Washington An Update

• Washington Food Coalition
• Annual Conference
• Martha Peppones MS, RDN, CSG, CD
• Nutrition Director
• Senior Services of Snohomish County

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Overview

• Demographics
• Nutritional needs of older adults
• Senior hunger
• Impacts of hunger
• Solutions
• Food assistance programs
• Other types of assistance
• Resources

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Number of Older Americans
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Older Americans in Poverty

• 8.7 live below FPL
• 15 are below the Supplemental Poverty Measure
• Considers regional variations of housing costs,
  non-discretionary expenditures, medical
  out-of-pocket expenses

Source Administration on Aging. A Profile of
Older Americans 2012 http//www.aoa.gov/aoaroot/a
ging_statistics/Profile/2012/Index.aspx
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Older Americans in Poverty

• Racial/ethnic
• 6.7 of elderly whites
• 17.3 of elderly African Americans
• 11.7 of elderly Asians
• 18.7 of elderly Hispanics

• Gender
• 10.7 women
• 6.2 men

Source Administration on Aging. A Profile of
Older Americans 2012 http//www.aoa.gov/aoaroot/a
ging_statistics/Profile/2012/Index.aspx
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Older Americans in Poverty

• Living arrangements
• 5 living with families
• 16.5 living alone
• Location
• 11.7 in principal cities
• 10.1 South

• Highest poverty rates
• Hispanic women who live alone (38.8)
• African American women living alone (32.2)

Source Administration on Aging. A Profile of
Older Americans 2012 http//www.aoa.gov/aoaroot/a
ging_statistics/Profile/2012/Index.aspx
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Nutrition Health

• Adequate nutrition is essential for
• Health
• Functionality
• Independence
• Quality of life

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Nutrients of concern in older adults

• Energy needs
• Vitamins and minerals or
• Fluid
• Protein

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Nutrient Concerns cont

• Fiber
• Vitamin D and Calcium
• Vitamins B12, folic acid, and B6
• Antioxidants

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Factors Affecting Nutritional Well Being of Older
Adults
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Washington Report Card for Health

• 42.7 report having a disability
• 60 are not eating recommended 2 servings of
  fruit per day
• 70 not eating 3 servings of vegetables per day
• One in four older adults are obese
• 32 older adults have lost 5 natural teeth

Source The State of Aging and Health in America
2013 CDC http//nccd.cdc.gov/DPH_Aging/default.as
px
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Senior hunger the 2011 numbers

• National
• 4,800,000 at risk of hunger (8.4)
• Washington State
• 7.6 at risk of hunger

SOURCE Ziliak, J. Gundersen, C. (2013).
Spotlight on Food Insecurity among Senior
Americans 2011. University of Kentucky and
University of Illinois.
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Hunger will continue to increase

• The senior food insecurity rate has more than
  doubled since 2001
• 10,000 adults will turn 65 every day until 2030

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Hunger is increasing.
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Whos more likely to be hungry?

• Poor, near poor (up to 200 FPL)
• African American (17), Hispanic (18)
• Single widowed, divorced
• Unemployed

• Younger than 74 especially 60-64
• Disabled
• Female
• Living with grandkids
• Lives in southern US

Being food insecure is like being functionally 14
years older.
Ziliak et al. Causes, Consequences Future of
Senior Hunger in America, Meals on Wheels
Foundation. March 2008. www.mowaa.org/
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Chronic illness and food insecurity

• 80 of older adults have one chronic condition
• 50 have at least two
• Increased number of chronic conditions related to
  higher level of food insecurity
• Additional health care costs
• Limited ability to manage with scarce resources

Tarasuk V, et al. Chronic Physical and Mental
Health Conditions Among Adults May Increase
Vulnerability to Household Food Insecurity. J
Nutr. Doi10.3945/jn.113.178483. 2013
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Impacts of food and nutrition on health

• POOR DIETS

WITHOUT ADEQUATE HEALTHY, SAFE FOOD AND
NUTRITION SERVICES
Low stamina
Slower recovery
Longer hospital stays
Sleep disturbance
Hospital readmission
Premature institutionali-zation
Depression anxiety
Increased morbidity mortality
Poor appetite
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IMPACT OF MALNUTRITION ON FUNCTIONALITY
Malnutrition Underweight Obesity
Limits Muscle Strength
Reduces Stamina
Prevents Physical Activity
Decreases ability to Perform ADLs IADLs Eat,
Walk, Grocery Shop, Prepare Meals Grip Items
Lift Heavy Objects
Increases Dependency
Increases Need for Caregiver Assistance Increases
Risk for Falls Fractures
Threatens Independence Reduces Quality
of Life Increases Healthcare Costs
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Solutions?

• Access to coordinated, comprehensive food and
  nutrition services
• Federal food and nutrition programs
• SNAP
• OAA
• CSFP
• CACFP
• SFMNP
• TEFAP - Local food banks and pantries

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SNAP and older adults
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Barriers to SNAP participation

• Perceived low benefits
• In 2009, actual monthly benefit for 60 was 102
• Less aware of eligibility requirements
• Stigma
• Mobility/technology

http//frac.org/initiatives/addressing-senior-hung
er/seniors-and-snapfood-stamps/
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Older Americans Act Nutrition Programs

• Established 1965, Nutrition added 1972
• No income requirements need based
• Age 60
• Targeted to those with highest needs
• Greatest social and economic need
• Low income minorities
• Rural
• Limited English speaking

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More than a meal.

• Nutrition Services includes meals, nutrition
  screening, assessment, education, Medical
  Nutrition Therapy to older adults and caregivers
• Socialization and access to services
• Promote independence.Aging in Place

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OAA Purpose

• Reduce hunger and food insecurity
• Promote socialization of older individuals
• Promote the health and well-being of older
  individuals through disease prevention and health
  promotion services

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OAA Home Delivered Meals

• Age 60
• Spouse of any age
• Homebound
• Lacking support
• Unable to prepare own meals

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OAA Congregate Meals

• Age 60 (Native Americans, 50)
• Spouse of any age
• Younger disabled person living with eligible
  person

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OAA Participant Profile

• 61 live alone
• 73 age 75
• 29 rate own health as poor
• 58 HS grad, 7 college
• One-third at or below poverty level 85 low
  income (lt 20,000)

• 66 - meal provides half of daily intake
• Half are at nutrition risk
• 84 need help with IADLs
• 13 Meals on Wheels clients need help with 3
  ADLs and are nursing home eligible
• 8 congregate, 19 HDM use SNAP

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The problem with funding
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Commodity Supplemental Food Program

• Low income
• Pregnant and breastfeeding women
• Other new mothers lt1 yr postpartum
• Infants and kids up to 6 yrs
• Age 60
• Older adults have to be poorer
• lt 130 poverty for older adults
• lt185 poverty for all others

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Commodity Supplemental Food Program

• Food packages include
• Infant formula and cereal
• NFDM and UHT fluid milk juice
• Cereals, rice, pasta
• Peanut butter, dry beans
• Canned meat/poultry/fish
• Canned fruits/vegetables

• In 36 States and 2 Tribal Organizations
• Serves gt518,000 per year
• 96 are age 65
• But.the quantities are often impractical for 1-2
  person households

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Child and Adult Care Food Program

• Low income children
• Functionally impaired adults or age 60
• Serves 3.2 M children, 112,000 adults
• Reimbursement tiers as in free/reduced/full
  school meals
• Federally regulated, State administered

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Senior Farmers Market Nutrition Program

• Goal Help farmers and improve nutrition for
  seniors
• Age 60, income lt 185 poverty
• Washington State
• Served 20,700 people in 2013
• 40/year per person

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TEFAP

• 3 million seniors served by Feeding America
• 18.6 households have 1 member age 65
• Difficult choices
• 30 chose between food and medical care
• 35 chose between food and paying for
  heat/utilities

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Barriers to Participation

• Lack of awareness
• Reluctance to accept help
• Inadequate funding of programs, wait lists
• Lack of transportation

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Getting By with Federal Nutrition Assistance

• BK - 79 years old
• Widow
• Generally good health, overweight, hypertensive,
  arthritis
• Worked part-time
• Lives alone, has children who live near by
• Relies on husbands social security and small
  pension

Wellman, N.S. B. Kamp. Federal Food and
Nutrition Assistance Programs for Older People.
Generations. Fall. 2004
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DESCRIPTION Monthly Income Monthly Expenses
Social Security 920
Widows Pension 420
Rent 600
Food 155
Utilities 120
Misc., transportation, clothing, etc. 80
Health insurance 157
Drugs/Medications 80
Medical Services 50
Medical Supplies 14
BALANCE 84
FEDERAL NUTRITION ASSISTANCE FEDERAL NUTRITION ASSISTANCE FEDERAL NUTRITION ASSISTANCE
OA Nutrition Programs Value of meals 100
Food Stamps 50
CSFP Actual retail value generally higher 17
SFMNP 40 annual benefit divided by 12 3
TOTAL VALUE 170
BKs Finances
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Other services available

• Senior Information and Assistance/Referral
• Connects older adults to services
• SHIBA
• Information about affordable health care
• Elder Abuse Prevention
• Call your local Area Agency on Aging or use the
  Eldercare Locator 800-677-1116

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One last note on funding..

• OAA
• Serves lt 5 of older adults
• 125 M in 1975
• 816 M in 2012
• 7-fold increase

• WIC
• Serves 53 of all infants born in the US
• 20.6 M in 1974
• 7.1 B in 2012
• 344-fold increase

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Nutrition and Aging Resources

• US Administration on Aging
• www.aoa.gov
• www.gpra.net
• Food and Nutrition Programs for
  Community-Residing Older Adults
• Position of the American Dietetic Association,
  the American Society for Nutrition, and the
  Society for Nutrition Education March 2010
• http//www.eatright.org/About/Content.aspx?id6442
  451115
• Position of the Academy of Nutrition and
  Dietetics Food and Wellness for Older Adults
  Promoting Health and Wellness 2012
  http//www.eatright.org/About/Content.aspx?id8374
  

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