The Causes, Consequences, and Future of Senior Hunger in America

Hunger due to limited economic resources is a serious threat facing hundreds of thousands of seniors in America. In 2005, 1.8 percent of persons over the age of 60 suffered from very low food security (hunger); among persons with incomes below 130 percent of the poverty line the figure is substantially higher - 5.9 percent. Despite this serious public health threat facing our country, we know very little about hunger and its consequences for the well-being of seniors, or what will happen in the next twenty years with respect to hunger among senior Americans. Our limited understanding hampers organizations like the Meals-on- Wheels Association of America Foundation (MOW AAF) as they seek to address Senior Hunger in America. To expand our understanding, this project addresses the following broad questions: What is the extent of hunger among the elderly across the United States? While annual reports on food insecurity report the proportion of elderly persons suffering from hunger, no research has examined the status of the elderly at more disaggregated levels. These disaggregated levels seem particularly important - disaggregated displays of hunger in the United States have found high levels of hunger among some groups (e.g., single parents with children) alongside low levels among other groups (e.g., married couples with children). We may expect to see similar differences among seniors once we examine subgroups by age, race/ethnicity, marital status, and geography. Understanding the prevalence of hunger across elders is especially important to the MOW AAF as they seek to distribute a limited amount of funding to address programmatic needs. To examine this question for MOW AAF, we will use data from the Core Food Security Module (CFSM) included in the nationally representative Current Population Survey (CPS) from 2001 to 2006. We use this data set for this portion of the project since it (a) is the data used to calculate the official hunger statistics in the U.S. and (b) allows us to look at multiple years in order to increase the sample size, especially for groups with limited representation in national surveys. The deliverab1es for this portion of the analysis will include tables and figures of hunger by age, race/ethnicity, and marital status, along with maps of hunger prevalence across regions of the United States. What are the causes and attendant nutrition, health, and economic consequences of senior hunger? An extensive literature has emerged which examines the causes of food insecurity and hunger in the general population and the nutrition and health consequences of food insecurity and hunger for the general population. There has, however, been very little work on these topics for seniors. And what work has been done has used smaller-scale cross-sectional datasets, hunger measures other than the official measures used by Federal government, or both. This limits the ability of MOW AAF to effectively ascertain who among seniors are most likely to suffer from hunger and how and why hunger matters for seniors. This then constrains the association's ability to fully articulate to potential funders why Senior Hunger in America is a serious problem. In this project we use the CPS to analyze the causes of hunger among seniors. To analyze the consequences of hunger on the well being of elders we use two large-scale nationally-representative data sets - the Panel Study of Income Dynamics (PSID) and the National Health and Nutrition Examination Survey (NHANES). Both data sets have extensive information on the demographic characteristics of individuals and households and the food insecurity status of households (from which it is possible to delineate hunger). We use two data sets in order to exploit the key advantages of each. The NHANES has an especially rich set of questions across a wide variety of health-related outcomes including those thought to be most affected by hunger. Especially relevant for this project are the questions on nutrient intake. While the PSID does not include as rich a set of questions on nutrient intake as the NHANES, it does have the central advantage of being longitudinal (since 1968). In addition, it has high quality data on the income and wealth status of families, and special supplements were added to the 1999, 200 I, and 2003 surveys addressing physical and emotional health. As a consequence, along with opening up a wider array of statistical techniques, with the PSID we can then understand how changes in hunger status can influence health and economic outcomes. What is the fi/ture of hunger among the elderly over the next 20 years? The proportion of elders in the American population will increase at a much faster rate than other age groups over the coming decades. Along with increasing in numbers, there will be a sharp increase in the proportion of elders who are older, in particular those over the age of 85. This age group is currently about 3 million; by 2050, it is estimated that over 19 million Americans will be in this category. MOW AAF is particularly interested in this group since a disproportionate number of meals distributed by MOW AA go to these older Americans. Using cohort analyses based on the income and demographic profiles of to day's elderly five, ten, fifteen, and twenty years in the past, we will make projections into the future based on several different assumptions. For this analysis, we will again use data from the 2001-2006 CFSM in the CPS, supplemented with information from the March CPS from 1980-2006.