Patterns, factors, and pathways contributing to nutritional risk among rural African American elders

In the United States, the increasing life expectancy and burgeoning older population have raised concerns about the adequate provision of health care for chronic medical conditions. One fundamental factor in the prevention and management of medical conditions is optimal dietary intake, which is notably lacking among older adults. Most researchers investigating factors associated with suboptimal diets limit their studies to developing nutritional risk profiles, and many conclude by advocating patient education. Using telephone surveys and in-depth interviews, this article identifies particularly vulnerable elders and explores the contextual and experiential pathways that place individuals at nutritional risk. Surveys of African American and white elders indicate that rural African American elders are disproportionately at risk of inadequate nutrition. In-depth interviews revealed four pathways to nutritional risk, including transitions in the social and physical significance of food, inaccessibility of resources, increased physical limitations, and inadequate or inappropriate dietary advice. Informants also identified a number of creative approaches to ensure a modicum of food security, including relying on supportive others, purchasing and preparation strategies, and hoarding. The article concludes by offering recommendations for improving nutritional status among elders that extend beyond the development of risk profiles and nutritional education.