The research: Using social science research methods, the study learns from older adults’ food routines and connects these routines to food (in)security. It looks at how rural older adults source their food - through shopping, social networks, restaurants, charity, and emergency food assistance. It also evaluates how older adults prepare food and the extent to which they source, cook, and eat on their own or with others. Some of the methods compare older adults’ routines and food (in)security before and since the COVID-19 pandemic.
Methods and timeline: The study began in 2019 with a series of ten focus group discussions with service providers and older adults in four counties of southern Indiana – Crawford, Greene, Lawrence, and Orange. In 2020, 1,400 older adults in these same counties filled out a mailed survey. In 2020 and 2021, thirty older adults provided phone interviews with researchers. Interviewees took pictures of their food routines to discuss them during the interview through an approach called photovoice. In 2021, the study is analyzing how well the U.S. Supplemental Nutrition Assistance Program (SNAP, previously known as the food stamp program) meets older adults’ dietary guidelines for chronic diseases. The study will conclude in summer 2021 by convening a series of co-design workshops with leaders and older adults in the focus counties to solidify responses and other next steps.
Preliminary findings: Older adults’ personal and social networks are a great asset for their food security and social and mental health. Family, neighbors and friends, many of whom are connected with one another, may bring food to rural older adults or drive them to get food. Interventions should recognize and build upon the immense value these networks provide. The World Health Organization emphasizes these types of “interdependence as well as intergenerational solidarity (two-way giving and receiving between individuals as well as older and younger generations)” as core tenets of healthy aging.
At the same time, rural older adults’ social networks are no substitute for formal services and networks. Our findings suggest that rural communities are in need of public and private transportation and ride-share services so that older adults who no longer drive can be mobile. (One-third of U.S. drivers are no longer driving by age 70; by age 85, most are not driving). Transportation services would not only serve to increase food security for rural older adults but also support their social interaction and community-building.
Congregate meal services of the Older Americans Act provide enormous social and nutritional value to adults age 60 and over. These meals are served on weekdays at senior centers, community centers, and senior housing communities. Although the meals are on pause during the pandemic, our findings suggest that as soon as it ends, congregate meals ought to re-open and be funded at a higher level through federal, state, and local mechanisms. Our findings match those from a national evaluation, emphasizing the major contributions that congregate meals make to older adults’ food security, their ability to continue to live at home, social and mental health, and civic society. Medical providers should refer patients who are over 60 to these meals when available and accessible.
Meal services and other food assistance programs must also consider the dietary needs of those with lactose intolerance, type II diabetes, renal disease, and other dietary restrictions. Nutritionally appropriate foods are not always available to older adults through local or federal assistance programs and are not affordable with the monetary benefits provided through SNAP. Similar to findings among other populations, preliminary results recommend increasing the SNAP budget for older adults, to prevent or alleviate dietary illnesses.
According to preliminary results from our recent survey, older adults report feeling much more isolated and lonesome since the COVID-19 pandemic began. Whereas 23% of those surveyed often or sometimes felt “left out” prior to the pandemic, 40% felt so after it began. Similarly, 22% often or sometimes felt “isolated” before the pandemic, but 63% felt isolated after the pandemic started. Additionally, 25% felt they “lacked companionship” often or sometimes prior to the pandemic, whereas 42% felt so after.
How often did/do you feel that you lacked companionship
How often did/do you feel left out?
How often did/do you feel isolated from others?
Some of the time
As Principal Investigator Professor Knudsen observes, this “jump in loneliness indicators with the onset of the pandemic is a most concerning finding and may speak to a need for a concerted mental health push this winter as winters are bad generally for seniors.” Winters are challenging because icy, snowy, dark conditions are risky to get around in, and the costs to heat one’s home and exchange holiday gifts increase older adults’ expenses. Interviews with older adults are illustrating how staying home and apart from people is separating them from many forms of support and connection, including their social networks and meals shared at houses of worship, community centers, and restaurants.
The survey further indicated that the pandemic had little influence on food security. Those who struggled with food security prior to the COVID-19 pandemic continued to do so and those that were food secure largely remained food secure. Food provisioning strategies of seniors changed significantly during the pandemic. There was a dramatic decline in the reliance on restaurants and food directly received from farmers, and a corresponding increase in provisioning from grocery stores and supermarkets, delivery services and social networks: relatives, friends and neighbors. Congregate meals shifted to grab-and-go models providing packaged food. Frequency of food shopping also changed, declining from weekly or more frequently to biweekly and monthly food provisioning.
Next steps: The study will convene co-design workshops with leaders and older adults in the focus counties to solidify responses and other next steps. The co-design workshops are anticipated to take place in summer 2021. If you might be interested in taking part in a co-design workshop, please contact us. The invitation is open.