By Melissa Patrick
Kentucky Health News
One in six Kentuckians older than 60 have faced the threat of hunger in the past year, prompting state officials to hold the first-ever Kentucky Senior Hunger Summit Oct. 30 in Frankfort to raise awareness of the issue and to help connect people in communities to find solutions.
Shannon Gadd, commissioner of the Department for Aging and Independent Living, told Kentucky Health News that while the government can’t fully fund or supply all of the resources needed to help all of these hungry seniors, it can act as a connector and catalyst to raise awareness of the issue and to marshal resources.
“To tackle food insecurity, it will require a grassroots, community-led effort. I believe that many resources already exist and there is much great work happening,” Gadd said in an e-mail. “The first step to addressing the issue is bringing everyone to the table to discover that good work and how we can work together to tackle the problem. The summit was a kickoff and there will be more to come.”
In Kentucky, 16.6 percent of those 60 and older suffer from food insecurity, a 10% increase over the last four years. Kentucky ranks 39th for food insecurity and 46th for home-delivered meals, according to the United Health Foundation‘s annual America’s Health Rankings.
Gadd said there were 2,917 Kentucky seniors on a waiting list for home-delivered meals on June 30, the end of the 2018-19 fiscal year.
She said the need for such services is great in Kentucky because “we have a very high number of adults ages 60 and older with independent-living difficulty, which translates to a higher need for home-delivered meals and other supportive services.”
Kentucky seniors rank 49th in physical inactivity and 45th in the percentage of seniors who are “able-bodied,” according to the rankings.
Gadd said other factors to consider “include supporting an increasing 60-plus population while sustaining a decrease in funds, a previous practice of funding only hot meals rather than frozen or shelf-stable meals, and the use of multiple food providers across the state, rather than a single state contract.”
Who’s at risk and health consequences
James Ziliak, founding director of the Center for Poverty Research at the University of Kentucky, pointed out that because most seniors live on a fixed income, any increase in their out-of-pocket spending puts them at risk of becoming food-insecure.
Ziliak, who has done research on food insecurity for more than a decade, noted that poverty is a substantial factor in whether a senior is food-insecure. For example, he said seniors with incomes under the federal poverty line ($12,490 for an individual and $16,910 for a couple) are 30% more likely to have food insecurity.
The risk of food insecurity is at least twice as high for minorities, Ziliak said. After controlling for age, income and race, the risk also increases for those with less education, those who have a disability, those who are divorced or separated, those who have a grandchild living in the home. In addition, he said that seniors who self-report as socially isolated have a 50% greater risk of food insecurity.
Ziliak also presented his and Craig Gunderson’s research on the health consequences of senior hunger. Gunderson is from the University of Illinois at Urbana-Champaign.
They found that food-insecure seniors, compared to those who were food-secure, had a 60% higher risk for depression; 40% higher risk for congestive heart failure; 22% greater risk for coronary heart disease; 53% greater risk for a heart attack, and 37% greater risk for chest pain. They were also 52% more likely to report they had asthma, and 20% more likely to report fair or poor health.
“The health consequences are real,” Ziliak said. “Feeding people feeds their soul, it feeds their mental health, it feeds their physical health. We need to make sure we are doing our job.”
Feeding people can also help them live longer. A study co-authored by Ziliak and published in Health Affairs found that people in the Supplemental Nuitrition Assistance Program (SNAP, formerly known as food stamps) have 1 to 2 percentage points less risk of mortality.
Ziliak noted that Kentucky leads the nation for the number of people between the ages of 50 and 59 who are food insecure, and said this is something that Kentucky should be paying attention to.
“It’s a tidal wave coming, people,” he said. “One in five of Kentuckians between the ages of 50 and 59 are food insecure. That’s astounding. We lead the nation.”
A recent report by the Kentucky Center for Economic Policy, “SNAP is Good for Kentuckians’ Health,” cited research showing that food-insecure seniors had roughly the same quality of life as someone 14 years older — and that SNAP participation leads to a 30% reduction in the likelihood that seniors will cut back on needed medications. It also cited a 2018 study of older adults, which concluded that getting SNAP benefits was associated with a 14% reduction in hospitalization and a 10% reduction in emergency-room use.
“SNAP is a really important tool, not only in our anti-poverty, anti-hunger toolbox, but also in our public health toolbox. And I think we would do well to start thinking of that more as a public health program,” Dustin Pugel, author of the report, told Kentucky Health News.
A 2018 federal report shows food-insecure households spend about 45% more ($6,100) on medical care in a year than people in food-secure households ($4,200). And currently, the health-care costs for food insecurity in Kentucky are more than $854 million.
What can be done?
Ziliak suggested several solutions, including making sure that the 65% of seniors who are eligible for SNAP but don’t use it get signed up; making it easier for them to sign up for the program and stay on it; changing federal regulations to give seniors more SNAP benefits; and changing the rules so mobility-challenged seniors can use SNAP to buy prepared food, not just in grocery stores.
In Kentucky, SNAP recipients over 65 must re-certify every two years, but those under 65 must do so annually. In 2017, 63,000 Kentuckians over 60 years old participated in SNAP, according to KCEP.
Pugel noted that the U.S. Department of Agriculture wants to restrict people with modest savings from getting SNAP, which would result in fewer seniors qualifying for the program. “If what we’re trying to do is reduce food insecurity and improve health, especially among seniors, then that is a harmful policy; that is counterproductive to those goals,” he said.
Roger McCann, executive director at Community Action Kentucky, said he hopes society is moving to a time when people recognize that food insecurity and other social determinants, like transportation and housing, play a significant role in a person’s health and that addressing those determinants should be part of a person’s medical care. He said this holistic approach would result in better health outcomes for everyone.
For example, he said, just like a person gets a prescription for a test or a drug, patients should also get prescriptions to have healthy meals delivered to them as they recover from a procedure if they live alone. “If you don’t eat, your’re not healthy,” he said. “It is as simple as that.”
Others spoke at the conference about innovative ways to address seniors’ food insecurity, including a university program in Ohio that has a congregate meal program on its campus, and a hospital in Owensboro that donates its extra food to create frozen home-delivery meals. Gadd spoke about the need to work across state agencies to find solutions and the need to consolidate resources and to create a centralized database to help people.
State Agriculture Commissioner Ryan Quarles told the crowd that he has been working on this issue for several years through his Kentucky Hunger Initiative, a first-of-its-kind program that involves farmers, charitable organizations, faith groups, community leaders and government entities. “It affects every county, every city and every community in Kentucky,” he said.
The Aging and Disability Resource Center provides information and resources about aging and disability issues.