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Hungry Seniors in Washington: An Update

Hungry Seniors in Washington: An Update. Washington Food Coalition Annual Conference Martha Peppones MS, RDN, CSG, CD Nutrition Director Senior Services of Snohomish County. Overview . Demographics Nutritional needs of older adults Senior hunger Impacts of hunger Solutions

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Hungry Seniors in Washington: An Update

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  1. Hungry Seniors in Washington: An Update Washington Food Coalition Annual Conference Martha Peppones MS, RDN, CSG, CD Nutrition Director Senior Services of Snohomish County

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

  3. Number of Older Americans

  4. 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/aging_statistics/Profile/2012/Index.aspx

  5. 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/aging_statistics/Profile/2012/Index.aspx

  6. 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/aging_statistics/Profile/2012/Index.aspx

  7. Nutrition & Health • Adequate nutrition is essential for • Health • Functionality • Independence • Quality of life

  8. Nutrients of concern in older adults • Energy needs • Vitamins and minerals or • Fluid • Protein

  9. Nutrient Concerns – con’t • Fiber • Vitamin D and Calcium • Vitamins B12, folic acid, and B6 • Antioxidants

  10. Factors Affecting Nutritional Well Being of Older Adults

  11. 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.aspx

  12. 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.

  13. 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

  14. Hunger is increasing….

  15. Who’s 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/

  16. 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. Doi:10.3945/jn.113.178483. 2013

  17. Impacts of food and nutrition on health AGE-RELATED CONDITIONS / DISEASES (Hearing Loss; Macular Degeneration; Destructive Joint Disease: knees and hips; Loss of Muscle Mass: Sarcopenia; Cognition / Mental Health) CHRONIC DISEASES (Heart Disease; Hypertension; Diabetes; Osteoporosis; Some Cancers: colon and breast; Arthritis; COPD; Renal Disease) ACUTE CONDITIONS (Dehydration; Pressure Ulcers; Infections; Pneumonia; Influenza; Fractures; Tooth Abscesses; Gum Disease) 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

  18. IMPACT OF MALNUTRITION ON FUNCTIONALITY Malnutrition UnderweightObesity 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 20

  19. 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

  20. SNAP and older adults

  21. 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-hunger/seniors-and-snapfood-stamps/

  22. 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

  23. 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

  24. 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

  25. OAA Home Delivered Meals • Age 60+ • Spouse of any age • Homebound • Lacking support • Unable to prepare own meals

  26. OAA Congregate Meals • Age 60+ (Native Americans, 50+) • Spouse of any age • Younger disabled person living with eligible person

  27. OAA Participant Profile • 66% - meal provides half of daily intake • Half are at nutrition risk • 84% need help with IADLs • 1:3 Meals on Wheels clients need help with 3+ ADLs and are nursing home eligible • 8% congregate, 19% HDM use SNAP • 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 (< $20,000)

  28. The problem with funding…

  29. Commodity Supplemental Food Program • Low income • Pregnant and breastfeeding women • Other new mothers <1 yr postpartum • Infants and kids up to 6 yrs • Age 60+ • Older adults have to be poorer • < 130% poverty for older adults • <185% poverty for all others

  30. 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 >518,000 per year • 96% are age 65+ • But….the quantities are often impractical for 1-2 person households

  31. 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

  32. Senior Farmers Market Nutrition Program • Goal: Help farmers and improve nutrition for seniors • Age 60+, income < 185% poverty • Washington State • Served 20,700 people in 2013 • $40/year per person

  33. 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

  34. Barriers to Participation • Lack of awareness • Reluctance to accept help • Inadequate funding of programs, wait lists • Lack of transportation

  35. 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 husband’s social security and small pension Wellman, N.S. & B. Kamp. Federal Food and Nutrition Assistance Programs for Older People. Generations. Fall. 2004

  36. BK’s Finances

  37. 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

  38. One last note on funding….. • OAA • Serves < 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

  39. 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?id=6442451115 • 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?id=8374

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