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Article Excerpt
Many elders experience hunger and food insecurity because of low incomes, limited mobility, or poor health (Cook & Brown, 1992; Cohen, Burt, & Schulte, 1993; Lee & Frongillo, 2001a; Nord et al., 2002). Food insecurity among elders contributes to poor diet and malnutrition, which exacerbates disease, increases disability, decreases resistance to infection, and extends hospital stays (Administration on Aging, 1994; Torres-Gil, 1996; Lee & Frongillo, 2001 b). Food insecurity is defined as "the inability to acquire or consume an adequate quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so" (Radimer, Olson, Greene, Campbell, & Habicht, 1992).
Food insecurity among the elderly also includes the inability to obtain and use food in the household (e.g., to gain access to, prepare, and eat available food) because of functional impairments, health problems, or lack of social support (Lee & Frongillo, 2001a). Social support affects whether an elderly person with financial or physical limitations or both experiences food insecurity. This support can result from informal social networks, such as family and friends, or more formal programs, such as food programs (Wolfe, Olson, Kendall, & Frongillo, 1996). Functional impairments, health problems, and lack of social support have significant relations with food insecurity (Burt, 1993; Frongillo, Rauschenbach, Roe, & Williamson, 1992; New York State Department of Health and Office for the Aging, 1996; Quandt & Rao, 1999; Roe, 1990; Wolfe et al., 1996). Social support and food insecurity interact in complex ways. At least partly due to methodological limitations, these interactions are neither well understood nor easy to study (Lee & Frongillo, 2001c). For example, equivocal evidence has revealed the buffering effect of social support among elders (Newsom & Schulz, 1996; Lee & Frongillo, 2001a).
For some elders, family or friends--even if needed routinely--cannot always help as planned, resulting sometimes in hunger or food insecurity. Although it is important to understand these types of situations, it is difficult to obtain adequate details about these experiences from one or even two in-depth interviews (Wolfe et al., 1996). When experiences such as these occur, participants tend to talk in general terms about what they did and suggest that they are okay. However, they often do not mention exactly what they consumed or mention the anxiety they experienced. In addition, they tend to talk more about one or two problematic times that resulted in greater anxiety or more severe food insecurity rather than including other less severe examples of lack of support or of the variability or precariousness of their support. Thus, it has been difficult to obtain the details that are needed to understand more fully the relation of social support to food insecurity in this population.
Many low-income elders also experience a monthly financial cycle that results in a food insecurity cycle--having less food insecurity and anxiety at the beginning of the month when they receive their monthly checks and experiencing greater food insecurity and anxiety at the end of the month when their money has been spent (Wolfe et al., 1996). Some low-income elders are so accustomed to this monthly cycle that they do not talk about these difficulties (even when asked) unless they happen to be interviewed during that time. It is unclear, however, how various management strategies relate to this monthly cycle.
Thus, the ways that both formal and informal social support serve to improve the food security of elders are not well understood, partly because of methodological limitations in research designs. In general, understanding the biological, psychological, and social dynamics of events, needs, practices, and help-seeking and other behaviors of elders is important...
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