A Survey of the Nutritional Status of Homeless Adults in Rural Northern California

Abstract

Homelessness is a growing problem in the United States. The health and nutritional status of the homeless population is effected by limited access to regular, nutritious meals. There are few published studies evaluating the nutritional status of homeless populations and all data collected have been from urban areas. The purpose of this survey was to assess the nutritional status of homeless adults living in rural northern California. Seventy-five subjects (60 males, 15 females) were recruited from a soup-kitchen (Chico) and a homeless shelter (Oroville). The subjects were predominately white (80%), aged 20 – 66 years (mean age of 40 years), high school educated (68%), unemployed (89%), and dominated by smokers (84%). Forty-six percent of the subjects had been homeless for a year or longer. Forty-nine percent described where they sleep at night as “camping out.” Nutritional status was assessed by means of dietary intake (24-hour recall), anthropometric measures (height, weight, tricep and subscapular skinfolds), and biochemical indices (a non-fasting blood sample). Dietary intakes (mean % of the Recommended Dietary Allowances (RDAs) ± SE) of magnesium (62 ± 4), zinc (55 ± 5), calcium (58 ± 5), vitamins A (61 ± 7) and B-6 (64 ± 5) were below two-thirds of the RDA. While subjects reported consuming, on average, only 2 meals per day, their caloric and protein intakes appeared adequate (2069 ± 141kcals, 70 ± 5 g, respectively). Mean body mass index (BMI = weight (kg)/height (m)2) of the men was 24.0 ± .5 and the women 25.6 ± 1.5. Tricep and subscapular skinfold measurements were compared to reference data of the general United States population, specific for age and sex (NHANES I and II). The χ2 distributions for this population's tricep and subscapular skinfolds differed significantly (p < 0.05) from percentile distributions of the general population. Forty-one percent of the tricep and 40% of the subscapular skinfolds were below the 25th percentile. Of the 42 subjects who agreed to a blood draw, 17 had elevated cholesterol levels, 6 had low hemoglobins, 7 had low hematocrits, and 5 had low serum iron. Our results indicate that homeless adults living in rural northern California are at nutritional risk. While caloric and protein needs appear to be met, there are shortages of essential miconutrients in the diet. Long-term caloric needs of this population may also fall short as indicated by this population's depleted fat stores. Despite this finding, we detected elevated cholesterol levels in 41% of those subjects who agreed to a blood draw.