FOOD INSECURITY AMONG OLDER ADULTS WITH A HISTORY OF INCARCERATION: A MIXED METHODS STUDY

We examined the association between history of incarceration (HOI) and food insecurity (FI) among older adults using pooled data from 12,702 respondents aged 51+ who participated in the 2012 and 2014 waves of the Health and Retirement Study. In our sample, 12.8% of participants reported FI. Those with a HOI had an increased odds of FI (OR 1.83; 95% CI 1.52-2.21). Race/ethnicity moderated the association between HOI and FI. The positive and statistically significant association was concentrated among Non-Hispanic Black and Non-Hispanic White participants. No statistically significant association was found among Hispanic participants or among those from other racial/ethnic groups. Income, depressive symptoms, and functional limitations mediated the association between HOI and FI, with the largest indirect effects observed for income. FI is an important issue among older adults with a HOI. Programs and policy initiatives to increase food access and/or improve earnings in this population may be needed.

The present study aimed to understand the relationship between need and help-seeking behaviour in older adults by examining the patterns of food insecurity and participation in food assistance programmes (FAP), i.e. the Food Stamp Program and home-delivered meals. Data from two longitudinal studies were used. The studies were designed to obtain nationally representative information on health, insurance coverage, financial status, family support systems, labour market status and retirement planning, every two years: the Health and Retirement Study (HRS, 1996-2002) and Asset and Health Dynamics Among the Oldest Old (AHEAD, 1995-2002). USA. There were 7623 participants for HRS and 3378 for AHEAD. The older adults appeared to have persistent patterns between food insecurity and participation in FAP, especially in the Food Stamp Program. More persistently food-insecure older adults had higher participation in FAP (P < 0.001). Food-insecure older adults at one time were more likely to shift from non-participation to participation in FAP the next time than food-secure older adults (P < 0.001). Regardless of previous food insecurity status, previous participants in FAP were more likely to participate subsequently. The relationship between need and help-seeking behaviour in older adults was found to follow a persistent positive pattern, determined by looking at the patterns of food insecurity and participation in FAP. Although food insecurity as a need is a good predictor of participation in FAP, it is not enough to fully predict participation in FAP. Help-seeking behaviour (i.e. previous programme participation) is also important in predicting participation in FAP.

Prior cross-sectional research has identified incarceration as a risk factor for food insecurity across the life course. However, there is a lack of longitudinal studies on the relationship between prior incarceration and food insecurity over time. This study uses biennial data across 10 time points from the Health and Retirement Study (years 2012-2022) to examine the association between prior incarceration and longitudinal trajectories of food insecurity among adults aged 55 and older in the USA (N=8229). Group-based trajectory modelling was used to assess patterns of food insecurity status over time. Multinomial logistic regression assessed the relationship between prior incarceration and food insecurity trajectory group membership. Three food insecurity trajectory groups were identified: no food insecurity (86.2%), declining food insecurity (11.0%) and chronic food insecurity (2.8%). Results from the multinomial logistic regression demonstrated that a history of incarceration was significantly associated with a higher likelihood of membership in the Declining Food Insecurity (relative risk ratio (RRR)=1.80, 95% CI 1.24 to 2.60) and Chronic Food Insecurity groups (RRR=2.14, 95% CI 1.35 to 3.39), relative to No Food Insecurity group after adjusting for covariates. However, after controlling for household income and wealth, this association was attenuated and remained statistically significant only for the Declining Food Insecurity group (RRR=1.59, 95% CI 1.06 to 2.37). A history of incarceration is associated with a greater risk of food insecurity across older adulthood, though this relationship appears to be largely due to disparities in socioeconomic status.

BackgroundStudies investigating the relationship between food insecurity and sleep among older populations are limited. This study aimed to cross-sectionally examine the associations between food sufficiency status and sleep outcomes in a nationally representative sample of older adults.MethodsOur study included 1,665 older adults (≥ 65 years), using data from the 2013 and 2014 National Health and Aging Trends Study (NHATS). Food insufficiency was determined via participants’ experience and utilization of food assistance programs (FAP). Sleep outcomes, including nighttime and total sleep hours, sleep latency, and sleep quality, were derived from self-reported data. Multivariable linear regression and logistic regression models were used to estimate the associations between food sufficiency status and sleep outcomes.ResultsIn 2013–2014, 86.1% of older adults were classified as food sufficient without FAP, 9.85% as food sufficient with FAP, and 4.08% as food insufficient. Adjusting for sociodemographic characteristics, food sufficient older adults with FAP reported more total sleep hours (\U0001d6fd = 0.31, 95% CI: -0.02, 0.64) than those participants who are food sufficient without FAP. Further adjusting for health factors, food sufficient participants with FAP had more nighttime sleep hours and greater total sleep hours compared to those participants food sufficient without FAP. Compared to those deemed as food sufficient without FAP, food sufficient participants with FAP had lower odds of having longer sleep latency (OR = 0.50, 95% CI: 0.28, 0.89), after further adjusting for physical function performance.ConclusionsAmong older adults, food sufficiency with FAP is associated with greater total sleep hours, greater nighttime sleep hours, and lower odds of longer sleep latency. Our findings may help inform nutrition food assistance programs targeting older populations.

Older adults returning to community settings after incarceration face a number of challenges, including food insecurity, difficulty finding housing, and adverse health outcomes. A number of qualitative studies have suggested poor employment outcomes among formerly incarcerated older adults; however, there have been few quantitative inquiries related to employment outcomes for these older adults. The purpose of this study was to understand associations between history of incarceration and employment outcomes among older adults. We used pooled data from the 2012 and 2014 waves of the Health and Retirement Study to examine associations between history of incarceration and employment outcomes among community-dwelling older adults aged &amp;gt;50 (n=4,985). History of incarceration and employment outcomes were assessed via self-report. While there were no associations between history of incarceration and employment status in the sample, employed older adults with a history of incarceration had more physically demanding jobs and reported more work stress and more work-related discrimination than their counterparts. They also reported less work satisfaction and less supervisor support than never-incarcerated older adults. Gender moderated the association between history of incarceration and several employment outcomes, with associations observed among women but not men. Taken together, our findings suggest that history of incarceration is associated with significant differences in employment outcomes, primarily among women. Future studies should explore factors contributing to poor employment outcomes in order to design interventions that improve outcomes in this population.

Participation in Food Assistance Programs Modifies the Relation of Food Insecurity with Weight and Depression in Elders

The goal of this study was to measure food insecurity among families with children in a low-income district of Lima, Peru and to identify the formal and informal food resources available to them that may affect their food security status. In June-July 2019, we collected data from 329 randomly selected households in Villa El Salvador (Lima, Peru). Following a mixed methods approach, we found that the percentage of households using food assistance programs (FAPs) increased with increasing levels of food insecurity, but two FAPs were heavily used by households regardless of food (in)security. The main reasons for using FAPs included financial need, already being signed up in the program, and believing that the food was of nutritional value; the main reasons for non-use were finding the program unnecessary, dislike or poor perceived quality of the food, and not being able to sign up for the program. Similarly, informal food resources, such as buying food on credit or receiving food from someone outside the household, were incrementally used with increased levels of food insecurity. Our study clarifies the relationship between level of household food insecurity and FAP use – FAPs more commonly used by food insecure households were used because of financial need, whereas the FAPs most commonly used by food secure households were those with automatic enrollment. At a programmatic level, our research highlights the need for making nutritious and preferred foods available in FAPs and standardizing the application of enrollment criteria.

Calling All House Call Patients: An Intervention for Older Adults During the COVID-19 Pandemic.

Background: Food insecurity may adversely affect cognitive function through pathways involving nutritional deficiencies, chronic stress, and comorbid health conditions, with potentially different effects across cognitive domains. Longitudinal evidence remains limited by time-varying confounding, and it is unclear whether Supplemental Food Assistance Program (SNAP) participation modifies these associations. Objectives: To examine the longitudinal association between food insecurity and cognitive function using marginal structural models (MSMs), and whether SNAP participation buffers these associations for overall cognition, episodic memory, and attention/mental processing. Methods: 30,641 adults aged ≥50 in the 1998-2020 Health and Retirement Study (HRS) contributed 156,066 person-year observations. MSMs with stabilized inverse probability of treatment weights were used to account for time-varying socioeconomic, health, and cognitive confounding affected by prior exposure. Weighted pooled linear regression models estimated marginal associations and interaction effects. Results: Moderate and high food insecurity were associated with lower overall cognition (b = -0.36 and -0.71, respectively; p < 0.001). Similar graded associations were observed for episodic memory (b = -0.22; -0.43) and attention/mental processing (b = -0.15; -0.28; all p < 0.001). SNAP participation significantly attenuated these associations across cognitive domains, with stronger buffering effects among non-Hispanic Black and Hispanic respondents. Effect sizes corresponded to differences equivalent to several years of cognitive aging. Conclusions: Food insecurity is associated with poorer cognitive function across multiple domains, while SNAP participation mitigates these associations. Despite limitations of observational data, these findings highlight the methodological value of MSMs and the potential role of food assistance programs in reducing cognitive health disparities in later life.

The number of older adults with criminal justice system involvement has increased by more than 280% since 1999. Previous studies show that justice-involved older adults have rates of chronic disease similar to those of the never-incarcerated; however, no studies have evaluated differences in disease management between groups. We examined associations between history of incarceration (HOI) and diabetes management using data from the Health and Retirement Study, a population-based sample of community-dwelling older adults. HOI was assessed via self-report. We assessed diabetes management via self-report/objective health indicators, health service utilization, and health behaviors. We used logistic and linear regression to evaluate associations between HOI and diabetes management, controlling for demographic characteristics. HOI was associated with fewer dental visits (OR: 0.069; 95% CI: 0.531, 0.917) and greater odds of insulin use (OR: 1.52, 95% CI: 1.13, 2.05), tooth loss (OR: 1.94, 95% CI 1.43, 2.65), foot swelling (OR: 1.44, 95% CI: 1.08, 1.90) and hospitalization in the last 2 years, (OR: 1.47, 95% CI: 1.12, 1.92). There was no association between HOI and other measures of diabetes management. Associations between tooth loss, dental visits, and incarceration were observed among White but not Black participants. Findings suggest that HOI may be associated with poorer diabetes management practices in some domains. Future research should identify interventions that improve diabetes-relevant outcomes among justice-involved older adults.

Objectives Previous research has found that many incarcerated individuals have mental health conditions and that incarcerated women may be at elevated risk. These individuals have been shown to experience mental health concerns shortly after their release, but little is known about their mental health later in life. This study compared depressive symptoms in older adults with and without a history of incarceration and examined the impact of gender on this relationship. Method Data from 160 pairs of adults aged 65 or older (82.5% male, mean age = 73.4 years) who participated in the 2012 wave of the Health and Retirement Study (HRS) was utilized. Older adults with a history of incarceration were matched to those without based on age, gender, race, and education level. Depressive symptoms (CES-D) of older adults with and without a history of incarceration were compared using a repeated-measures ANOVA. Results The main effect of incarceration history (p=.001, partial eta2 =.07) and the interaction between incarceration history and gender (p=.01, partial eta2 =.04) were significant. Follow-up analyses revealed that the difference between depressive symptoms for older women with and without a history of incarceration was significant (p=.02, d = 0.69), whereas the difference for older men was not significant (p=.19, d = 0.16). Conclusions Findings suggest older adults with a history of incarceration report more depressive symptoms than those without and that the effect is seen among older women. Negative effects of incarceration on mental health may therefore persist into later life, highlighting the importance of pre- and post-release mental health services.

Incarceration is linked to poor health outcomes across the life course. However, little is known whether and to what extent incarceration histories shape pain in later life. This study examines the relationships between incarceration histories and pain outcomes among middle-aged and older adults in the United States. Data from a nationally representative sample of community-dwelling adults aged 51 and over in the 2012-2018 biennial waves of the U.S. Health and Retirement Study was analyzed to examine how incarceration histories influence older adults' risks of reporting moderate-to-severe pain and pain with physical limitations. We relied on a propensity score matching approach to account for the potential confounding bias. We fit weighted generalized estimating equation models to assess the relationships between incarceration history and pain outcomes. Models were further stratified by gender. After propensity score matching, our sample included 2,516 respondents aged 65 years on average (SD = 8.72), 21% female, and 838 with incarceration histories. Persons with incarceration histories have a greater risk of reporting moderate-to-severe pain (prevalence ratio [PR] = 1.30, 95% confidence Interval [CI]: 1.20, 1.52) and pain with physical limitations (PR = 1.48, 95% CI: 1.30, 1.68) even after adjusting for sociodemographic covariates and early life experiences. In the models stratified by gender, the associations between incarceration histories and incarceration were similar among women and men. In a nationally representative sample of older adults (with or without incarceration history), our study demonstrates an independent association between a history of incarceration and pain in later life. Our findings highlight the far-reaching impact of incarceration and the need for developing optimal management strategies to reduce the burden of disabling pain. Interventions should prioritize socioeconomically vulnerable groups who may have the least access to pain treatment in later life.

Food Insecurity, Race and Ethnicity, and Cognitive Function Among United States Older Adults

Examining associations of food insecurity with major depression among older adults in the wake of the Great Recession.

Depression is a significant health concern that is yet to be recognised as an important public health challenge in India. Furthermore, given the critical condition of food insecurity among older people in India, it is likely that they are more vulnerable to depression. The interplay of depression among older people resulting from food insecurity is an under-explored phenomenon in the Indian context. Therefore, this study examines the association between food insecurity and depression among older people in India. The study used data from the Longitudinal Ageing Study in India (LASI). Food insecurity was measured with a set of questions formed into dichotomous variable and depression was measured with Center for Epidemiological Studies Depression (CES-D scale). Binary logistic regression was performed to confirm the findings. Results showed that older adults who reported food insecurity were more likely to be depressed (OR= 1.20; C.I.=1.03-1.25) than their younger counterparts. Furthermore, older adults who were independent for Activity of Daily Living (ADL) were less likely (OR= 0.73; C.I.=0.53-1.00) to report depression, whereas, female (OR= 1.12; C.I.=1.00-1.26) and never married (OR= 2.11; C.I.=1.18-3.79) older adults were more likely to be depressed than their respective counterparts. It is important to integrate mental health with food insecurity. Future studies may consider including mental health services with food assistance programs or vice versa.