Food Insecurity and Perceived Diet Quality Among Low-Income Older Americans with Functional Limitations

Abstract

ObjectiveTo evaluate how functional limitations are associated with food insecurity and perceived diet quality in low-income older Americans. DesignNationwide repeated cross-sectional surveys regarding health and nutritional status. SettingThe National Health and Nutrition Examination Surveys, 2007–2008, 2009–2010, and 2011–2012. ParticipantsIndividuals aged ≥65 years with household incomes ≤130% of the federal poverty level (n = 1,323). Main Outcome MeasuresDependent variables included dichotomous indicators of food insecurity and poor-quality diet, measured with the household food security survey module and respondents' own ratings, respectively. Independent variable was presence of limitations in physical functioning. AnalysisWeighted logistic regressions with nested controls and interaction terms. ResultsFunctional limitations in low-income older adults were associated with 1.69 times higher odds of food insecurity (P < .01) and 1.65 times higher odds of poor-quality diet (P < .01) after accounting for individuals' health care needs and socioeconomic conditions. These associations were greatest among those living alone (odds ratio = 3.38 for food insecurity; 3.07 for poor-quality diet; P < .05) and smallest among those living with a partner. Conclusions and ImplicationsLow-income older adults who live alone with functional limitations are exposed to significant nutritional risk. Resources should be directed to facilitating their physical access to healthful foods.