1. Methods Discussion
Examining Food Insecurity in Older African American Adults
Angelia M. Paschal, PhD, Jen Nickelson, PhD, Wanda Burton, MS, Ashley White, MPH, Carol Agomo, MPH, MBA
The University of Alabama, Tuscaloosa, AL
Introduction Results
 Food insecurity among older adults is an
ongoing national problem in the U.S. 1,2
 Food insecurity is defined as limited or
uncertain availability of nutritionally adequate
and safe foods or limited or uncertain ability to
acquire acceptable foods in socially acceptable
ways.2
 About 15% of older adults are in threat of
becoming food insecure (i.e., marginally food
insecure).3
 Alabama ranks third in the nation, with 20.34%
older adults being in threat of food insecurity. 3
 Nationally, African American older adults are
134% more likely to be at risk for food
insecurity compared to older whites.3
 The actual food insecurity rate of African
American older adults is significantly higher
than older whites (16.66% vs. 4.40%) and older
Hispanics (16.66% vs 13.26%). 6
 An objective of Healthy People 2020 is to
“reduce household food insecurity and in doing
so reduce hunger”.1
 Efforts to research and reduce food insecurity
are important steps towards meeting the
Healthy People 2020 objective.
 Special attention is also needed to address
disparities in racial and ethnic minorities.1
The purpose of this study was to examine food
insecurity in a sample of African American older
adults and to examine strategies and solutions for
improvement.
1. U.S. Department of Health and Human Services & Office of Disease Prevention and Health Promotion. (2010). Healthy People 2020. Washington, DC: Government
Printing Office. http://healthypeople.gov/2020.
2. Coleman-Jensen, Alisha, Mark Nord, and Anita Singh. (2013). Household Food Security in the United States in 2012, ERR-155. Washington, DC: U.S. Department of
Agriculture, Economic Research Service.
3. Ziliak, J. & Gundersen, C. (2013). The State of Senior Hunger in America 2011: An Annual Report. Alexandria, VA: National Foundation to End Senior Hunger.
4. Ziliak, J. & Gundersen, C. (2009). Senior hunger in the United States: differences across states and rural and urban areas. Lexington, KY: University of Kentucky
Center for Poverty Research Special Reports. January 2014 from http://www.ukcpr.org/Publications/seniorhungerfollowup.pdf
5. Economic Research Service (ERS), United States Department of Agriculture (USDA), Household food security and food insecurity measurement methods.
http://www.ers.usda.gov
6. Ziliak, J. & Gundersen, C. (2009). Senior hunger in the United States: differences across states and rural and urban areas. Lexington, KY: University of Kentucky
Center for Poverty Research Special Reports. January 2014 from http://www.ukcpr.org/Publications/seniorhungerfollowup.pdf
7. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Questionnaire, Atlanta GA: U.S. Department of Health and
Human Services, 2013.
8. Lee, J.S., Fischer, J.G., & Johnson, M.A. (2010). Food insecurity, food and nutrition programs and aging: experiences from Georgia. Journal of Nutrition for the Elderly,
29(2), 116-149.
Conclusions
Food insecurity is a public health issue that affects
many older adults. Increased attention is needed on
groups which are at higher risk. Culturally appropriate
interventions should be considered. This study has
implications for further research, health education and
health promotion strategies, and policy
recommendations.
References
 A survey was developed which included questions
about participants’ demographics, food security
status, use of assistance programs and resources,
fruit and vegetable intake, health and healthcare,
and opinions about and suggestions for strategies
and solutions.
 The 10-item USDA Food Security Module was used
to assess food insecurity.2 Other standard tools
were used for other sections and items (e.g.,
BRFSS).7
 The survey was piloted on three older African
American adults to adjust for literacy, terminology,
understanding, flow of questions, missed items, etc.
The tool was modified based on this feedback.
Included were concerns about memory recall and
types of food items used as examples.
 A convenience sample of older African American
adults were recruited from a community-based
program, Kids and Kin program. Additional
participants were recruited through word of mouth.
Participants were provided a $25 visa gift card for
participating.
 For study inclusion, participants had to be African
American, at least 65 years old, and either lived
alone, with a spouse or partner, or was head of
household (residency in group home settings
weren’t eligible).
 Data were collected in-person and via telephone.
 SPSS was used to analyze the data. Descriptive
statistics were conducted and significance was
defined as an alpha <.05. Univariate analysis and
nonparametric tests (Pearson chi-square, Fisher’s
exact test, and Kendall rank coefficient) were used
to examine statistical associations.
 Funding for the study was provided by the
University of Alabama Research Grants Committee.
 Sample size: N=52
 Demographics & Other Characteristics
 When food insecurity was present, it was either
“midrange severity”, which meant the participants or
members of their households reduced/cut the size
of their meals or skipped them or it was “most
severe” which meant someone did not eat for at
least one whole day in the past 30 days.
 Although nearly one-half used food assistance
programs & other resources in the past 30 days,
food insecurity was still present. This finding was
consistent with previous studies.6,8
 Concerning is the potential adverse affect that food
insecurity may have on participants’ chronic
diseases. About 87% had long-term illnesses.
 Inadequate & marginal health literacy rates pose
further concerns about the long-term health and
ability of food insecure older adults to access the
information & resources they need to be healthy.
 Several recommendations by participants were
noted. Further research is needed to explore these
suggestions.

Not Married

Married

< $20,00

$21-30,000

<$31-40,000
 .
 Food Insecurity and Other Factors
 Annual household income (p=.028)
 Education level (p=.022)
 Health literacy (p=.007)
 Needed dental care in past 12 months but couldn’t
afford to get services (p=.004)
 Participants’ Recommendations by Ranking
1. Increased food programs (e.g., free meal programs)
2. Outreach programs (e.g., churches could check monthly
on seniors; programs could go door-to-door to check)
3. Health literacy efforts (e.g., help seniors with paperwork
& enrollment into programs; inform about resources)
4. Increased government funds for purchasing foods
 Role of Churches by Ranking (most cited)
1. Create church-based food pantries or food banks
2. Provide food & outreach directly to elderly in community
3. Collect food or donations for church members in need
 Important factors to consider when developing
programs for older African American adults
1. Limited transportation; 2. Income; 3. Outreach; 4. Time;
5. Literacy; 6. Healthy/special foods needed;
7. Physical/health status; 8. Church involvement; 9. Others

Yes

No

Female

Male

Yes

No

Inadequate

Marginal

Adequate

College graduate

Some college or
technical school

H.S. or GED

<H.S.