Dr. Mithuna Srinivasan described the association between social determinants (food insecurity, loneliness, and barriers to transportation) and older adult health and discussed how food insecurity further impedes good health for those experiencing loneliness and transportation challenges.
Pooler, J. & Srinivasan, M. (2018). Does food insecurity exacerbate the association between poor health and other social determinants? Presentation at the American Public Health Association Meeting and Exposition, San Diego, CA.
Social determinants matter for health outcomes, but little is known about the role of multiple social barriers on older adult health. This study explores whether the association between two social risk factors (loneliness and transportation challenges) and health status is heightened for those who are also food insecure.
Self-reported health status and social determinants were assessed via a nationally representative survey of adults over age 50 (n=1,595). Logistic regression assessed the relationship between health status and social determinants, controlling for demographic characteristics. Interaction terms were incorporated into separate models to determine whether food insecurity modifies the association between loneliness (and transportation challenges) to health status.
Over 16% of older adults experienced food insecurity in the past year, 22% were frequently/often lonely, and 12% had transportation challenges. The odds of being in good health was lower for individuals who are food insecure (aOR 0.68, 95% CI 0.47-0.99), lonely (aOR 0.41 95% CI 0.30-0.55), and experiencing transportation challenges (aOR 0.39, 95% CI 0.26-0.57). Interaction effects suggest that food insecurity further worsens the odds of good health among older adults suffering from loneliness and transportation challenges, compared to their food secure counterparts.
Food insecure individuals faced with transportation challenges or loneliness have greater odds of poor health compared to food secure individuals with the same challenges. Given the increased risk of poor health among those facing multiple barriers, practitioners and policymakers should support and encourage programs that address multiple barriers to good health, such as home-delivered and congregate meals.