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Food insecurity and multidimensional healthy aging across 31 countries: pooled longitudinal evidence from four cohorts

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  • Cui, Guanghui
  • Hu, Mingzheng
  • Tang, Kaixuan
  • Li, Shaojie

Abstract

Food insecurity is a social determinant of health, yet population level evidence on its relation to multidimensional healthy aging across countries remains limited. We pooled harmonized data from four longitudinal studies conducted in the United States, England, 28 European countries, and Mexico from 2010 to 2019, including 232,228 adults aged 60 years or older. Food insecurity was measured with cohort specific questionnaires. Healthy aging was operationalized across four domains: absence of major diseases, absence of functional limitations, no cognitive impairment, and good mental health. Within cohort associations were estimated using generalized estimating equations and combined using random effects meta-analysis. Food insecurity prevalence ranged from 0.1 % in Denmark to 31.8 % in Mexico. In meta-analysis, food insecurity was associated with lower odds of healthy aging (odds ratio 0.78, 95 % confidence interval 0.72 to 0.85). It was most consistently related to higher odds of functional limitations (odds ratio 1.29, 95 % confidence interval 1.15 to 1.45) and poor mental health (odds ratio 1.56, 95 % confidence interval 1.35 to 1.80). Regional heterogeneity was evident, with stronger associations for cognitive impairment in Europe and for functional limitations in Mexico. Associations were larger among adults younger than 75 years and among those who were physically inactive. Food insecurity is linked to worse multidimensional healthy aging. Routine screening and mitigation of food insecurity within aging and social protection programs, tailored to health system capacity and vulnerable subgroups, may help sustain healthier aging.

Suggested Citation

  • Cui, Guanghui & Hu, Mingzheng & Tang, Kaixuan & Li, Shaojie, 2026. "Food insecurity and multidimensional healthy aging across 31 countries: pooled longitudinal evidence from four cohorts," Social Science & Medicine, Elsevier, vol. 388(C).
    • Handle: RePEc:eee:socmed:v:388:y:2026:i:c:s0277953625010895
    DOI: 10.1016/j.socscimed.2025.118758
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    1. Andrew Allee & Lee R. Lynd & Vikrant Vaze, 2021. "Cross-national analysis of food security drivers: comparing results based on the Food Insecurity Experience Scale and Global Food Security Index," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 13(5), pages 1245-1261, October.
    2. Rena, Melinda & Fancourt, Daisy & Bu, Feifei & Paul, Elise & Sonke, Jill K. & Bone, Jessica K., 2023. "Receptive and participatory arts engagement and subsequent healthy aging: Evidence from the Health and Retirement Study," Social Science & Medicine, Elsevier, vol. 334(C).
    3. Elgar, Frank J. & Pickett, William & Pförtner, Timo-Kolja & Gariépy, Geneviève & Gordon, David & Georgiades, Kathy & Davison, Colleen & Hammami, Nour & MacNeil, Allison H. & Azevedo Da Silva, Marine &, 2021. "Relative food insecurity, mental health and wellbeing in 160 countries," Social Science & Medicine, Elsevier, vol. 268(C).
    4. James P. Ziliak & Craig Gundersen & Anna Vaudin, 2023. "Introduction to senior hunger special issue," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 45(1), pages 221-233, March.
    5. Tamargo, Javier A. & Cruz-Almeida, Yenisel, 2024. "Food insecurity and epigenetic aging in middle-aged and older adults," Social Science & Medicine, Elsevier, vol. 350(C).
    6. Maxwell, Daniel G., 1996. "Measuring food insecurity: the frequency and severity of "coping strategies"," Food Policy, Elsevier, vol. 21(3), pages 291-303, July.
    7. Eric T. Klopack & Eileen M. Crimmins & Steve W. Cole & Teresa E. Seeman & Judith E. Carroll, 2022. "Social stressors associated with age-related T lymphocyte percentages in older US adults: Evidence from the US Health and Retirement Study," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 119(25), pages 2202780119-, June.
    8. Penne, Tess & Goedemé, Tim, 2021. "Can low-income households afford a healthy diet? Insufficient income as a driver of food insecurity in Europe," Food Policy, Elsevier, vol. 99(C).
    9. Isabel Maia & Andreia Oliveira & Ana Cristina Santos, 2023. "Food insecurity is associated with an unhealthy lifestyle score in middle- and older-aged adults: findings from the EPIPorto cohort," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 15(3), pages 661-671, June.
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