Understanding the measurement of hunger and food insecurity in the elderly

The elderly are one of the population subgroups at greatest risk for hunger and food insecurity. To date, no accurate measures of this problem have been developed. What is needed are a thorough understanding of the phenomenon, and an assessment of how the elderly perceive and answer items commonly used to measure hunger and food insecurity in other subgroups. In-depth, open-ended interviews were conducted with forty-one low-income urban black and rural white residents of upstate New York. Results suggest a conceptual framework of food insecurity in the elderly with two significant differences from frameworks proposed for younger families: the major role of health problems and physical disabilities, and the impact of personal history on perceptions of food insecurity. In a telephone follow-up (approximately six months after the initial interviews) twenty-four respondents were asked commonly used food insecurity questionnaire items from six different sources. Results suggest that hunger and food insecurity among the elderly can be measured directly. The commonly used measures tested here will help categorize the stages of food insecurity. However, these direct measures might underestimate the prevalence of food insecurity because of a perceived reluctance to report problems with food.