Understanding targeting in the Elderly Nutrition Program: A focus of food insecurity

This research examined whether the current concept and measures of food insecurity have utility in targeting those elderly in need of food assistance programs, particularly Elderly Nutrition Program (ENP). Both quantitative and qualitative research methods were used to address this goal. The quantitative portion of the research used secondary data analysis to examine whether food insecurity identifies the elderly in need of food assistance programs. The qualitative part of the research used open-ended and discovery-oriented interviews to understand how targeting and the need for services are perceived and operationalized in the delivery of services in ENP. Interviews were conducted with 36 local ENP providers in six counties of Upstate New York.; The current definition and measure of food insecurity used by USDA/DHHS for nutrition monitoring purposes may not be sufficient because they do not incorporate some of the unique components of food insecurity in the elderly. Specifically, the component that is missing relates to food use.; Food insecurity, even as it is presently defined, indicates those who are in need of food assistance programs. Food insecure elderly experience multiple problems that compromise their nutritional status, such as poverty, low-education, minority status, and functional impairments. Furthermore, food insecurity indicates those elderly at nutritional risk. Food insecurity was significantly associated with lower nutrient intakes and skinfold thicknesses, poorer self-reported health status, and higher nutritional risk scores. This research, however, was incapable of showing the potential to benefit from program participation among food insecure elderly due to limited data and research design.; The broadened concept of food insecurity is definitely an important indicator of need for food assistance programs in the elderly. However, even the expanded concept of food insecurity is not a sufficient indicator of service needs for the ENP. Local ENP providers' perceptions of need for services were rich and complex. Food insecurity only partially indicates those who are in need of the ENP. A holistic understanding of the living situation and the mental, physical, and medical conditions of the elderly are critical to a full understanding of nutritional risk of the elderly and to targeting decisions for the ENP.