To better understand the nature of food insecurity in the elderly and to improve its measurement, in-depth interviews were conducted with 41 urban Black and rural White elderly in 35 households, followed by telephone administration of commonly used measures of food insecurity in 24 of these elderly. Elderly food insecurity appears to follow a progression of severity, beginning with compromised diet quality, followed by food anxiety, socially unacceptable meals, use of emergency food strategies, and finally actual hunger. The five quantitative measures tested were compared to each elderly person's food insecurity status based on the in-depth interview. All measures had reasonable specificity, and good sensitivity for those experiencing severe food insecurity. However, the Cornell-Radimer, Community Childhood Hunger Identification Project (CCHIP) and Nutrition Screening Initiative (NSI) measures appeared more sensitive than the USDA food sufficiency or Urban Institute measures in correctly identifying those in the lesser stages of food insecurity.
Get full access to this article
View all access options for this article.
References
1.
Administration on Aging, United States Department of Health and Human Services, National Aging Information Center . (1994, December). Food and Nutrition for Life: Malnutrition and Older Americans (Report No. NAIC-12). Washington, DC: Administration on Aging.
2.
Anderson, S. A. (1990). Core indicators of nutritional state for difficult-to-sample populations. Journal of Nutrition, 120, 1559-1600.
3.
Burt, M. R. (1993). Hunger among the elderly: Final report of a national study on the extent and nature of food insecurity among American seniors. Washington, DC: Urban Institute.
4.
Cohen, B. E. , Burt, M. R., & Schulte, M. M. (1993). Hunger and food insecurity among the elderly. Washington, DC: Urban Institute.
5.
Cook, J. T. , & Brown, J. L. (1992). Estimating the number of hungry Americans (Working paper No. HE01-090292). Medford, MA: Tufts University, Center for Hunger, Poverty, and Nutrition Policy.
6.
Frongillo, E. A., Jr. , Rauschenbach, B. S., Roe, D. A., & Williamson, D. F. (1992). Characteristics related to elderly person's not eating for one or more days: Implications for meal programs. American Journal of Public Health, 82, 600-602.
7.
Frongillo, E. A., Jr. , Rauschenbach, B.S., Olson, C. M., Kendall, A., & Colmenares, A. G. (1997). Questionnaire-based measures are valid for the identification of rural households with hunger and food insecurity. Journal of Nutrition, 127, 699-705.
8.
Glaser, B. G. , & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.
9.
Hamilton, W. L. , Cook, J. T., Thompson, W. W., Buron, L. F., Frongillo, E. A., Jr., Olson, C. M., & Wehler, C. A. (1997). Household food security in the United States in 1995 (Executive summary, summary, and technical reports of the Food Security Measurement Project). Washington, DC: U. S. Department of Agriculture, Food and Consumer Service, Office of Analysis and Evaluation.
10.
Jobe, J. B. , & Mingay, D. J. (1990). Cognitive laboratory approach to designing questionnaires for surveys of the elderly. Public Health Reports, 105, 518-524.
11.
Kendall, A. , Olson, C. M., & Frongillo, E. A., Jr. (1995). Validation of the Radimer/Cornell measures of hunger and food insecurity. Journal of Nutrition, 125, 2793-2801.
12.
Kendall, A. , Olson, C. M., Frongillo, E. A. Jr., & Kepple, A. (1994). Validation of the Radimer! Cornell Hunger and Food Insecurity Measures: Final Project Report. Ithaca, NY: Cornell University, Division of Nutritional Sciences. (mimeograph)
13.
Lincoln, Y. S. , & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.
14.
Miles, M. B. , and Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage.
15.
Parker, S. L. (1992). A national survey of nutritional risk among the elderly. Journal of Nutrition Education, 24, 23S.
16.
Radimer, K. L. , Olson, C. M., Greene, J. C., Campbell, C. C., & Habicht, J. P. (1992). Understanding hunger and developing indicators to assess it in women and children. Journal of Nutrition Education, 24, 36S-44S.
17.
Reuben, D. B. , Greendale, G. A., & Harrison, G. G. (1995). Nutrition screening in older persons. Journal of the American Geriatric Society, 43, 415-425.
18.
Spradley, J. (1979). The ethnographic interview. New York: Holt, Rinehart & Winston.
19.
Sutton, D. , & Blizniak, P. (1995). Nutritional health of elderly New Yorkers: Selected highlights from the New York State Elderly Nutritional Survey. New York: New York State Office for the Aging.
20.
Taylor-Davis, S. A. , & Smiciklas-Wright, H. (1993). The quality of survey data obtained from elderly adults. Journal of Nutrition in the Elderly, 13, 11-21.
21.
Torres-Gil, F. M. (1996). Malnutrition and hunger in the elderly. Nutrition Reviews, 54, S7-S8.
22.
VanAmberg Group, Inc . (1994). Second Harvest: 1993 National Research Study. Chicago: Second Harvest.
23.
Wawrzynek P. A. , & Wolfe, W. S. (1989). Q-Cards: A qualitative data analysis program for the Macintosh [Unpublished software package]. Ithaca, NY: Authors.
24.
Wehler, C. A. , Scott, R. I., & Anderson, J. J. (1992). The community childhood hunger identification project: A model of domestic hunger-demonstration project in Seattle, Washington. Journal of Nutrition Education, 24, 29S-35S.
25.
Werner, O. , & Scheopfle, G. M. (1987). Systematic fieldwork. Newbury Park, CA: Sage.
26.
White, J. V. , Dwyer, J. T., Posner, B. M., Ham, R. J., Lipschitz, D. A., & Wellman, N. S. (1992). Nutrition Screening Initiative: Development and implementation of the public awareness checklist and screening tools. Journal of the American Dietetic Association, 92, 163-167.
27.
Wolfe, W. S. , Olson, C. M., Kendall, A., & Frongillo, E. A., Jr. (1996). Understanding food insecurity in the elderly: A conceptual framework. Journal of Nutrition Education, 28, 92-100.
