Not Such Golden Years for Many Older Americans Because Hunger Stalks

June 13, 2016

I learned only belatedly that last month was Older Americans Month — an after-the-fact answer to why my social media accounts had so many links to posts, feature stories and the like about seniors.

We who’ve entered our supposedly golden years are, as a whole, better off than younger people, thanks mainly to Social Security retirement benefits and Medicare. But substantial numbers of us suffer hardships of various sorts. And in some cases, public programs don’t serve us as well as they could.

As followers know, I’m passionate about food. So I’ll deal here with what public programs do — and don’t — to ensure that all seniors have enough of it and of the right kinds for lives as healthy as we older folks can expect.

Seniors at Risk of Hunger, Despite SNAP

Nearly 9% of households with at least one elderly member were food insecure in 2014. These, as you probably know, were households that couldn’t always afford enough food for everyone to eat healthfully.

Elderly people living alone had a slightly higher rate of food insecurity. And 3.8% of them — about 480,000 — didn’t always have enough to eat, healthful or otherwise.

The Food Research and Action Center views such evident struggles with hunger as a symptom of “senior SNAP gaps” — gaps state agencies and community-based organizations can partially close.

Agencies, for example, can make the application process simpler by, among other things, replacing an extremely burdensome requirement to document medical expenses with a standard excess medical deduction.

Both they and community-based organizations can do targeted outreach to seniors who probably could receive SNAP benefits, but haven’t applied. We’ve long known various reasons for this that outreach can address.

Seniors don’t know they’re eligible, for example. They’d feel ashamed to receive a welfare benefit. Or they believe (wrongly) that they’d be effectively taking food away from someone needier.

But this is far from the whole story, as a U.S. Department of Agriculture analysis shows. Elderly people living alone — as the vast majority of those in SNAP do — received, on average, $119 a month in 2012-13.

That translates into about $1.30 per meal — yet another sign that SNAP benefits are too low. Too low for anyone, but for some seniors especially because they can’t stretch their benefits as the food plan USDA uses to set them assumes.

They may, for example, not have ready access to a full-service grocery store — and even more likely, not a form of transportation that would enable them to stock up on food for a week, let alone buy more of what’s on sale.

They may not have either the kitchen facilities or the capacities to prepare their meals from scratch either. But neither they nor anyone else can use SNAP benefits for carryout meals. And microwaveable meals are obviously budget-busters.

USDA cited the age-related challenges in its fact sheet for last year’s Older Americans Month. Yet only two initiatives it announced then addressed problems inherent in the food plan — both pilots, including one I’ve celebrated before.

It would perhaps enable more seniors — and people with disabilities, regardless of age — to use their SNAP benefits for home-delivered groceries. But the benefits would still reflect unrealistic assumptions.

Hunger Not Only Because of SNAP Gaps

Some seniors, of course, can’t get out and about at all — or cook food delivered to them, whether through the SNAP purchasing and delivery option or by some well-meaning relative or friend.

Meals on Wheels enables them to eat, though generally not every day, my Googling around suggests. Those who can get out and about can get meals at a community center, church or some other facility that has them eating together.

The Older Americans Act is a major source of funding for both. Congress recently reauthorized it, with some improvements in the meals portion.

That, however, doesn’t ensure any particular level of funding for nutrition assistance — or any other service state agencies can use their OAA share for. The programs get whatever Congress decides in any given year.

So they took a hit when the Budget Control Act required across-the-board spending cuts. Congress has reportedly restored what the nutrition programs lost. But they’ve gotten no increase in the past two years.

Not surprising then that communities still report waiting lists for Meals on Wheels. A genuine risk of malnutrition, it seems — and a foregone opportunity to reduce other health risks.

A recent study of that fine control-group kind found that daily home-delivered meals improved seniors’ mental health and sense of well-being more than frozen foods delivered weekly.

The Meals on Wheels group also reported falling less, suggesting potential cost-savings beyond those that simply providing enough to eat would achieve.

Further savings, of course, insofar as home-delivered meals can enable seniors to age in place, as most of us want to, rather than moving to a nursing home — at a cost so high that all but the wealthiest (or best-insured) would ultimately have to rely on Medicaid.

As more of us live longer and the costs of feeding us rise, the OAA nutrition programs will need more money to remain an effective part of the food safety net.

This is also true for other public programs that help feed low-income seniors — the Child and Adult Care Food Program, for example. The meals and snacks it subsidizes don’t make much of a dent in senior hunger — only 120,000 or so adults served and not all of them elderly.

A piece of the food safety net nonetheless — and one I would think already needs more money, given the reimbursement rates.

The bottom line here is the bottom line. Food insecurity and hunger — among seniors, children and everyone in between — is a problem Congress can solve. But it can’t without shortchanging other basic needs until it puts a higher priority on them than on reducing the deficit by spending cuts alone.

Down from the soapbox now so that I, among the fortunate, can go fix dinner. But I’ll climb back on it to take up housing — another basis need that even more seniors can’t afford.

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Home-Delivered Groceries: A SNAP Solution Who’s Time Has Come

October 29, 2015

Several years go, an online fresh food order and delivery service launched a pilot in the Bronx that enabled low-income residents to use their SNAP (food stamp) benefits for purchases and have them delivered for free.

I’m told the company — FreshDirect — views the experiment as a roaring success, presumably because the profits from the additional purchases at least offset the costs.

It’s surely a model worth further trials because it promises to reduce food insecurity and improve the healthfulness of what poor and near-poor people eat.

This is perhaps especially true for some low-income seniors and people with disabilities because getting to a grocery store — and then home with bundles of groceries — poses obvious challenges for people who can’t drive or find some helpful soul to chauffeur them.

Now there’s an opportunity for nonprofits and/or government agencies to address their problem.

Food Insecurity and Hunger

About 5.4% of people in their 60s suffer from food insecurity, according to updated (but not up-to-date) figures in an analysis for the AARP Foundation. Somewhat over 3.7% more have “very low food security,” i.e., at least sometimes don’t have enough of anything to eat.

Both rates are lower than for the U.S. population as a whole. But they still mean that about one in nine seniors who haven’t reached 70 can’t always afford “enough food for an active, healthy life.”

This doesn’t mean the rest have a healthful diet, however. As the analysts note, the questions in the survey used for food insecurity focus on financial resources. For seniors, other factors may also matter, as I suggested above.

We don’t, so far as I know, have food insecurity and hunger rates for people with disabilities. The best we’ve got come from a U.S. Department of Agriculture analysis of food insecurity among households that included a working-age adult too severely disabled for employment.

A third of them were food insecure in 2009-10. And nearly half of these included at least one member who at least sometimes went hungry.

Costs associated with disabilities help explain the extraordinarily high rates — health care and special equipment, for example, and in some cases, lower (or no) earned income by another household member because s/he had to be home to provide care.

USDA also notes other factors, e.g., insufficient Supplement Security Income and SNAP benefits. But even if SNAP benefits would cover food costs, it says, someone with a disability may face logistical challenges.

These are basically the same as those confronting seniors, who may, of course, have disabilities. Advancing age tends to bring these on us.

FreshDirect Pilot and Other Online Services

The pilot involved both some investments and approval from USDA so that the company could accept SNAP benefits as payment. It had two problems to address — one technological and one reflecting federal policy.

On the technological front, the company had to develop a way to scan the electronic benefits cards that are our modern-day equivalent to food stamps and to modify its website so that it could accept orders from people who’d pay with these cards.

On the policy front, it had to either absorb the delivery costs or charge its SNAP customers because their benefits cover only food and beverage costs.

Several other grocery companies have somewhat similar online services, though most, it seems, not free delivery. Perhaps Safeway, but only for people with disabilities and only through some direct interaction with its customers service department.

USDA Initiatives

The latest version of the Farm Bill, like the one it replaced, allows some organizations to accept SNAP benefits for home-delivered food. In mid-July, USDA proposed a rule to reflect the law.

Only government and nonprofit organizations can qualify. And they can accept the benefits only for food delivered to households headed by someone who’s at least 60 years old or disabled and “unable to shop for food,” i.e., by going to a grocery story.

Organizations can charge for delivery, but no more than $20 at any one time. They can also set an order minimum up to $50.

At the same time, USDA said it would soon seek up to 20 food purchasing and delivery services for a one-year pilot. Details yet to come. Lessons learned, it said, will help shape the final rule.

Better Than Nothing, But …

The rule USDA will issue — and thus the projects it will pilot — have limits rooted in the Farm Bill. So not everyone who could benefit will. Nor those who could as much as they might perhaps.

For example, using EBT cards to pay for home-delivered food would benefit SNAP recipients who are neither elderly nor too disabled to shop easily at a grocery store.

The CEO of FreshDirect cites “working moms.” We should also, I think, consider others who don’t drive or have someone who’ll regularly drive them for free.

Speaking from personal experience, trundling a weeks’ worth of groceries home in a cart, as I briefly had to, takes a fair amount of strength when you’re trundling on uneven brick sidewalks and across potholed streets.

And it drives up costs because it pretty well rules out economy-size packages — assuming you can’t trundle repeatedly every week. Ditto for stocking up when foods are on sale.

Potential delivery charges are problematic too. We can assume, I think, that most SNAP recipients don’t have big freezers or a lot of other food storage space. So they’d have to use a home delivery services at least several times a month.

A person with a severe disability who relies on SSI benefits receives, at most, $733 a month. And that’s often got to cover all basic living costs except food and some health care. Home delivery at the maximum allowable would even mean less money for them.

Ideally, SNAP recipients could use their benefits for home delivery charges. But merely expanding what the benefits can cover is no solution because they’re already too low — at most, only about $2.30 per meal for a single person and less than twice that for a couple.

Low for anybody, but especially for people who can’t prepare most of what they eat from scratch, as the basis for SNAP benefits assumes.

On the other hand, expecting nonprofits to swallow the costs of home delivery service seems like the sort of cost-shifting we already see, as they (and their donors) help stave off hunger among those who receive SNAP benefits, as well as those who, for various reasons, don’t.

So I would hope that state and local governments seize the opportunity to defray delivery costs. Like as not, they’d save at least as much as they spend, since regular, reasonably balanced meals help prevent — and control — a range of chronic diseases that drive up their healthcare costs.

 

 

 


More Seniors Facing Hunger Nationwide and in DC

March 17, 2014

Somewhat belatedly, I’ve come upon the National Foundation to End Senior Hunger and its latest annual report on (what else?) hunger among seniors in the U.S.

The report encompasses all seniors facing what NFESH calls the “threat of hunger,” i.e., people 60 and over who are, at best, “marginally food secure.” These are seniors who answered in the affirmative to at least one of the survey questions the U.S. Department of Agriculture uses to measure food security or lack thereof.

In 2011, there were 8.8 million seniors who did — 15.2% of the age group.

But 6.7 million of them — 11.6% of the age group — weren’t just teetering on the brink of food insecurity. They were either what NFESH terms at “risk of hunger” or “facing hunger,” i.e., sometimes didn’t have enough to eat.

The percents of seniors in these two categories were somewhat lower than what USDA reported for the U.S. population as a whole and also lower than what it reported for adults.

But while USDA’s results were statistically the same as for 2010, the percent of seniors facing hunger rose by more than 15% — to about 1.9 million.

Over the longer haul, both the risk of hunger and hunger itself have trended upward for seniors. Since 2007, when the recession set in, the number of seniors at risk of hunger increased by 49% and the number facing hunger by 48%.

Increases since 2001 were 109% and 200% respectively. The increase for the broader threat of hunger category was lower. So what we seem to be seeing is a worsening hunger situation that can’t be attributed to the economic misfortunes of the recession alone.

Both risk of and actual hunger can be attributed largely to lack of income, of course. Nearly 73% of seniors in these two categories lived below the poverty line. And of these, nearly 41% faced hunger.

As with the poverty rate itself, rates of hunger risk and actual hunger were markedly higher for blacks and Hispanics than for non-Hispanic whites.

For black seniors, the risk of hunger rate was 17.2% and the actual hunger rate 6.8%, as compared to 7.5% and 2.9% for non-Hispanic white seniors. Rates for Hispanic seniors were highest — 18.2% and just under 7%.

Rates were also very high for seniors with disabilities. About 26% were at risk of hunger, and more than 11.5% faced hunger. These figures are, in a general way, consistent with USDA’s findings on food insecurity in households with a working-age disabled member.

They’re also consistent with the extraordinarily high poverty rates consistently reported for people with disabilities in the same 18-64 age range — 27.6% in 2011, according to the Census Bureau’s Supplemental Poverty Measure. This is nearly twice as high as the rate for their counterparts without disabilities.

The NFESH hunger rates also, in a general way, correspond to poverty rates geographically. Virtually all the states with the highest hunger risk and actual hunger rates are in the South and Southwest.

The hunger rates don’t altogether track poverty rates, however. For example, the senior poverty rate in the District of Columbia was higher than in all but one state during the 2009-11 period — 23.2%, according to SPM.

Yet both the District’s risk of hunger and actual hunger rates were lower than those of all but nine states — 6.2% and 1.8% respectively.

No cause for celebration here, especially when the hunger rate is notably higher than in 2010. But the figures do suggest that efforts to enroll eligible seniors in SNAP (the food stamp program) and a robust network of emergency food programs make a difference.

They’re also a red flag, as are the nationwide figures. Last November, all SNAP recipients lost a portion of their benefits. The maximum for seniors living alone, as most in the NFESH hunger category seem to be, is now $11 a month less than it was before, leaving them with about $2.07 per meal.

Some SNAP recipients — seniors as well as others — will soon take a second hit because the new Farm Bill restricts the so-called “heat and eat” option, which the District and 15 states have used to boost the value of SNAP benefits, mainly for households whose utility costs are covered in their rent.

Six states have decided to protect their residents from the latest cut by increasing the heating assistance they provide to the $20 million the Farm Bill sets.

Seems to me that the District should do the same. Back-of-the-envelope calculation, based on the latest SNAP household figure, suggests this would cost a bit over $1.6 million a year — hardly a budget-breaker for a city that’s looking forward to more than $6.3 billion in revenues this fiscal year and nearly $6.7 billion next FY.

What NFESH reports for seniors is true for people of all ages. Food insecurity has a wide range of adverse health impacts. Bad for kids in other ways too.

Restoring SNAP benefits would more than pay off in healthcare and other savings, revenues generated by increased local spending and greater well-being for a whole lot of vulnerable people.

UPDATE: Shortly after I posted this, Stateline reported that seven states have said they will block the cuts that would otherwise result from the new “heat and eat” threshold. It says the District will as well. Responding to a survey, some unidentified source said D.C. would “find a solution,” without specifying where the money would come from.

The estimated cost is lower than what I calculated — less than $1.4 million, including what the District has been spending on “utility aid.”