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.


New Evidence for Old Food Stamp Problem

December 16, 2015

A new report from the White House delivers a mixed message on the benefits of SNAP (the food stamp program).

On the one hand, as Census data and a plethora of research show, SNAP reduces poverty, food insecurity and adverse consequences of both, e.g., poor physical and mental health, problems in school, eventual dropouts.

On the other hand, many households that receive SNAP benefits year round are still food insecure — more than half, according to the latest U.S. Department of Agriculture report. And nearly half of these include at least one member who actually had to skimp on meals or skip them altogether.

Nothing fundamentally new here. What is new — at least to me — are two types of studies reinforcing other evidence that SNAP benefits are too low.

Effects on Temporary SNAP Boost

As I’ve written before, the Recovery Act included an increase in the maximum SNAP benefit a household could receive. USDA researchers looked at the impacts on food insecurity during the first year of the boost.

They found that the food insecurity rate for households eligible for SNAP dropped about 8%, while the rate rose for households with incomes somewhat above the standard maximum for eligibility.

At the same time, the very low food security rate, i.e., the percent of households where hunger was more than a risk, dropped by about 17%.

The boost thus provided roughly 530,000 more households with the resources needed to “have consistent, dependable access to enough food for active, healthy living.”

But Congress twice foreshortened the duration of the boost to help offset the costs of newer spending measures. But the effects while it lasted tend to indicate that benefits are too low — and in fact, still were while they were higher. We didn’t, after all, see anything close to a zero percent food insecurity rate for SNAP recipients then.

End-of-the-Month Effects

Several studies looked at what happens during the course of a month — from the time households receive their SNAP benefits to the time they’re due for more.

They tend to use a disproportionate share of their benefits early on, but not to stock up on non-perishables they can use to prepare meals all month long, the research indicates. Nor do they generally buy more pricey foods like fresh fruits and vegetables. So the dietary quality of what they eat doesn’t change.

They apparently just eat less over the course of a month. Their calorie consumption declines as much as 25%, according to one researcher’s estimate. But the end-of-the-month drop was less when they still had the higher Recovery Act benefits.

Though some of us may view reduced calorie intake as a good thing, it can cause serious health problems. Diabetics, for example, can suffer from dangerously low blood sugar levels when they don’t eat regularly.

So one research team looked at hospital admissions for hypoglycemia (the technical terms for a low blood sugar level) over the course of the monthly SNAP benefits cycle. They found 28% more admissions during the last week than the first.

This understates the effects of having to cut back on food, the White House report tells us. The hospital admissions don’t include treatments in emergency rooms. Nor, of course, untreated cases that can lead to more serious health problems — or even death.

Two other studies looked at children’s performance in school over the monthly benefits cycle. One found higher average math and reading test scores among children whose families had received their SNAP benefits several weeks before the tests, when the kids would have been learning what they were tested on — and probably getting prepped.

The other study focused on behavioral problems, as measured by disciplinary actions in a large public school district. It found a higher rate of disciplinary actions against children from SNAP households than others.

There could be various reasons for this, including what seems a greater readiness to suspend or expel black, Hispanic and certain other minority students who are more likely than others to have poor or near-poor parents.

But the disciplinary actions rate gap grew toward the end of the benefits month. Factoring out differences in student characteristics suggests that the late-month exhaustion of SNAP benefits causes an 11% increase in disciplinary actions against students in families that receive them.

Inferentially then, if families had larger SNAP benefits, their school-age children would do better academically and be less likely to act up in ways that deny them the chance because they’re in the principal’s office, confined to a room where they may not get taught anything or barred from the school altogether.

Root of the Problem

The White House report briefly summarizes new research indicating that the Thrifty Food Plan — the basis for determining SNAP benefits — is overly thrifty, even when households supplement them with some of their own income, as they’re expected to.

We’ve had evidence of this for some time, as followers of this blog know. We have studies of the actual costs of a TFP market basket.  We have a report from experts at the Institute of Medicine, citing, among other things, unrealistic assumptions built into the TFP.

None of this seems to make any difference. The latest Farm Bill cut SNAP benefits for 850,000 or so households — and would have been much worse if the House Republicans’ version had prevailed. So much for evidence.

The White House report nevertheless amply bolsters the case for an altogether revamped TFP — or as the Food Research and Action Center has long advocated, a switch to USDA’s cheapest food plan for everybody who doesn’t have to depend on SNAP to stave off hunger.

 

 


Brooding on My Blog’s Seventh Birthday

December 7, 2015

Yesterday was my blog’s seventh birthday. The occasion always prompts reflections, some of which I’ve shared.

I’ve spoken in the past about how things were when I launched the blog, compared to how they were when the birthday rolled round. I’ve spoken about the value of the blog as a source of discipline for learning and of relationships with advocates who inspire me — and readers who keep me going.

What’s top of mind today — and has been for awhile — grows out of the scope I carved out for the blog, but only gradually got a purchase on.

The scope is very — or one might say self-indulgently — broad, as the blog’s name indicates. It essentially licenses posts on any nexus between public policies and poverty, though as a practical matter, I’ve confined myself to the American scene.

I’ve stretched the scope as I’ve come to understand how our official poverty measure fails to do justice to the extent of economic hardship in our country.

Some of our major federal policies recognize this and so set income eligibility maximums above the federal poverty line — a simplified version of the thresholds the Census Bureau uses for the official measure.

At the same time, those income eligibility maximums vary a lot from state to state insofar as federal programs grant states flexibility.

We also see marked variations when we look at how states invest their own tax revenues in programs that provide a safety net and others that can help low-income people achieve a modicum of financial security.

States have always faced the challenges these choices reflect. They surely face them now, as they have ever since the Budget Control Act capped federal spending on non-defense programs that depend on annual appropriations.

The fact that the recent budget deal temporarily lifts the caps doesn’t relieve them from the challenges because the non-defense part of the budget includes a very wide range of programs.

Congressional appropriations committees have divvied up the new, higher spending level now. And at least on the House side, Labor, Health and Human Services, and Education — a major source of funds for programs that benefit low-income people — reportedly won’t get its fair share.

Highly doubtful that the Transportation-Housing and Urban Development budget will fully undo the damages to the federal housing voucher program or the capital fund that local agencies use to keep public housing units habitable.

Meanwhile, Congress will clearly do nothing now about a long-neglected piece of the federal budget that’s not subject to annual appropriations — the Temporary Assistance for Needy Families block grant.

It’s not only the federal government’s major share of funding for states’ TANF programs. It also determines how much of their own funds they must spend to get that share.

And as I’ve written (perhaps too often), it’s never gotten a penny more than it did the year that TANF ended welfare as we knew it. This means it’s now worth about a third less in real dollars.

Which brings me to the other nexus I’ve tried to deal with, but mostly one nibble at a time. That’s the nexus between federal policies — budgets included — and related state and local policies. These too include budgets, but not budgets only.

I’ve referred to states’ TANF policies — mainly the very low cash benefits they provide. And I’ve taken a poke from time to time at some states’ Medicaid eligibility policies.

I’ve also cited states’ varying responses to federal policy choices that can enable them to enroll more low-income people in SNAP (the food stamp program) — and qualify some of them for higher benefits.

I’ve noted disparities in minimum wages, as some states raise their minimums above the federal, while others either preserve the link or have no minimum of their own at all. I haven’t noted, but probably should have how much those higher minimums vary.

These and other such differences have made me increasingly conscious of what I think of as geographic inequality. We read a lot about income inequality — and about how children’s future financial prospects hinge so much on whom they’re born to.

But how low-income people, including children fare depends a whole lot on where they live. Part of that, of course, is that some local economies offer better opportunities than others. But a major part stems from policy choices.

I know I’m not saying anything new or original here. Only taking this occasion to say how the more I learn, the more I’m disturbed by how unfair our federal-state-local system is to so many poor and near-poor people who’ve got little, if any choice of where they live.

Not saying I’d like to see all policies determined by our federal government — surely not the one we have now. Low-income people have it bad enough already. I shudder to think how much worse off the geographically fortunate would be if left to the tender mercies of the majorities in Congress.

Won’t think because I can’t bear to what would happen to all struggling people if the next election not only sustains those majorities, but puts a like-minded candidate — or a loose cannon — in the White House.

What would a ninth birthday post look like then?

 


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.