Information on Seniors

INTRODUCTION

There is no doubt about it – the population is aging. With more older adults in our community comes a responsibility to focus more on their needs. One of those is fighting food insecurity and hunger. Almost half (47%) of California’s elderly are unable to afford even their most basic needs¹. Limited finances and fixed incomes mean that older adults are often faced with having to choose between food and rent, heat or medicine. Even those already receiving some benefits, such as SSI or Medicare/Medi-Cal, are struggling on a daily basis to provide for themselves. The purpose of this issue brief is to address hunger as it relates to older adults, presenting both challenges and opportunities to make sure we do our part in supporting a dignified existence for the elderly.

RETHINKING HOW WE DETERMINE POVERTY AMONG THE ELDERLY

Elder Index vs. Federal Poverty Level (FPL)

Poverty is a major factor in food insecurity and hunger among the elderly. Some advocates are pushing for a new standard for measuring poverty in the elderly, known as the Elder Index.

• The creation of an Elder Index, “based on the actual cost in each county of the basic expenses needed by older adults to age independently with dignity in their own homes,”² comes in response to FPL’s out-of-date (it was developed in the 1960s) and inaccurate measure of true poverty.
• FPL is used to determine eligibility for many government programs, but it is not only outdated but national as well, meaning that poverty in Santa Clara County is legally equivalent to poverty in Jefferson County, Mississippi, where the cost of living is significantly lower. 39% of older adults in California earn more than FPL but less than the Elder Index.³
• Most government programs for older adults are available to those at 125% or less of FPL ($13,538/yr for one person).⁴ While this rule helps cover some seniors, it is not enough. Some older adults find that they earn too much to qualify for certain FPL-determinant public programs, but are not making enough to cover even their most basic needs. According to the Elder Index, a senior renting and living alone in California needs to earn at least $21,000/yr to be self-sufficient.⁵

PRIMARY RESOURCES

Senior Nutrition Program.

This is a two-part federal program, established by the Older American’s Act of 1965, divided into congregate and home-delivered meals.

• Congregate meals are offered at community centers where older adults can have a meal and social interaction.
• Meals on Wheels (MOW) delivers meals directly to the homes of those who are unable to make it to congregate meals, even if transportation were provided (such as if they were ill or frail). These programs make it convenient for homebound older adults to eat and eat healthily, as well as prevent their premature institutionalization. It is also a chance for social interaction, as the trained program staff also chat with clients, checking up on their health and well-being. The average MOW client is 83, lives alone, and has a monthly income of less than $1,000. 86% of them are assessed to be in high nutritional risk.⁶ 1 year of hot meals through MOW cost less than 1 day in an acute care hospital.⁷
• Some of the most common health issues among the elderly, including diabetes, high blood pressure, and high cholesterol, while having genetic components, can largely be prevented and treated with proper nutrition. The menus for Older Adult Nutrition Programs are monitored by registered dieticians, helping ensure that seniors receive balanced, healthy meals that meet US Dietary Guidelines. These programs are thus an important preventive measure against many health problems.

Because of the economic crisis, Second Harvest Food Bank reports that older adults are turning more than ever to emergency food pantries and soup kitchens, even though these are not traditional places for them to receive nutritional resources.

Many of these services do not have the resources to provide food for clients with diabetes or other dietary restrictions, common among the elderly.

Operation Brown Bag

Operation Brown Bag is a Second Harvest Food Bank program that provides weekly supplemental groceries to low-income older adults. Bags contain healthy foods with an emphasis on fresh fruits and vegetables. Recognizing that 125% of FPL disqualifies many seniors from much-need services, Brown Bag allows seniors earning up to 200% of FPL to participate.

For Santa Clara and San Mateo Counties (FY 2008-09):

• # of seniors served (per month): 10,219 / 4,400
• # of meals provided (per month): 5,902,405 / 172,000
• Number of sites: 57 / 24
• Increase in people served due to the economy: 8% / 17%

County Services for Older Adults

• Santa Clara County Council on Aging Silicon Valley provides a wide range of services to keep seniors, people with disabilities, and dependant adults living safely and independently.
• Aging and Adult Services of San Mateo County provides a wide range of services to keep seniors, people with disabilities, and dependant adults living as safely and independently as possible in the community.
• In-Home Supportive Services provides a variety of services to older adults and blind & disabled individuals who can not safely live at home on their own.

Supplemental Security Income (SSI)/State Supplemental Payment (SSP).

This state financial assistance is designated for low-income older adults and persons with disabilities. However, California is the only state in which seniors receiving SSI are ineligible for food stamps, the central federal nutrition program.⁸ Seniors receiving SSI are allotted a minimum of $14 per SSI payment in compensation, but it is far short of what most economically insecure seniors require to cover their nutritional needs. Having food stamps is a way of making sure low-income seniors don’t find themselves forced to choose between groceries and other basic expenses such as heat and medicine. Furthermore, the value of SSI/SSP is decreasing as the CA state government has been slow to provide cost-of-living adjustments⁹ and this year’s state budget will cut payments.

RISK FACTORS FOR FOOD INSECURITY AND HUNGER FOR OLDER ADULTS IN SANTA CLARA COUNTY

Economic insecurity increases the risk of food insecurity and hunger.

Economic insecurity among the elderly is the result of many factors, including living arrangements, gender, race, and age.

Many seniors live alone.

More than ¼ of Californians age 65+ lived alone in 2007. For LGBT elders the statistics are even more startling. LGBT seniors are twice as likely as heterosexuals to live alone and 10 times less likely to have a caretaker should they fall ill.¹⁰ Half a million older adults living alone could not make ends meet, meaning they lacked the income to pay for a minimum level of housing, food, health care, transportation and other basis expenses.

Women are more affected than men.

Of seniors living alone, 54% of women, vs. 44% of men, are economically insecure.¹¹

Race matters.

Older Latinos, African Americans, and Asian Americans are three times more likely to be food insecure than non-Latino whites. Latino elders who lived alone or lived only with a spouse had the highest rates of economic insecurity, followed by African-Americans and Asians. Non-Latino whites had the lowest rates. In CA, 76% of Latino older adults living alone have incomes below the Elder Index; the same is true for about 70% of Asian and African-American seniors.¹²

Economic insecurity increases the likelihood of health problems.

A lack of fruit and vegetable consumption, common among the economically insecure, has been associated with increased risk for cancer and other chronic diseases. Food insecurity has also been linked to diabetes and obesity. In California, almost 1 in 5 older adults is obese and almost 1 in 5 have diabetes.

*Why is diabetes such a health threat? Diabetes is the leading cause of kidney failure, adult blindness, and amputations, and is a leading contributor to strokes and heart attacks – strokes are the third leading cause of death for both men and women in the US and California. The number one killer – heart disease – can also be treated and prevented to some extent through proper nutrition, something economically insecure older adults struggle with every day.*¹³

Renters are more at risk than homeowners.

Housing is the biggest cost for most older Californians and 1/3 of elders living alone rent. Older renters are more than twice as likely to be economically insecure as those who own their homes and have paid off their mortgages.¹⁴

Risk increases with age.

Economic insecurity is more common among those 75+ than those ages 65-74.

Older adults living alone who are disabled and need long-term care are most at risk.

Throughout California, the cost of long-term care plus basic living expenses far exceeds the median income of older adults.¹⁵

Transportation & Mobility

Many older adults have difficulty reaching services in their area, increasing their likelihood of poor health, which includes everything from under-nutrition to social isolation.

• Physical impairments/ailments can prevent them from leaving the home or traveling/driving on their own, as well as creating difficulty in carrying home anything they receive at service centers, as is sometimes the case with grocery programs.
• Others find that public transportation is inaccessible or very limited where they live.
• Some can’t afford to pay for transportation.

Many simply do not know how to access services.

There is a need for better media campaigns and outreach materials to help elders know how, when, and where to receive services available to them.

The more vulnerable seniors are increasing their demographic share.

Not only are Latinos more likely than non-Latino whites to be food insecure and thus suffer from all related problems, they are also an increasingly large percentage of the senior population.

The population is aging.

This means that more people than ever are and will be seeking senior resources, which puts additional pressure on existing programs and services that are already strained by budget cuts and increases in their clientele due to the economic crisis.

By 2020, the older adult population in California is expected to grow by over 75%, reaching over 6 million individuals.¹⁶ 

Unless otherwise noted, data is courtesy of:

UCLA Center for Health Policy Research. “Half a Million Older Californians Living Alone Unable to Make Ends Meet.” Feb. 2009.

UCLA Center for Health Policy Research. “Trends in the Health of Older Californians: Data from the 2001, 2003, and 2005 California Health Interview Surveys.” Nov. 2008.

WHERE YOU CAN HELP

Tell state officials that senior nutrition programs matter.

The federal government has taken initial steps:

The American Recovery and Reinvestment Act of 2009 provides nearly $10 million of federal money to senior nutrition programs in California.¹⁷

At the same time, Brown Bag is being threatened:

Current California budget proposals include eliminating the Brown Bag Program to save $541,000, but which deprives the state of $21 million generated in food and services to the elderly.¹⁸

Inform your elected representatives about the California Elderly Economic Security Initiative.

This program “helps advocates, service providers, and policymakers improve programs and policies for California’s older adults by educating them about the Elder Index.”¹⁹ This is an important step to understanding – and responding to – the true extent of elderly poverty in Santa Clara County.

http://www.insightcced.org/communities/cfess/cal-eesi.html

Support legislation that fights hunger.

California’s state government is working to address hunger in the elderly. The Elder Economic Dignity Act of 2009 (Beall) calls on CA to track seniors in poverty using the Elder Index.

http://democrats.assembly.ca.gov/members/a24/

Participate in local initiatives.

There are many local groups that run programs for the elderly who rely on volunteers and donations to stay open, such as Second Harvest Food Bank’s Brown Bag Program.

Support for affordable housing is also important for older adults living on fixed incomes. It can increase the likelihood of being located within walking distance of grocery stores and social services, as well as having access to social interaction. It has been shown that individuals who live near supermarkets (rather than fast food outlets and convenience stores) are more likely to eat fresh produce and less likely to be obese.²⁰

CONCLUSION

The elderly are one of our most vulnerable populations and their share of the population is growing dramatically as the baby-boom generation retires. Those on limited incomes in particular should not have to make the tough – and dangerous – decisions of choosing between their medical needs, heating, social interaction, and of course, nutrition. Santa Clara County is a community wealthy enough to provide all older adults with a dignified living. It is Second Harvest Food Bank’s hope that this issue brief has served as an introductory message for the vital work that needs to be done in the area of hunger among the elderly.

DATA SOURCES

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¹The San Jose Mercury News. Almost Half of California Seniors Struggle to Survive. Feb. 24, 2009. www.mercurynews.com

²UCLA Center for Health Policy Research. Half a Million Older Californians Living Alone Unable to Make Ends Meet. Feb. 2009.

³Insight: Center for Community Economic Development. Elders Who Can’t Make Ends Meet in California. 2008. www.insightcced.org

⁴United States Department of Health and Human Services. The 2009 HHS Federal Poverty Guidelines. Feb. 2009. http://aspe.hhs.gov

⁵Insight: Center for Community Economic Development. Elders Who Can’t Make Ends Meet in California. 2008. www.insightcced.org

⁶Santa Clara County Community Benefits Coalition. Santa Clara County Community Health Assessment. 2007.

⁷The Health Trust. Meals on Wheels Brochure. 2009. www.mowsiliconvalley.org

⁸USDA. Supplemental Nutrition Assistance Program. 2009. www.fns.usda.gov

⁹Working Partnerships USA. Life in the Valley Economy: Silicon Valley Progress Report 2008. Aug. 2008.

¹⁰Health Policy Research and Newsweek Magazine. Invisible and Overlooked. September 2008.

¹¹Insight: Center for Community Economic Development. Elders Who Can’t Make Ends Meet in California. 2008. www.insightcced.org

¹²Insight: Center for Community Economic Development. Elders Who Can’t Make Ends Meet in California. 2008. www.insightcced.org

¹³Santa Clara County Community Benefits Coalition. Santa Clara County Community Health Assessment. 2007.

¹⁴Insight: Center for Community Economic Development. Elders Who Can’t Make Ends Meet in California. 2008. www.insightcced.org

¹⁵University of California Newsroom. Long-term care costs exceed yearly income for many Calif. Seniors living alone. 2009. www.universityofcalifornia.edu/news

¹⁶California Budget Project. Planning for California’s Future: The State’s Population is Growing, Aging, and Becoming More Diverse. Aug. 2008.

¹⁷The Office of Congresswoman Jackie Speier. Resource Guide to the American Recovery and Reinvestment Act of 2009. May 22, 2009. www.speier.house.gov

¹⁸California Association of Food Banks. Restore the Brown Bag Program. 2009. http://www.cafoodbanks.org/Policy_Advocacy.html

¹⁹UCLA Center for Health Policy Research. Half a Million Older Californians Living Alone Unable to Make Ends Meet. Feb. 2009.

²⁰Working Partnerships USA. Life in the Valley Economy: Silicon Valley Progress Report 2008. Aug. 2008