Food Insecurity in Israeli Elderly is Associated with Sociodemographic Characteristics, Disability, and Depression: Policy Implications

Doris Wiesmann; Rebecca Goldsmith; Tal Shimony; Lesley Nitsan; Lital Keinan-Boker; Tamy Shohat

doi:10.1016/j.cdnut.2022.100006

Food Insecurity in Israeli Elderly is Associated with Sociodemographic Characteristics, Disability, and Depression: Policy Implications

Curr Dev Nutr. 2022 Dec 23;7(2):100006. doi: 10.1016/j.cdnut.2022.100006. eCollection 2023 Feb.

Authors

Doris Wiesmann¹, Rebecca Goldsmith², Tal Shimony³, Lesley Nitsan³, Lital Keinan-Boker^{3

4}, Tamy Shohat⁵

Affiliations

¹ Independent Consultant, Halendorf, Schönwalde, Germany.
² School of Public Health, The Hebrew University in Jerusalem, Ein Karem, Jerusalem, Israel.
³ Israel Center for Disease Control (ICDC), Ministry of Health, Gertner Institute, Sheba Medical Center, Tel Hashomer, Israel.
⁴ School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel.
⁵ School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Abstract

Background: Food insecurity (FI) and poor health can turn into a vicious cycle with detrimental effects, especially in the elderly, however, few studies have examined the relationship between FI and health in this age group.

Objectives: We investigated associations of FI with physical and mental health and health behaviors among community-dwelling elderly.

Methods: We used nationally representative, cross-sectional data from the 2014-2015 Israel National Health and Nutrition Survey of the Elderly (Rav Mabat Zahav) on FI, sociodemographic characteristics, noncommunicable diseases (NCDs), disability, self-assessed physical, oral, and mental health for 1006 individuals aged ≥65 y.

Results: FI affected 12.3% of all households with elderly and was significantly higher among late immigrants and Arabs. Bivariate associations of FI with the number of NCDs, depression, disability in all 6 domains (vision, hearing, mobility, self-care, remembering, communication), poor self-assessed physical and oral health, chewing and swallowing problems, feelings of loneliness, insufficient physical activity, and smoking were significant (P < 0.05). In a multivariable logistic regression controlling for population group, household size, age and sex, FI was significantly associated (P < 0.05) with lack of formal education (OR: 6.26; 95% CI: 1.66, 23.65), being in the lowest (OR: 23.56; 95% CI: 3.71, 149.76) or second-lowest (OR: 16.75; 95% CI: 2.68, 104.52) per capita household income quartile, having one (OR: 2.11; 95% CI: 1.05, 4.23) or several disabilities (OR: 4.04; 95% CI: 1.72, 9.45), and having ever been diagnosed with depression (OR: 3.34; 95% CI: 1.35, 8.28).

Conclusions: FI is associated with physical and mental health problems, multiple disabilities, and loneliness among Israeli elderly. Providing income support could reduce FI, and subsidized congregate and home-delivered meal services could be expanded to meet the needs of elderly with disabilities and counter social isolation. Because low education, disability, and depression are particularly prevalent among the food insecure and vulnerable groups face language barriers, assistance with applications for these services should be increased.

Keywords: Israel; Rav Mabat Zahav; USDA 6-item household food security scale; Washington Group short set of questions on disability; elderly; food security; health status.