Identifying Cofactors Contributing to Food Insecurity in Elderly Maine Residents Living at Home

Abstract Objectives The purpose of this study was to identify cofactors that contribute to food insecurity in Maine's older adults living at home, examine how the COVID-19 pandemic affected access to nutritious food, and make recommendations for program expansion and development. Methods This study was a cross-sectional survey design of older adults aged 65 years and older participating in the Meals on Wheels program in Maine (n = 58) in early 2021. Research participants were compensated with grocery store gift cards. The DETERMINE Nutrition Checklist total nutrition scores and USDA Six-Item Food Security scores were compared to self-reported access to food to see how accurately older adults view their nutritional status. Chi-squared analysis was used to examine associations among food insecurity and demographic traits. A probability of p ≤ 0.05 was chosen for significance. Results Region of residence and food security score were significantly associated; 55.2% (n = 32) of participants had scores (0–1) indicating they were food secure. One-quarter of participants had low food security, and 11 persons had very low food security. DETERMINE scores were not statistically significant for either age range or region, suggesting that risk of malnutrition functioned independently from region and age range. However, 75.9% (n = 44) of participants received scores indicating that they were at high risk of malnutrition. Only 20 persons regularly used SNAP benefits, and few people took advantage of other food programs such as the Senior Farmers Market Nutrition Program and food pantries. Conclusions Food security among Maine seniors is not necessarily related to finances, especially during the COVID-19 pandemic. The most common cofactors influencing access to food were physical access and ability, and fear or guilt of asking for help. Future work should seek to survey older adults, especially those in the most rural and impoverished counties, who are not currently using food support services such as Meals on Wheels to better evaluate food insecurity among older Maine residents. Funding Sources Maine Top Scholar Award and NIFA Hatch funds were used in this study.