Remarks from Enid Borden, president and CEO of Meals on Wheels Association of America, at the 2012 Rural Health Journalism Workshop. She focuses on the health and social implications for seniors living in rural America.
Thank you Trudy for inviting me here today and I thank the AHCJ for actually thinking about and talking about the very special health and social implications for seniors living in rural America. You have just heard from Scott about the issues confronting our friends who are vital partners in the anti-hunger movement. Scott and the food bank folks work to end hunger by providing food to those who have the capacity to seek it out. They are able to get to a food bank and receive the vital food they need. I, on the other hand, represent the population of folks who cannot do that. Senior hunger in our country is generally hidden behind closed doors. It is an urban, suburban and rural issue. In fact, rural senior hunger is often the easiest kind of hunger to hide. It resides at the end of a dead-end dirt road in the farthest reaches of backwater towns of America. Because the hunger about which I speak is hidden, it has been largely ignored.
I would like to lay out for you today a general framework of senior hunger based on the research that my organization, the Meals On Wheels Research Foundation, underwrote in order to really understand the facts about the pervasiveness of senior hunger.
Before I do, let me explain who “we” are and what “we” do. The programs that are called Meals On Wheels are local, community-based Senior Nutrition Programs that operate in all 50 states. In fact, there are approximately 5000 Meals On Wheels programs across the country. These local programs provide in excess of 1 million nutritionally balanced meals each day to seniors in need. The programs are for people who are 60 years of age and older and are considered homebound. They cannot get out of the house to shop and they have a difficult time cooking and bathing and performing other activities of daily living. As impressive as the daily delivery of 1 million meals is, it does not even begin to scratch the surface of the growing need.
I am speaking about a mater that rarely finds its way onto the front pages of any newspaper in this land but that exists in each and every community across this great nation … and that will, if we don’t address it, only worsen.
So, let’s talk about the research that I mentioned. On May 3, we released our annual research study on the state of senior hunger in America. The research, based on federal data sources, was conducted by Dr. James Ziliak, of the University of Kentucky Center on Poverty and Dr. Craig Gundersen at the University of Illinois. Doctors Ziliak and Gundersen have conducted previous research studies for us. The findings of the first report shocked us. It told us that in America in 2005 there were 5 million seniors, or just over 11%, facing the threat of hunger. That was one in nine seniors. That was shocking and unacceptable.
In 2009, we asked the researchers not only to update the national figures but also to take a look at state-by-state senior hunger rates. We identified what we termed the Top 10 hunger states, that is those with the highest rates of hunger among their senior populations. And we identified risk factors.
The report we issued just a few weeks ago found a great many similarities to the previous reports we issued: for example, those seniors most likely to face the threat of hunger:
- Live in states in the South and Southwest
- Are racial or ethnic minorities,
- Have lower incomes,
- And are younger seniors (ages 60-69).
The biggest difference in 2010 (the most current year about which data is reported) is that the number of seniors who face the threat of hunger has grown to 8.3 million. That is exponential growth since 2005, and it far outpaces the growth of the senior population itself. That 8.3 million represents 14.85% of the senior population in America. That is more than one in seven.
Between 2001 and 2010, that is, in less than a decade we have seen a 78% growth in the number of seniors facing the threat of hunger in America. That is the national average for all seniors. For African-American seniors the rate of increase was 132%; for Hispanics, 131%.
The greatest growth in senior hunger between 2009 and 2010 was among whites, those living in rural areas, women, and the near poor – those with incomes between 100 and 200% of the federal poverty level.
And what about the health consequences of senior hunger? We know that seniors who are hungry or experiencing some form of food insecurity are significantly more likely to be in poor or fair health. And, because many of these seniors are poor or near poor they are less likely to be able to see a doctor or use prescription medications. Or, more likely, they are in a position to have to choose between food and medicine. These same seniors are also more likely to have activities of daily living limitations. In fact, the effect of being a senior at risk of hunger has been found to have the same chance of an ADL limitation as someone 21 years older. This means that there is in effect a large disparity between actual chronological and “physical” age, so that a 60 year old senior suffering from hunger is likely to have the ADL limitations of an 81 year old.
87% of older Americans have a chronic disease that can be improved through nutrition.
I could go on and on with statistics about the problem of senior hunger. I’m not a statistician or an economist, I’m not even good balancing my own checkbook. That’s not who I am. I am instead trying to be the voice of those homebound seniors who have lost their voice. They don’t vote so often times they seem not even to count.
The latest numbers from the U.S. Census, for example, were interesting discussion points for us. Their SPM (or Supplemental Poverty Measures) showed that real poverty among seniors had been dramatically underestimated by the conventional decades-old standard. It was an important day for us. The data at last confirmed what those of us who touch the hidden poor and hungry have known for decades now about the magnitude of the hungry poor senior population in America. Ironically, the SPM didn’t change today’s reality one bit. But by translating the reality of people into data and statistics and official measures that policymakers tend to rely on when creating or changing programs or directing resources to them, the SPM may have provided the platform for changing tomorrow’s reality. That is my hope. And that is why this discussion is so important. Unlike other segments of the population, once the elderly fall into poverty, they are much more likely than any other cohort to remain in poverty. Their options are limited. Good times are rarely around the corner.
One final point I need to make is one that Trudy asked me to touch upon. And that is what are the political issues around all this. I always hesitate to talk politics because as a non-profit I really can’t. I will, however, tell you that we have become somewhat of a political football when Members of Congress discuss budget cuts. We are always a topic of discussion when one side or the other wants to make a point. When budgets are threatened to be on the chopping block it is a very compelling argument that Members make about having to cut Meals On Wheels. Who, they say, would ever want to take food out of grannie’s mouth? And yet, where is that courage when it comes to adding money to a program that saves lives and saves money. You see, I can feed a senior for one year for the cost of one Medicare day in a hospital. We keep people in their own homes and out of institutions. We provide them more than just a meal. We provide them with sustenance and nourishment and ensure that their health doesn’t deteriorate. And when we see that they need other services, we help get them those community services before they need to be institutionalized, thus costing hundreds of thousands of dollars.
What is lacking in the discussion of ending senior hunger is courage. We need the courage to shine a bright light on the issue of every aspect of hunger in America. We can’t talk about hunger and not talk about senior hunger. We must tell the story of those who raised us and now are too ashamed to tell us they need us. We must talk about the 87-year-old African American woman who lives on a pig farm in rural Arkansas whose only visitor she ever sees is her Meals On Wheels volunteer and who lived to bury all of her 12 children. We must speak out for the 64-year-old former truck driver who lives in a trailer in Appalachia and whose body is so riddled with cancer that the only thing that keeps him alive is the pureed meals he receives from his MOW volunteer. The food is pureed so that he can swallow it. The cancer has literally eaten away at his esophagus.
These are the teachers who taught us and the farmers who tilled the soil. These are Americans and they need their stories to be told. I am so thankful to you for inviting me here to begin to tell you a little about their lives and their circumstances.
