For Nutrition and Hydration Week, we are highlighting an ARC EoE project that is urgently addressing the growing issue of food insecurity among older adults. This study explores their access to food aid and the significant impact it has on their health and wellbeing. In this blog, the project team discusses why supporting this vulnerable group is so important and shares the key findings so far.
The project team consists of Dr. Angela Dickinson, Principal Investigator, Emilia Tylenda a Research Assistant at the ARC East of England (ARC EoE), Dr. Claire Thompson, Theme Lead of ARC EoE’s Prevention and Early Detection in Health and Social Care, Emily Barnes, a Research Assistant, and Irene McClelland a dietitian at Torbay & South Devon NHS Foundation Trust & University of Plymouth.
The UK food system has been severely impacted by the COVID-19 pandemic, geopolitical conflicts, the exit of the UK from the EU, and the cost-of-living crisis, all contributing to rising food prices and increased food insecurity. Older adults are particularly vulnerable to these challenges, as they often struggle with poor physical health, mobility issues, social isolation, and economic hardship. While each of these factors can independently hinder an individual’s ability to access nutritious food, a combination of them creates a complex barrier to maintaining a healthy diet. Funding cuts to services which have traditionally supported the food security of older people, for example, Meals on Wheels, have further exacerbated the difficult situation faced by older people who live in food poverty.
"Between the years of 2018 - 2019 and 2023 – 2024, there was a 345% increase in the number of households with pensioners that sought support from food banks. Meanwhile, non-pensioner households experienced an 81% increase during that timeframe, highlighting the disproportionate impact of food poverty on older adults."
Emilia Tylenda, Research Assistant at the ARC EoE and the study
Even though there is an increase in older people using food aid, there is limited research exploring their interactions with and their assumptions of food aid, including the challenges they face. There is a need to understand older people’s experiences of food poverty and food assistance for the public health sector to better support this often-overlooked population.
Dr. Angela Dickinson, Principal Investigator, explained the background to the study: “I have undertaken a number of studies looking at food insecurity of older people over the last decade, and ten years ago when we spoke to food banks, they told us that they very rarely saw older people. However, during the pandemic, food bank staff told us they were starting to see older people using their services. The media, as well as organisations representing food banks, also began to report on increasing numbers of older people needing support.
"It seemed timely to explore what was happening and to talk to older people and service providers about their experiences of using food aid. Prolonged food insecurity in later life can result in malnutrition, and, as one in ten older adults in the UK already experience malnutrition, any increase in food insecurity is a cause for concern.”
Dr. Angela Dickinson, Researcher at the ARC EoE and Principal Investigator of the study
Identifying the complexities of food aid for older people
To understand this growing issue, we are bringing together academics, older people and services that work with this population to explore older people’s experiences of accessing food aid and the impact of food insecurity on their health and wellbeing. The study seeks to provide a comprehensive picture of the challenges, needs, and preferences of this vulnerable demographic.
"We all know older people are particularly at risk from malnutrition. The difficulties with accessing food in our current environment are inevitably causing them problems and causing increases in hospital admissions.
Irene McClelland, Dietitian at Torbay and South Devon Health and Care NHS Trust
Irene McClelland added: "A recent article in The Guardian describes a 10-fold rise in admissions for patients with iron deficiency and a 4-fold increase in folate deficiency. This decrease in malnutrition status is often caused by poor nutritional intake, which in turn can be linked to poverty.
"A Royal College of GP members survey showed a 74% increase in presentations linked to poverty in the past year and urged the government to commit to a prevention-based approach to health to improve quality of life and alleviate pressures on the NHS. We really need our older people to have more access to healthy, nutritious food at a reasonable price and in close proximity to where they live."
Irene McClelland, Dietitian at Torbay and South Devon Health and Care NHS Trust
Initially, we conducted a scoping review of academic literature but found that research in this area in the UK was both limited and sparse. To address this gap, we broadened our search to include studies from countries within the Organisation for Economic Co-operation and Development (OECD). Additionally, we consulted with professional networks and services, including Hertfordshire County Council’s Adult Social Services, Health and Independent Living Services, and engaged experts in the field. We interviewed 18 older individuals, aged 66 to 89, to gain insights into their perspectives on the issue. We also spoke with 11 volunteers and members of staff of voluntary sector organisations to gain better understanding of food aid use by older people.
"Our findings show that food insecurity significantly affects older adults' health, social interactions, and overall wellbeing. While food aid provides nutritional and social benefits, barriers like lack of awareness, transportation issues, service inflexibility, shame and stigma hinder access. In particular, people who live in rural areas face additional challenges due to limited travel options."
Dr. Angela Dickinson, Researcher at the ARC EoE and Principal Investigator of the study
Our data also indicate a misconception that older people tend to be financially secure as they are on a regular, fixed pension. Many of our interviewees talked about how much effort they put into budgeting their money and emphasised the deeply adverse effects of any sudden changes affecting their finances, such as the recent loss of winter fuel allowance or the price increases due to the cost-of-living crisis.
For various reasons, food poverty among older adults is often an overlooked issue. One of the interviewed volunteers observed that: "Following the pandemic cost of living crisis energy surges, [a group of those older people who are just about managing] was discovered as a cohort for people that have never, never been in a system, never experienced financial hardship, wouldn't know where to start. They could be asset rich, but cash poor…I was trying to get this community centre on board to be a home and home energy support hub. A gentleman [volunteer] there said, well, we don't have poverty, so we're affluent.
"I started talking to a couple there and they were in their 80s and they had no boiler, the boiler was 47 years old. They couldn't get any help from anywhere because they weren't on pension credit, age-old story, and they were coming to the community pantry to get food and staying at the coffee morning to get a cup of coffee. He'd had a stroke and was blind in one eye.
Participant in the study who volunteered
"They were boiling kettles for hot water and it just absolutely dismayed me to think that these poor people were in that position, but because they had their property, big 4 bedroom property, they were deemed that they could cope. Quite clearly they weren’t."
Participant in the study who volunteered
Finally, our study identified the crucial role of food aid services in the lives of older individuals. For many, these services are a lifeline, providing not only essential nutrition but also offering much-needed relief from loneliness and isolation. While expressing gratitude for the support offered, several interviewees pointed out areas for improvement, particularly regarding the availability of fresh produce, culturally appropriate foods, and the accommodation of dietary restrictions. There is also a need to raise awareness of available resources, so that older people know where to turn to if they experience food insecurity.
"More people need to know about foodbanks because there are a lot of people who are struggling and it seems like it's only like a unique lot of people that know because they belong to a group. Because I was in there, a lady was telling me about some other food things all over the place."
Older person interviewed for the study
The study is funded by and collaborating with Food4Years Ageing Network, an interdisciplinary healthy ageing research network, UK Research and Innovation (UKRI) Biotechnology and Biological Sciences Research Council,
What's next?
We plan to publish several papers that explore various aspects of this issue and will submit a funding proposal for a larger-scale study. We have done a number of presentations of our findings, including to local government and have a number of abstracts accepted at academic conferences. We believe this study will have a significant impact in three key areas: addressing a substantial gap in knowledge and raising awareness of an overlooked issue, influencing policies to better support older individuals facing food insecurity, and providing evidence-based recommendations to reduce barriers to accessing food aid. Our findings could help make food assistance more flexible, inclusive, and better tailored to the specific needs of older people, ultimately leading to economic benefits, such as reduced healthcare costs.
If you are interested in learning more about this project, then get in touch with Angela Dickinson at a.m.dickinson@herts.ac.uk.
