March is National Nutrition Month, making it the ideal time to think about nutrition and the challenges older adults can face accessing nutritious food. The issues of older adult food insecurity and related risk for malnutrition have been on the rise during the COVID-19 pandemic. Rates of food insecurity have now become substantially elevated, with Black and Latinx families facing disproportionately higher rates.
We do not yet have precise statistics on older adult malnutrition during the pandemic, but poor nutrition because of food insecurity tends to correlate with increased malnutrition risk. Clearly more needs to be done to combat these issues, including a comprehensive federal agenda for older adult nutrition.
Laying the Groundwork
Prior to the pandemic, poor nutritional status and food insecurity were growing crises among older Americans. Up to one out of every two older adults was already at risk for malnutrition. In 2018, approximately 7.3 percent (5.3 million) of those ages 60 and older in the United States were food insecure.
Congress has taken some positive steps during the pandemic to provide increased funding and flexibility for older adult nutrition programs. Most significantly, this month, President Biden signed into law the American Rescue Plan Act, which includes important funding and policies that will impact older adult malnutrition.
OAA and USDA nutrition programs do not have enough funding or support to handle the exponential increases in caseloads.
The American Rescue Plan Act added another $750 million in emergency funding for Older Americans Act nutrition programs, extended the 15 percent increase in Supplemental Nutrition Assistance Program (SNAP) benefits, and added $37 million for the Commodity Supplemental Food Program, which provides food boxes to older adults.
Building a Comprehensive Federal Agenda
A comprehensive federal agenda for older adult nutrition includes additional areas of focus, too. United States Department of Agriculture (USDA) Secretary Tom Vilsack recently stressed the importance of “nutrition security” as opposed to food insecurity. Vilsack has repeatedly underscored that it is as important to improve the way Americans eat as it is to make sure they have enough to eat.
The following are some federal policy actions that could be taken this year to build a comprehensive federal agenda and impact nutrition security and malnutrition risk for older adults:
Add a malnutrition electronic clinical quality measure to hospital inpatient quality reporting programs. The Centers for Medicare & Medicaid Services (CMS) has a program which tracks the quality of medical services Medicare beneficiaries receive in different care settings, including in hospitals. A new “global malnutrition composite score” measure would incentivize screening all older adults for malnutrition risk at hospital admission, assessing those found to be at risk, recording diagnosed malnutrition, and developing a nutrition care plan to follow patients as they transition to community or long-term care settings.
Provide increased and regular appropriations for older adult nutrition programs. Older Americans Act nutrition programs and USDA nutrition programs suffer from one major defect: they do not have enough funding or support to handle the exponential increases in caseloads and demand for services, leaving many people in need without access to these critical programs.
Pass the Medical Nutrition Therapy Act. Currently, Medicare beneficiaries only have access to coverage for medical nutrition therapy provided by registered dietitian nutritionists, if they have diabetes, renal disease, or have had a-kidney transplant. Yet the majority of older adults have chronic conditions and evidence shows their nutrition is associated with their health outcomes. The Medical Nutrition Therapy Act, which is on the brink of being reintroduced in this Congress, would add other nutrition-related conditions and diseases to this list, including malnutrition. Advocacy must begin immediately once the Act is introduced, to get this important bill passed.
Encourage and fund nutrition research in advance of the 2025–2030 Dietary Guidelines for Americans. The next iteration of the Dietary Guidelines for Americans (DGAs) will include an enhanced focus on older adult nutrition. However, it will be impossible for the DGAs to reach solid, evidence-based conclusions about older adults’ nutrition needs and dietary patterns without a solid research base. This highlights the need for immediate funding of older adult nutrition research so that studies have a chance to be completed and published prior to the 2025 DGA evidence review.
What Can You Do?
Beyond advocating for these federal policy suggestions, there are steps you can take in your community to help older adults gain nutrition security. You can assist older adults in applying for SNAP benefits—use our interactive map to find your state agency or use the Eldercare Locator to find local counselors who can assist. You can also point older adults to their local OAA nutrition programs using our map or the Meals on Wheels America program locator.
In short, there are many actions we all can take to increase nutrition security and decrease malnutrition risk in the older adult population. It starts with a comprehensive federal plan and then drawing the attention of leaders. National Nutrition Month is a great time to advocate for this change!
Meredith Ponder Whitmire is policy director for Defeat Malnutrition Today and vice president at Matz, Blancato & Associates in Washington, DC.