Household Food Insecurity Among Older People in Canada: the Exploration of a Public Health Issue Rendered Invisible
Food insecurity, an issue of inadequate or insecure access to food due to financial constraints, is under-researched among older people. Of this limited literature, the relevance of aging to food insecurity remains unclear. My goals with this thesis were to: i) synthesize and critically examine the literature on food insecurity and aging; ii) contribute a profile of food insecurity among older people to the population estimates of food insecurity in Canada; and iii) examine more closely key predictors of food insecurity among older people in Canada. I undertook a scoping study, and characterized this collection of literature by methodological, empirical, and conceptual contributions. Population estimates varied greatly between studies, with an overall emphasis on individual risk and experience, alongside attempts to explicate a perceived complexity of this issue with respect to health. Of the very limited inclusion or application of theory overall, most emphasis was placed on frameworks of disease and disability, with many assumptions made about how aging relates to food insecurity. Taken together, these findings suggest a strong tendency towards biomedicalization. The two subsequent empirical studies involved the use of data from the Canadian Community Health Survey (CCHS). In the second manuscript I found the overall prevalence of food insecurity among older Canadians to be 2.4%, and using a generalized linear model in the second manuscript, I found sex, age, racial background, self-perceived health, marital status, living arrangement, and low household income to be predictive of food insecurity. In the third manuscript, logistic regression revealed that women are at greater risk of food insecurity and this inequity largely operates through household income. Younger old people were most vulnerable to food insecurity, and age modified the relationship between household income and food insecurity. In the discussion chapter I offer a brief political-historical context of hunger and aging in Canada, explore the relevance and implications of the major findings from each study, and demonstrate the connection between consistent monitoring of food insecurity in exploring the geographic heterogeneity of this issue. Overall, I argue that, like younger populations, food insecurity among older people is an income-based issue.