Wolfe Wendy S, Frongillo Edward A, Valois Pascale
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853-6301, USA.
J Nutr. 2003 Sep;133(9):2762-9. doi: 10.1093/jn/133.9.2762.
A full conceptualization of the elderly food insecurity experience has been lacking, leading to limitations in the definition and measurement of food insecurity in elders. Based on the qualitative analysis of two in-depth interviews 6 mo apart with each of 53 low income urban elders, using principles of grounded theory, the experience of elderly food insecurity was shown to have four components: quantitative, qualitative, psychological and social. The inability to obtain the right foods for health is a new element specific to elders. Common to each of these components were dimensions of severity, time and compromised food choice. Although money is a major cause of food insecurity, elders sometimes have enough money for food but are not able to access food because of transportation or functional limitations, or are not able to use food (i.e., not able to prepare or eat available food) because of functional impairments and health problems. These findings suggest that augmentation of the U.S. Household Food Security Survey Module (FSSM), a national measure of food insecurity based on research in younger persons, may result in more accurate assessments for elders. We developed 14 new items for possible augmentation and administered them by telephone to these same elders along with the FSSM. Elders were independently classified according to food insecurity status based on their experience from the in-depth interviews, and these definitive criteria were used to evaluate the new and existing items. The results suggest that "couldn't afford right foods for health" and two policy-relevant immediate causes, "couldn't get the food I needed" and possibly "unable to prepare," should be added, although further testing is needed.
一直缺乏对老年人粮食不安全经历的全面概念化，这导致了老年人粮食不安全定义和衡量方面的局限性。基于对53位低收入城市老年人每人进行的两次间隔6个月的深入访谈的定性分析，运用扎根理论原则，结果表明老年人粮食不安全经历有四个组成部分：数量、质量、心理和社会。无法获取有益于健康的合适食物是老年人特有的一个新因素。这些组成部分的每一个都有严重程度、时间和食物选择受限等维度。虽然金钱是粮食不安全的主要原因，但老年人有时有足够的钱购买食物，但由于交通或身体功能限制而无法获取食物，或者由于身体功能受损和健康问题而无法食用食物（即无法准备或吃掉现有食物）。这些研究结果表明，扩充美国家庭粮食安全调查模块（FSSM）（一项基于对年轻人的研究得出的全国性粮食不安全衡量指标）可能会对老年人做出更准确的评估。我们制定了14个可能用于扩充的新项目，并通过电话向这些老年人发放了这些项目以及FSSM。根据深入访谈中的经历，将老年人按照粮食不安全状况进行独立分类，并使用这些明确标准来评估新的和现有的项目。结果表明，应增加“买不起有益于健康的合适食物”以及两个与政策相关的直接原因，即“无法获得我需要的食物”以及可能的“无法准备食物”，不过还需要进一步测试。
