EP28: Senior Nutrition (HAPF SERIES) with Marie Gualtieri, PhD

Senior Nutrition (HAPF SERIES) with Marie Gualtieri, PhD and Liz Albertine "For older adults in 2018, which is the most recent data that we have, approximately 5.3 million Americans, 60 and older, were food insecure."— Marie Gualtieri, PhD (03:47-03:58) COVID-19 has elevated a lot of issues that impact older adults. So, we're going to dig into the details of the impact of aging and food insecurity. In this week's episode, I'm joined by Health and Aging Policy Fellow, Marie Gualtieri, PhD and her Discussant, Liz Albertine, Legislative Director for Representative Rosa L. DeLauro (D-CT-03). Part One of 'Senior Nutrition (HAPF SERIES) with Marie Gualtieri, PhD' Marie Gualtieri is a sociologist making sure vulnerable populations have the nutrition support they need. She has worked with communities and engaged with policy to increase food access and support to improve people's health outcomes across the lifespan. For the past decade, Marie has partnered with community-based organizations, health providers, and foundations, listening to the experiences and stories of food insecurity, food access, and nutrition among children, families, and older adults. And, for older adults, she learned that they face unique challenges when accessing food. Marie's joy is to take people's lived experiences, stories of food insecurity, and translate that into meaningful change. Marie has accomplished these changes through her work in policy, research, program evaluation, and securing additional grant funding for organizations to expand their capacity.  More recently, in her Health and Aging Policy Fellowship on Capitol Hill, Liz Albertine indicated that Marie was able to help advise Rep. DeLauro (CT-03) and her staff on nutrition issues across the lifespan. This work included introducing bipartisan legislation to expand nutrition support for families and working on the various emergency spending packages for COVID-19, focusing on senior nutrition and food assistance programs. Marie is committed to creating meaningful strides in addressing the hunger and food crises in the national and global sphere.  Liz Albertine was promoted to Legislative Director role back in January 2018. Albertine graduated from the University of Virginia in 2008, receiving a Bachelor of Arts degree in history. She has served on Rep. DeLauro's staff since 2010, rising from Staff Assistant to her latest role. Her legislative knowledge, experience, and demonstrated passion for serving the people of Connecticut's Third Congressional District make her an excellent fit for her role. "One of the things that the pandemic has brought to light are the issues that impact older adults." — Melissa Batchelor, PhD, RN, FNP, FAAN (13:26-13:31) Are you wondering what food insecurity means for older adults before COVID-19? First, let's find out what food insecurity is. It's the social and economic factors related to someone's household experience in terms of accessing food, which is different from hunger. The U.S. Department of Agriculture (USDA) will separate the two terms because hunger is more about a physiological feeling. But food insecurity is when you don't have some means to access food. In 2018, which is the most recent data that we have, approximately 5.3 million Americans, 60 and older, were food insecure. And that's about 7.3% of the senior population at the time, with millions more at risk for food insecurity. And when you factor in the at-risk population, that number increases to about 10 million.  There are a few root causes of food insecurity. The first thing is income. We know that poverty and food insecurity rates are positively correlated, meaning that as one increases, the other increases, as well. And during the Great Recession, we saw both poverty and food insecurity at a record high. In 2011, when we saw the conditions improving, food insecurity, and poverty rates decreased among the general population, but it remained high for older adults. But why is that? That's because income isn't the sole driver of food insecurity for older adults, because they also have issues with transportation, physical mobility, and waiting lists for services. When Marie found out about the waiting lists while working on an evaluation project several years ago in Central Florida, she got hooked. "The Government Accountability Office released a report on senior nutrition programs in January this year, citing that some communities had as many as 12,000 older adults waiting for meal services." —  Marie Gualtieri, PhD (05:00-05:12) Part Two of 'Senior Nutrition (HAPF SERIES) with Marie Gualtieri, PhD' Because of COVID-19, there has been a massive shift in organizational efforts to address food and nutritional needs among older adults. Congregate meal programs had to revamp their services to offer things like to-go meals or even convert to home-delivered meals. Meals on Wheels America, an organization that operates in virtually every community nationwide to address senior hunger and isolation, released a pandemic-related report in May of this year. They took a snapshot of what their services were like before March 1st and afterward. They found that 89% of their programs, which is about 5,000 programs across the country, saw a substantial increase in meal requests. In fact, 79% report the number of new requests for meals has at least doubled. And the waiting list, which already existed before COVID-19, had an increase of 26%. Aside from funding, a majority of the programs find it challenging to obtain PPE so that their staff and those they're delivering to can remain safe. There have been many capacity issues as well, considering these organizations rely on volunteers for their services. But a lot of those volunteers are older adults themselves. With the pandemic, because older adults are more likely to contract the virus, the number of volunteers decreased.  But food advocacy groups predict that the pandemic's impact on food insecurity will be worse than that of the Great Recession. The passing of emergency spending packages has been pivotal in giving direct support to organizations addressing senior nutrition. Marie monitored the issues of senior nutrition issues for the Families First and CARES acts, and became staff lead on senior nutrition for the House-passed HEROES Act. Big wins were made, such as $750 million for Older Americans Act Title-3 nutrition programs under Families First and CARES, with additional funding in the HEROES Act. Additionally, the HEROES Act includes a SNAP boost of 15% and raises the minimum benefit from $16 to $30, as well as blocks administration rules to reduce SNAP benefits.  During her fellowship year, it has been a highlight for Marie to take the stories of constituents, advocacy groups, and older adults and translate them into policy responses and change. Throughout the process, Marie learned the different policy vehicles to move ideas forward. With this new knowledge and skill set, her fellowship experience has given her new opportunities to pursue as her next steps; opportunities that would not exist without her experience on the Hill. While the pandemic may have impacted the predictability of Marie's experience this year, it has also illuminated the many issues that older adults face in various aspects of daily living and access to resources. Because of this, Marie believes that it is the perfect year to be a Health and Aging Policy Fellow, and is grateful for the opportunity. How to Connect More with Liz and Marie:   Elizabeth Albertine: https://www.linkedin.com/in/liz-albertine-123b0314/ Marie Gualtieri: https://www.linkedin.com/in/mariegphd/   About Melissa I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I truly enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home and office visits) then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my PhD in Nursing and a post-Master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the faculty at George Washington University (GW) School of Nursing in 2018 as a (tenured) Associate Professor where I am also the Director of the GW Center for Aging, Health and Humanities. Find out more about her work at https://melissabphd.com/.