Free Online Course to Help Health Care Providers Address Senior Hunger

Screen and Intervene: Addressing Food Insecurity Among Older Adults

In just 60 minutes, health care providers and community-based partners can learn how to screen patients age 50 and older for food insecurity and connect them to key nutrition resources like the Supplemental Nutrition Assistance Program (SNAP).

The course, developed by FRAC and the AARP Foundation, is approved for 1.0 AMA PRA Category 1 Credits™ (MDs and DOs). All other learners can download a certificate of participation upon completion of the course. See the course for more information.

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Obesity in America

Obesity rates have more than doubled in adults and children since the 1970’s (National Center for Health Statistics, 2009). While recent estimates suggest that the overall rates of obesity have plateaued or even declined among some groups, obesity is widespread and continues to be a leading public health problem in the U.S. (Flegal et al., 2016; Ogden et al., 2016; Robert Wood Johnson Foundation, 2016; Wen et al., 2012). In addition, severe obesity is a serious and increasing problem among children, adolescents, and adults (Flegal et al., 2016; Fryar et al., 2012; Ogden et al., 2016; Skinner & Skelton, 2014). Plus, substantial disparities exist based on demographics (e.g., race-ethnicity, gender), geographic region, and socioeconomic status.

Quick Facts:

  • 37.7% of U.S. adults and 17% of U.S. children are obese. Disparities exist based on race-ethnicity, gender, age, geographic region, and socioeconomic status.
  • Poor nutrition and obesity have serious consequences for health and well-being in the short-term and long-term.
  • While all segments of the U.S. population can be affected by poor dietary intake and obesity, low-income and food insecure people are especially vulnerable due to the additional risk factors associated with inadequate resources and under-resourced communities.
  • The federal nutrition programs play a critical role in improving nutrition and combating obesity.

Check out this new report that reviews existing and emerging opportunities to document food insecurity screening, assessment, intervention, and billing for each part of a patient visit using discrete codes and language from standardized EHR medical vocabularies.

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Poverty, Hunger, and Obesity

Why Low-Income and Food-Insecure People are Vulnerable to Poor Nutrition and Obesity
Key Factors:

  • Limited resources
  • Lack of access to healthy, affordable foods
  • Cycles of food deprivation and overeating
  • High levels of stress, anxiety, and depression
  • Fewer opportunities for physical activity
  • Greater exposure to marketing of obesity-promoting products
  • Limited access to health care

Factors Contributing to Obesity
Obesity is a complex condition with biological, genetic, behavioral, social, cultural, and environmental influences.

Adult Obesity

More than one-third of U.S. adults are obese (Flegal et al., 2016).

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Consequences of Adult Obesity 

Overweight and obesity in adulthood is associated with many serious physiological, psychological, and social consequences, as listed below.  Given these health and social consequences, it should not be surprising that obesity has serious economic consequences as well.  The annual medical costs alone have been estimated as high as $190 billion (in 2005 dollars) – 21 percent of all medical spending (Cawley & Meyerhoefer, 2012).

  • Physiological Consequences of Adult Overweight or Obesity

    • Diabetes (Nguygen et al., 2008)
    • Heart disease (Guh et al., 2009)
    • Stroke (Guh et al., 2009; Strazzullo et al., 2010)
    • Dyslipidemia (e.g., high blood cholesterol and triglycerides) (Nguygen et al., 2008)
    • High blood pressure (Nguygen et al., 2008)
    • Metabolic syndrome (Nguygen et al., 2008)
    • Liver disease (Clark, 2006)
    • Gallbladder disease (Guh et al., 2009)
    • Kidney disease (Eknoyan, 2011)
    • Asthma (McHugh et al., 2009)
    • Sleep apnea (Punjabi, 2008)
    • Arthritis (Crowson, et al., 2013; Mokdad et al., 2003)
    • Chronic back pain (Guh et al., 2009)
    • Mobility limitations (Houston et al., 2009)
    • Some types of cancer (Guh et al., 2009, Song et al., 2016)
    • Reproductive complications (e.g., irregular menses, infertility) (Practice Committee of the American Society for Reproductive Medicine, 2008)
    • Pregnancy-related complications (e.g., birth defects, gestational diabetes, preeclampsia) (Practice Committee of the American Society for Reproductive Medicine, 2008)
    • Poor health-related quality of life (Hassan et al., 2003; Jia & Lubetkin, 2010)
    • Increased all-cause mortality (Berrington de Gonzalez et al., 2010; Flegal et al., 2013)
    • Decreased life expectancy (Fontaine et al., 2003)
    • Increased risk of hospitalization (Han et al., 2009a)

  • Psychological and Social Consequences of Adult Overweight or Obesity

    • Depression (Luppino et al., 2010; Petry et al., 2008)
    • Anxiety (Petry et al., 2008; Simon et al., 2006)
    • Substance use disorders (Barry & Petry, 2009)
    • Social discrimination and stigmatization (Puhl et al., 2008; Puhl & Heuer, 2010)
    • Employer discrimination (e.g., hiring prejudice, lower wages) (Han et al., 2009b; Puhl & Brownell, 2001)
    • Work impairment (Rodbard et al., 2009)
    • Time away from work (Trogdon et al., 2008)
    • Disruption of work, family, and social life (Rodbard et al., 2009)