Food Intake, Obesity, and Nutritional Risk Among the Homeless in Rhode Island - PowerPoint PPT Presentation

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Food Intake, Obesity, and Nutritional Risk Among the Homeless in Rhode Island

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Food pantries were used by only 11.8% of the participants in the past month, while 65.5% had not been to a food pantry in the past month. ... – PowerPoint PPT presentation

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Title: Food Intake, Obesity, and Nutritional Risk Among the Homeless in Rhode Island


1
Food Intake, Obesity, and Nutritional Risk Among
the Homeless in Rhode Island
  • Leah Murphy, BA
  • Sekboppa Sor, BSN
  • Jonah Martins
  • Mercy Otieno
  • Jennifer De la Cruz
  • Maria Mendez
  • Melissa Kirton, BS

2
Homeless in Rhode Island. Tent City, July 09
3
Overview
  • I. Introduction
  • II. Key concepts
  • III. The issue at hand
  • IV. What we did
  • V. What we learned why it matters

4
INTRODUCTIONWHO WE ARE
  • An interdisciplinary team representing the
    following disciplines
  • - Nursing
  • - Pharmacy
  • - Nutrition
  • - Social Work
  • - Statistics
  • Working under a grant from Area Health Education
    Center for Central Rhode Island

5
With funding from Central RI AHEC.
  • We teamed with community agencies to better
    understand the challenges facing Providences
    homeless population.
  • The agencies we worked with included
  • Crossroads Rhode Island
  • Rhode Island Coalition for the Homeless
  • The RI Family Shelter
  • WARM Shelter
  • McAuley House
  • Providence In-town Churches Association
  • Providence Community Health Center
  • The SNAP Outreach Program (Food Stamp outreach)

6
Our group(not pictured Maria and Jonah)
7
Our group in actionOutreach _at_ Grace Church
8
Key Concepts
  • Homelessness
  • a person is considered homeless when he/she
    lacks a fixed, regular, and adequate night-time
    residence and... has a primary night time
    residency that is (A) a supervised publicly or
    privately operated shelter designed to provide
    temporary living accommodations... (B) An
    institution that provides a temporary residence
    for individuals intended to be institutionalized,
    or (C) a public or private place not designed
    for, or ordinarily used as, a regular sleeping
    accommodation for human beings (Stewart B.
    McKinney Act, 42 U.S.C. 11301, et seq. , 1994).
    The term homeless individual does not include
    any individual imprisoned or otherwise detained
    pursuant to an Act of Congress or a state law."
    National Coalition for the Homeless. (2009). Who
    Is Homeless, NCH Fact Sheet 3. Washington, DC.

9
Key Concepts
  • Food Security access at all times, to enough
    food for an active healthy life for all household
    members.
  • Food Insecurity At times in the year, there
    exists uncertainty of having, or inability to
    acquire, enough food to meet the needs of all
    household members because of insufficient money
    or other resources for food.
  • Source Nord, M. (2008). Food Security in the
    United States Key Statistics and Graphics.
    Retrieved from http//www.ers.usda.gov/Briefing/Fo
    od Security/stats_graphs.htm

10
U.S. Food Insecurity, 2007
  • In 2007, 11.1 of U.S. households were food
    insecure (13.0 million households)

11
  • Food insecurity is measured per household in the
    United States by the US Bureau of the Census.
  • Therefore, the homeless populations food
    security status is not captured in the national
    measure.
  • source Alaimo, K. (2005). Food Insecurity in
    the United States An Overview. The Journal of
    Topics in Clinical Nutrition. Vol. 20, No. 4,
    281-298.

12
The Issue
  • There is a need for more knowledge about the
    nutrition status and ability to access food
    within the homeless population.

13
Questions about
  • How do homeless people eat if they dont have
    access to a place to prepare and store food?
  • What does a homeless persons diet consist of?
  • Do homeless people in Providence experience
    hunger?
  • Are there any patterns or trends in the health
    parameters of Providences homeless population?

14
Tent City, Providence- July 2009
15
(No Transcript)
16
Our Assessment
  • Homeless individuals and families were recruited
    at Rhode Islands largest service agency for the
    homeless (Crossroads RI).
  • A healthy snack was offered as an incentive

17
  • Voluntary, informed consent was required by
    participants.
  • Trained research assistants collected the
    following data
  • Height
  • Weight
  • Waist circumference
  • Blood pressure
  • Body Mass Index (BMI) calculated by height
    weight

18
  • The participant would then engage in a
    face-to-face interview with the research
    assistant.
  • The interview featured
  • Questions regarding demographics and living
    situation
  • A detailed 24 hour dietary recall
  • Six-item Subset of the USDA Food Security
    Survey.

19
  • What We Learned about Providences Homeless
    Population, Phase I

20
Regarding the population
  • The studys population featured diverse cultural
    backgrounds, including people who are Puerto
    Rican, Dominican, Colombian, Cape Verdean,
    Caucasian, African American, Asian, and Native
    American.
  • The studys population ranged in age from young
    adult to older adult (65 y.o. ).
  • Many did not have access to a kitchen to prepare
    food, therefore, food of their ethnic background
    was not eaten unless they used the little money
    they had to purchase the food from ethnic
    restaurants.

21
Regarding the population
  • As a result, many of the individuals who
    participated in the study were not satisfied
    after eating in soup kitchens.
  • Older adults who are homeless often have no
    choice but to eat foods from soup kitchens. They
    have little or no access to foods from their
    ethnic backgrounds.

22
Regarding health
  • From Phase I of the study, it was established
    that in a group of 115 homeless adults in
    Providence
  • - 77 of the sample was overweight or obese
  • - 34 overweight
  • - 43 obese

23
Regarding disease risk
  • Disease risk was calculated by comparing the
    participants BMI and waist circumference to
    norms for these two measures as defined by The
    National Heart Lung and Blood Institute.
  • 77 of the participants are at increased risk for
    disease
  • 56 fell into the range of high-to-extremely high
    risk for disease

24
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25
Regarding food insecurity
  • Of the 115 participants, only 15.5 were food
    secure.
  • Sixty-seven percent were food insecure with
    hunger, while 17.5 were food insecure without
    hunger.
  • This means a total of 84.5 of the participants
    were found to be food insecure.

26
Regarding diet quality
  • The participants intake does not meet the USDA
    recommendations, with far fewer servings of
    vegetables, fruit, dairy and meats/beans than
    recommended, and excessive servings of fats.



27
Regarding methods used to access food
  • 42 of the participants visited a soup kitchen
    daily in the past month
  • 18 visited a soup kitchen more that once daily
    in the past month.
  • Food pantries were used by only 11.8 of the
    participants in the past month, while 65.5 had
    not been to a food pantry in the past month.

28
Regarding use of governmental nutrition
assistance programs
  • Supplemental Nutrition Assistance Program (SNAP)
    formerly known as the Food Stamp Program
  • Of the 115 participants, 79 had been on the SNAP
    at one time and 69 had been on the SNAP in the
    last 12 months. Fifty-five percent of the
    participants were currently on SNAP.

29
How can we empower the homeless to better access
food, improve their nutritional status, and thus
their overall health?
  • To address an issue as complex as homelessness
    and hunger in the USA, successful solutions must
    informed by numerous disciplines
  • - nutrition
  • - nursing
  • - social work
  • - medicine
  • - pharmacology
  • - economics
  • - agriculture
  • - political science and government
  • - philosophy and ethics

30
References
  • Alaimo, K. (2005). Food Insecurity in the United
    States An Overview. The Journal of Topics in
    Clinical Nutrition. Vol. 20, No. 4, 281-298.
  • Bengiveno, N. (2009). Seeking a Home With No
    Certain Address. New York Times 07-30- 2007.
  • National Coalition for the Homeless. (2009). Who
    Is Homeless, NCH Fact Sheet 3. Washington, DC.
  • National Institutes for Health. (1998). First
    Federal Obesity Clinical Guidelines Released.
    Retrived from http//www.nhlbi.nih.gov/new/press/o
    berel4f.htm.
  • Nord, M. (2008). Food Security in the United
    States Key Statistics and Graphics. Retrieved
    from http//www.ers.usda.gov/Briefing/Food
    Security/stats_graphs.htm
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