Title: Food Intake, Obesity, and Nutritional Risk Among the Homeless in Rhode Island
1Food 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
2Homeless in Rhode Island. Tent City, July 09
3Overview
- I. Introduction
- II. Key concepts
- III. The issue at hand
- IV. What we did
- V. What we learned why it matters
4INTRODUCTIONWHO 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
5With 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)
6Our group(not pictured Maria and Jonah)
7Our group in actionOutreach _at_ Grace Church
8Key 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.
9Key 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
10U.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. -
12The Issue
- There is a need for more knowledge about the
nutrition status and ability to access food
within the homeless population.
13Questions 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?
14Tent City, Providence- July 2009
15(No Transcript)
16Our 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
20Regarding 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.
21Regarding 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.
22Regarding 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
-
23Regarding 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(No Transcript)
25Regarding 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.
26Regarding 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.
27Regarding 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.
28Regarding 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.
29How 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
-
30References
- 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