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J Public Health (Oxf). 2018 Apr 2. doi: 10.1093/pubmed/fdy063. [Epub ahead of print]

Factors associated with food insecurity among older homeless adults: results from the HOPE HOME study.

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School of Public Health, University of California, Berkeley 94720, USA.
Division of General Internal Medicine, University of California, San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, UCSF Box 1364, San Francisco, CA 94143, USA.
Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco 94143, USA.



The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity.


We conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. We assessed food security and receipt of food assistance. We used multivariable logistic regression to examine factors associated with very low food security.


The majority of the cohort was male and African American. Over half (55.4%) met criteria for food insecurity, 24.3% reported very low food security. Half (51.7%) reported receiving monetary food assistance. In the multivariable model, those who were primarily sheltered in the prior 6 months, (multi-institution users [AOR = 0.44, 95% CI: 0.22-0.86]) had less than half the odds of very low food security compared with those who were unsheltered. Depressive symptoms (AOR = 3.01, 1.69-5.38), oral pain (AOR = 2.15, 1.24-3.74) and cognitive impairment (AOR = 2.21, 1.12-4.35) were associated with increased odds of very low food security.


Older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.


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