Page 52 - IJPS-7-1

Food insecurity and social support in Brazil

individual presenting with food insecurity. Concerning sociodemographic covariates, older adults with <9 years of
schooling (P = 0.022), women (P = 0.041), the African American ethnicity (P = 0.016), and individuals with low income
(P < 0.001) were more likely to have food insecurity. In the adjusted model, only the positive social interaction dimension
was significantly associated with the outcome (P = 0.002). Regarding sociodemographic covariates, only low-income
(OR: 2.01; P = 0.001) and African American ethnicity (OR: 1.48; P = 0.026) were associated with food insecurity.
4. Discussion

In this study, we partially confirmed our initial hypothesis, showing that food insecurity was significantly associated with
the positive social interaction domain of social support, and that this effect was independent of important indicators of
social inequality, such as income and ethnicity.
The prevalence of food insecurity was different from that reported in the previous studies conducted among older adults
in Brazil. Marín-León et al. (2005), for example, found a prevalence of 52% of food insecurity in families with older adults.
Souza and Marin-Leon (2013),;however, found a prevalence of 21.8% in their study among older adults who attended
popular restaurants. More recent data from a nationwide survey (2018/2019) showed that 27.3% of older Brazilians had
some degree of food insecurity (IBGE, 2020). At the international level, the prevalence found in our study was much higher
than that found in a study of older adults in the United States (7.8%) (Holben and Marshall, 2017) and Portugal (23%)
(Fernandes, Rodrigues, Nunes, et al., 2018) but similar to that found in China (45%) (Cheng, Rosenberg, Yu, et al., 2015).
These differences observed between our study and national and international counterparts show that both the period
and the region in which the research was conducted have great importance in determining the prevalence of food
insecurity, along with the type of questionnaire used in the research. Our study was conducted more recently than other
Brazilian studies, and our instrument included an additional question that assessed mobility difficulties that could also
influence food access, which could explain the higher prevalence in relation to national data. Only a few recent studies
have analyzed the association between social support and food insecurity among older adults, especially considering all
social support dimensions. Burris et al. (2019) in a study with older adults who utilized primary care services, found that
lack of social support was strongly associated with food insecurity. Similarly, Wang and Bishop (2019) found that low
emotional social support was associated with food insecurity among older adults.
Although almost all dimensions of social support were significantly associated with food insecurity in our study, only
the positive social interaction sustained this association in our adjusted model. This association can be understood when
we consider food as beyond merely something that nourishes the body, but also as complex, with a social impact and
connection with issues such as cultural belonging, family relationships, pleasure when eating, and behavioral aspects
(Oliveira and Santos, 2020). In this context, less positive social interaction may decrease the desire to eat, which can
lead to food insecurity among older adults. This phenomenon was also observed by Interlenghi and Salles-Costa (2015)
in a study conducted in Rio de Janeiro that evaluated the association between food insecurity and social support among
adults between 18 and 60-years-old. The study showed that individuals with high scores in the positive social interaction
dimension had lower chances of experiencing food insecurity. Another qualitative study that analyzed food choices and
food access among low-income older adults pointed out that social interactions, especially with family and friends, can
positively affect the eating behavior of older adults, increasing the consumption of healthier meals and decreasing the
intake of quick meals, such as toasts and cereals (Oemichen and Smith, 2016).
The importance of social interactions for healthy aging among older adults has been highlighted by the Brazilian
Ministry of Health. The Brazilian Dietary Guidelines encourage making meals in the company of family members or
friends to make this moment more pleasurable, which gives a sense of belonging and integrity to older adults, stimulating
food intake and reducing their food vulnerability (Brazil, 2021). Positive social interaction with others can also help older
adults not only maintain adequate nutrition but also improve their subjective well-being, providing an emotional resource
to deal with adverse situations, such as food insecurity (Farriol-Baroni, González-García, Luque-García, et al., 2021; Na,
Miller, Ballard, et al., 2018; Sharifian and Grühn, 2019).
Another factor significant in our results is income, which is considered to be one of the main determinants related to
access and availability of food. In our study, those with a family income equal to or less than two minimum wages were
more likely to experience food insecurity. This finding is expected and is accordance with plenty of previous studies.
Grammatikopoulou et al. (2019) observed similar results in older adults from communities in Greece. In their study, older
adults without food insecurity had a medium income of 700 euros per month, which was higher than that of the group
with food insecurity, which had a medium monthly income of 560 euros. Fernandes et al. (2018), in a study of older adults
in Portugal, found that having a monthly income of 500 euros or less, reporting having financial difficulties, or reporting
that it was very difficult to live with their current income, were associated with increased odds of living in a food-insecure

46 International Journal of Population Studies | 2021, Volume 7, Issue 1