Betsy, a food bank recipient in rural Kentucky, never expected to need handouts of food.
For nearly 35 years, she had a good job making decent money. But now, at age 51, she suffers from health problems and often has to decide between buying food or medicine. (EDITOR’S NOTE: This story uses the first names of food-pantry recipients to protect their privacy.)
Decisions like those are part of the reason senior citizens in rural America are facing food insecurity, a new study shows. In fact, one in five rural seniors has difficulties getting enough to eat.
According to Dr. James Ziliak, director of the University of Kentucky’s Center for Poverty Research and the co-author of the study, nearly 30 percent of senior citizens living below the poverty line are food insecure, or concerned they won’t have anything to eat. About half of those seniors, defined as 60 years and older, have very low food security, meaning they frequently worry about access to food.
Of the top 10 states for food insecurity in seniors, nine of them are in the Southeast.
The study shows that while the economy has recovered since the Great Recession, it hasn’t recovered as quickly for those in rural areas. Lack of jobs, lack of access to food and lack of income are hampering seniors’ ability to rest assured that they will have food when they want it, Ziliak says.
“Despite an improving economy and financial markets, millions of seniors in the United States are going without enough food due to economic constraints,” Ziliak said in the study. “This stubbornly high proportion of food-insecure seniors continues to impose a major health care challenge in the U.S. One group of practical concern is those seniors experiencing VLFS (Very Low Food Security), the ranks of which have especially swelled since 2001.”
In Kentucky, where Betsy lives, food insecurity rates are also elevated for middle-aged residents. Nearly 20 percent of Kentucky adults in their 50s are food insecure – compared to 11.3 percent nationwide. Kentuckians over the age of 60 have a higher rate of food insecurity regardless of their income – 8.4 percent of them are hungry, compared to 7.7 percent across the country.
“Too many older adults and senior citizens in Kentucky are struggling to put food on the table after decades of hard work,” said Tamara Sandberg, executive director of Feeding Kentucky, a network of food banks that serve all of the state’s 120 counties. “They are faced with agonizing choices such as paying for food or paying for medicine.”
Betsy has had to make just those choices.
As a child, Betsy began working at age 9, babysitting to save up for the name brand clothes she wanted. As an adult, she worked as a lab technician in Florida. But when her mother got sick, she returned to Morehead, in the coalfields of northeast Kentucky. She continued to work and returned to her Florida job after her mother died.
“I’ve worked all my life,” she said. “There wasn’t a time I wasn’t working up until I had to file for disability.”
After moving back to Florida, Betsy was diagnosed with kidney cancer. Manageable at first, she thought she could continue to work while going through treatment. Then the doctors had to take out a kidney. Later, she was placed on dialysis. The treatments left her unable to work. In response, she moved back to the small town of Morehead, population 6,897, so she could be closer to the support of her family.
Her disability checks and government housing leave her with little money for luxuries. Betsy lives on a little over $900 a month, $100 of which goes to prescriptions. Government housing costs about $143. The rest goes to bills first and food second.
Her son, a 31-year-old living and working in a nearby factory, struggles to make ends meet too, she said.
“He needs to worry about himself,” she said. “He needs to get a new vehicle. The one he has now has issues. He needs to take care of himself first.”
Even though she has an income, she still can face dark times, she said.
“I remember one year a few days before Christmas, I had $2 in my checking account,” she said. “I didn’t know how I was going to pay for any food. I didn’t know where our Christmas dinner was coming from, or what I was going to do about Christmas.”
In that circumstance, a check from her landlord, where she had overpaid her rent for a year, helped to smooth out the difficulties. Most times, she’s not so lucky. Betsy gets food from the food bank once every three months, but volunteers there almost daily.
“I don’t eat much,” she said. “So I don’t need to go and get as much food. I figure others probably need it more than me.”
Ziliak’s study found that seniors in rural areas are statistically more likely to be hungry if they are divorced, widowed or separated; if they are sick, disabled or unemployed, and if they are renters.
The study, he said, points not only to the lag in the economic recovery seen in rural America, but also the lack of access to food and resources for seniors in rural areas.
“Our studies have shown that those who are 50 and above were, like the rest of the country, dramatically affected by the Great Recession,” Ziliak said. “But what we’re seeing is that those groups in non-metro areas did not recover like the rest of the population… Non-metro areas have lower incomes generally than metro areas… and it took a long time for the economy to recover for those in the lower income stratus.”
Another cause for food insecurity may be that there just isn’t a way for seniors to get to the food and resources, Ziliak said.
“In non-metro areas, there are fewer outlets that are in reasonable proximity to the full bevy of fruits and vegetables that one needs,” he said.
Michael Halligan, CEO of God’s Pantry, a Lexington-based food bank that supplies pantries in Rowan County and other locations,, said sometimes one twist of fate can be costly for those in rural areas:
It’s a different economic reality today than others had to deal with. Put yourself in a situation where you live 30 to 45 minutes away from a grocery store. And imagine being 50 to 59 and losing your job thanks to a downturn in the economy. All of a sudden after 20 or 30 years, you don’t have a job, which means you don’t have a commute so you can’t stop at the store on your way home from work. You don’t have an income, so you have to think about the gas it takes to drive into town. The hardships become very complicated very quickly. … Many people are just one unfortunate or one unexpected incident away from food insecurity. The vast majority of individuals who are food insecure are working to stretch their budget as best as they can.
For 53-year-old Joe, worrying about food is a daily concern. He, his 22-year-old wife and their 18-month old daughter, as well as a 17-year-old son from a previous marriage, all live together in government housing. All told, they live on less than $1,500 a month, he said.
“For people who don’t understand what it’s like, they should take a box of macaroni and cheese, a pound of hamburger and a pack of hot dogs and use that to feed a family of four for a day,” he said. “It’s a constant struggle. I think about it every day.”
Joe grew up in Phoenix, Arizona, and was working in a factory making $27 per hour when the factory closed.
Divorced with three kids, he was ordered by the court to pay $800 in support each month. To make it, he drove with a friend to Indiana to find work. There he met his second wife and moved with her to Morehead to be closer to her family. Within a few years, they had three children. Not long after the birth of their third child, his wife died of breast cancer.
Through it all, Joe worked. He worked as a custodian at nearby Morehead University and at a local school. He worked as a cashier at various places. He worked doing what he could, making what he could.
But finding jobs in a small town presents its own challenges.
“It’s such a small town,” he said. “Unless you have family and friends here to support you, it’s tough to get a job.”
Getting a job is complicated by the fact Joe doesn’t have a driver’s license. In Arizona, he said, the state suspends your license if you fall behind on child support.
Joe owes the state of Arizona more than $165,000 in child and spousal support — an amount that he has owed for more than a decade even though his children are grown and living in Michigan.
“How am I supposed to fight that?” he said. “I’d have to go there and go to court. And every attorney I’ve ever talked to said they need $5,000 just to look at my case… I’ll never drive again. It’s hard to find a job that you can get to around here if you can’t drive.”
Now he and his current wife feed their small family on $234 per month in food stamps. That money is supplemented by food they get at food banks in the area.
“People talk a lot about the last time they went out to eat and what they had,” he said. “I can’t remember the last time we went out to eat. A big treat for us is a four pack of Totino’s pizza. That’s what eating on $234 a month looks like.”
For some seniors, taking care of their grandchildren means added expenses and gnawing concerns. People over 60 with children living with them are almost twice as likely to have food insecurity, the study found.
Mary, another Christian Outreach Services food bank participant, cares for her 17-year-old daughter and her 12-year-old grandson. For her, summers are hard because they mean breakfasts and lunches for the kids who would normally eat via free and reduced lunch programs at school.
“I know a lot of people in the area who are raising their kids and grandkids,” Mary said. “I pay bills and then I buy food. I’m always trying to save all I can. I try to stretch every dollar. My ex-husband died three years ago of a heart attack and I get his Social Security. And we get money for my grandson and money for my daughter.”
While Mary manages her household on around $1,200 a month, there’s not much left after car payments, insurance, loans and utility payments, she said.
Another factor, Halligan said, is the culture surrounding asking for help.
Senior citizens, he said, are less likely to take advantage of assistance because they come from a generation that doesn’t ask for help. In rural areas, that pride can be just as strong if not stronger than in metropolitan areas. Programs like the Supplemental Nutrition Assistance Program (SNAP) and Senior’s Farmers Market Program may some help for seniors, but many don’t know about the programs or are disinclined to use them, he said.
“Senior citizen participation is under-indexed when it comes to the SNAP program,” he said. “I think we need to make those who are vulnerable more aware of the programs and get them signed up.”
For Halligan, the issue of food insecurity is one that policy makers need to be thinking about now.
“I think we need to really think through how we’re going to take care of folks as our society ages,” he said. “It’s great to say people need a larger nest egg to live on, but how do we ensure people are stable? How do we get services to where people live rather than where they aren’t? I think we really need to envision and reimagine solutions to the problems that I see as indicators of increased risk for all seniors.”