Black and Hispanic senior women are considerably more likely to experience food insecurity compared with White senior women, largely due to lower levels of social support. These vulnerable groups are also more prone to loneliness. An article published in The Nursing Clinics of North America shows that nurses are in a unique position to help. Using a specific model, nurses can mediate the impact of many social determinants of health (SDOH) by acting as sources of primary, secondary, and tertiary support for the wellness of the elderly Black and Hispanic communities.
Historically, Black and Hispanic people have experienced higher levels of poverty compared with White people, and the COVID-19 pandemic exacerbated this reality. Data presented in the article show that compared with White people (0.08%), Black (1.4%) and Hispanic (2.1%) people were the 2 groups that experienced the greatest increases in poverty rates amid the pandemic. Given these inequities, Black (50.2%) and Hispanic (48.7%) women are far more likely to live 200% below the poverty line compared with White women (30.7%). Household income is correlated with food insecurity, and Black and Hispanic women face an appreciably higher risk of food insecurity compared with White women. Specifically, Black (15.1%) and Hispanic (14.8%) seniors aged 60 and older are significantly more likely to be food insecure compared with White (6.2%) seniors.
Among women, food insecurity is linked with insufficient social support, and a lack of social capital augments the risk of food insecurity. Moreover, during the COVID-19 pandemic, seniors (specifically women) reported increased loneliness, which is linked to negative health outcomes, including depression. Food insecurity alone is associated with comorbidities such as heart disease, cancer, chronic fatigue, and health-adverse behaviors like smoking, alcoholism, and poor eating habits.
Nurses can use the Neuman Systems Model framework to address the lack of social support and loneliness experienced by elderly Black and Hispanic women. The framework is based on a client system—a single client, group, or, in this case, multiple groups—and focuses on how the client interacts with their environment, “to actual or potential environmental stressors.”
Nurses can apply the Neuman Systems Model in 3 modes of prevention: primary, secondary, and tertiary. In primary prevention, nurses should identify food insecurity as a potential stressor to this population, assess the extent to which food insecurity can negatively impact the group, pinpoint social support and loneliness as potential influencers on the group’s perceived severity of food insecurity, and based on all assessments, aid in providing solutions. These solutions may include recommending food assistance programs or providing educational materials. In secondary prevention, nurses can participate in formal or informal screening for food insecurity, lack of social support, and signs of loneliness. They can encourage the use of support services (ie, food, emotional, and instrumental support) and companionship programs. Lastly, in tertiary prevention, nurses can promote group adjustment and adaptations to changing health conditions by assessing feedback on secondary prevention measures.
“The inclusion of SDOH as an essential concept of learning for nurses underscores the important role nurses can serve in addressing SDOH and health inequities that contribute to inequity in health outcomes. Through health and needs assessments, health promotion, patient education, and improved access to care, nurses may have a direct impact on the health care of community members from vulnerable populations,” the researchers concluded.