Development and Current Status of Home-Delivered Meals Programs in the United States: Who Is Served?

Federal home-delivered meals programs for the frail elderly began in the United States in the 1970s. During the 1980s the provision of meals to the homebound elderly was expanded through development of state-funded meals programs. The time has come to pose two questions relative to coverage and impact of these programs. These questions are whether the program serves those who are most needy, and whether the meals programs reduce the need for more costly care. Information available suggests that the elderly most often served are those with socioeconomic problems reducing their ability to obtain regular meals. Medical disability is less often used as a criterion for program eligibility or priority. The recent finding that provision of home-delivered meals reduces hospitalization rates should be reexamined to answer the question of whether the medically needy are actually kept out of the hospital by provision of home-delivered meals.