Food insecurity among senior citizens in high out-migration areas: evidence from Western Nepal

Food insecurity is a critical public health challenge, particularly in low- and middle-income countries such as Nepal. The demographic transition has resulted in a growing population of senior citizens. However, the determinants of food insecurity among Nepali senior citizens remain unknown. This study aims to fill this gap by assessing food insecurity among the older populations in the far-western region, one of the poorest regions of the country. Further, we also aim to assess the potential association between adult children's migration and the food insecurity status of the left behind older parents.

A community-based cross-sectional study was conducted among 260 randomly selected senior citizens in the Kanchanpur district in far-western Nepal. The short form of the household food security scale, originally developed by the United States Department of Agriculture, was used to measure household food security. Associations were examined by logistic regression.

The prevalence of food insecurity in senior citizens' households was 41.1%. Senior citizen households with their adult children's migration (AOR = 0.47, 95% CI: 0.24-0.95) had lower odds of being food insecure whereas households with lower family income (<$100 compared to ≥ $100) had two times higher odds of being food insecure (AOR = 2.26, 95% CI: 1.08-4.76). Also, households owning a cultivable land/farm (AOR = 0.14, 95% CI: 0.05-0.40), primary source of income as service/pension (AOR = 0.26, 95% CI: 0.08-0.89) or business (AOR = 0.15, 95% CI: 0.03-0.59) and participants who received geriatric allowances (AOR = 0.05, 95% CI = 0.01-0.16) had lower odds of being food insecure.

The prevalence of food insecurity among households with a senior citizen in Kanchanpur district was high and associated with the migration status of adult children, and household socioeconomic status. This calls for a greater policy response focused specifically on households with older adults and the integration of gerontological evidence into the existing food security and nutrition strategies.