Public assistance program and food diversity among older people: a cross-sectional study using the Japan...

Food diversity plays an important role in people's healthy and affluent lives. However, poverty and eating alone can create multi-dimensional barriers to food diversity. Although public assistance programs guarantee a minimum income to people in need, financial support alone may not be sufficient to support the health of people in poverty. This study aimed to identify the differences in food diversity intake between older recipients of public assistance and non-recipients.

This cross-sectional study utilized data from the Japanese Gerontological Evaluation Study (2022), involving 14,467 participants aged 65 years and older. The Dietary Variety Score (DVS), ranging from 0 to 10 (higher scores indicate higher dietary variety), assessed dietary diversity based on the regular consumption of ten food groups. Receiving public assistance was categorized as "yes" or "no." Eating together was defined as eating with others every day. To assess the relationship between receiving public assistance and the DVS, we calculated the unstandardized coefficient (β) and p values using a general linear model. Additionally, the interaction between public assistance and eating together was examined. As covariates, we adjusted for sociodemographic factors such as age, disease, marital status, and living alone.

Men recipients of public assistance had a lower DVS, even after adjusting for sociodemographic factors (adjusted β: -0.72, p = 0.04). For women, no association was seen between receiving public assistance and a lower DVS (adjusted β: -0.19, p = 0.66). An interaction between public assistance and eating together was observed among men (p = 0.07).

Even after adjusting for sociodemographic factors, men recipients of public assistance have less food diversity than non-recipient men. Men recipients were more likely to increase their food diversity by eating together. To ensure recipients' rights to food security, the public assistance program should provide additional support to integrate recipients into communities that enable them to eat together in addition to providing financial support.