Who Are the Long-Term and Short-Term Users of Meals on Wheels Services in the 65+ US Population?

This study identifies the long-term and short-term users of home-delivered meals, i.e., Meals on Wheels (MOW) services, and how they differ across socioeconomic and health status. The analysis relies on a nationally representative sample of 65+ Medicare beneficiaries from the 2013-2021 National Health and Aging Trends Study. A fixed effect multinomial logit model, with lagged indicators and complex survey design, predicts the probabilities of being a short-term (1 year or less) or long-term (2+ years) MOW client. Beneficiaries' characteristics predictive of long-term MOW use include identifying as Black, being on Medicaid, pre-frail, and having 2+ IADL limitations. Medicaid enrollment is one of the few statistically significant predictors for short-term MOW use. These results reveal that long-term MOW users are more heterogeneous and vulnerable than short-term users. Understanding the reasons various individuals rely on MOW services for multiple years may inform policy on the social and care needs of older adults.