A Trend Analysis of Home-Delivered Meal Programs in the US.

Abstract

Home-delivered meals improve diet quality and increase independence in homebound individuals. Yet, home-delivered meal service data at a US national level remains scarce. Based on NHANES (National Health and Nutrition Examination Surveys) data from 23 000 participants (2009-2023), we performed a secular trend analysis and reviewed the prevalence of home-delivered meals from community programs, "Meals on Wheels," and other government programs in adults aged ≥60 years. A special focus was put on sociodemographic characteristics and physical disabilities of home-delivered meal recipients. Up to 4% of the older US population reported home-delivered meals in the 2021 to 2023 NHANES cycle - the highest weighted proportion in all examined cycles. This constitutes a 2-fold increase compared to 2009/2010. Home-delivered meal recipients were more likely to live alone and in poverty. Very low food security increased the odds for receiving home-delivered meals by 5.09 (CI: 3.11-8.34). Vision problems and difficulties doing errands alone emerged as the leading causes of disability associated with home-delivered meals (OR: 2.65 (CI: 1.70-4.15) and OR: 3.90 (CI: 2.59-5.88), respectively with a <i>P-value</i> <.001). Increasing age and decreasing household size were also significant predictors. Results suggest an increasing prevalence of home-delivered meals among adults aged ≥60, particularly among those in precarious, food-insecure situations. Given the rapidly aging population and the desirable cost-benefit ratio of home-delivered meals, policymakers and public health strategies may consider expanding such programs to address the increasing demand.