Using a social ecological model to explore upstream and downstream solutions to rural food access for the elderly

Abstract

A social ecological model is applied to the secondary analysis of qualitative data to study the impact of place on rural food access for older adults in West Virginia. The use of a social-ecological model to review the senior’s coded narratives provided a clearer picture of higher impact, upstream levers to address food security for older adults in a rural region. The elderly have restricted access to food in rural West Virginia because of an indirect relationship with place that acts through the social ecological domains of the built environment, macrosocial factors, stressors, the natural environment, and social support. The results of this analysis add to theories on upstream policy sectors that may contribute to food security and the quality of dietary intake for older adults in rural places. As senior populations increase the need for greater understanding of the place-based causal pathways for rural food insecurity and poor nutrition in older adults will become more important for program and policy decisions.

Keywords:

• elderly
• food access
• nutrition
• population health
• qualitative
• rural
• food security
• geography

Public Interest Statement

This paper uses theories from the fields of geography and anthropology on the social construction of place to examine the complex social, economic, and political factors that result in material inequities in food security that can exist between places. As the analysis demonstrates, addressing food access issues may be classified as upstream or downstream approaches. The more traditional responses to food access are downstream efforts addressing physical and emotional wellbeing. To get at root causes of food access solutions should focus on upstream policy issues at the macro, intermediate, and proximate levels.

Competing interests

The author declare no competing interest.

Acknowledgements

Special thanks to Sandra Fallon for editing and Kathy Kirk for assistance with additional arrangements at the community level in Preston County, West Virginia.

Cover image

Source: Andress, L., and Hallie, S. S. (2017).

Additional information

Notes on contributors

Lauri Andress

Lauri Andress has dedicated her career as an instructor, social sciences researcher, and policy analyst to public service where her expertise lies in linking scholarly work with social issues, the public policy process, and community organizing. She is interested in gaps between groups based on socio economic status and the different ways to portray and measure the effects of power on marginalized communities. She utilizes qualitative research skills that integrate ethnographic techniques with content analysis of documents, and data collected from interviews, focus groups, print media and videos. She is currently using a constructivist approach to consider the ways that the media and public discourse shape behaviors and therefore material realities. In West Virginia, she has utilized ethnographic techniques, focus groups, and interviews to explore the food access issues of low income women and the elderly along with the policy discourse for built environment initiatives at the local level.