Malnutrition, food insecurity and poverty in older persons from Mexico City

The relationship between malnutrition, food insecurity, and poverty in older persons from urban Latin America has, to date, received relatively little attention. This thesis aims to address this important issue in the setting of Mexico City and its Metropolitan Zone. A theoretical framework has been developed to understand the causal linkages between the determinants of malnutrition, food insecurity and poverty, and current data are then used to describe how this public health concern manifests itself in urban Latin American contexts. This is followed by a discussion of recent social policy interventions aimed at improving nutrition, access to food and well-being in older people in Latin America. The quantitative part of the thesis presents a study which assessed indicators of nutritional status, food security, health, quality of life and living conditions among 1,263 households with residents aged 70 and over from sociogeographically- defined poor areas of Mexico City and its Metropolitan Zone. The literature suggests that a regular source of economic resources is important to ensure food security during old age; thus the impact of an ongoing old-age monetary-transfer programme on nutrition-related indicators, food security and poverty was assessed at the levels of both older persons and households. This was carried out through a quasi-experimental study using an ex-post comparison of intervention and control groups with no baseline measures. Overall, results suggest differential access to food, quality of life and living conditions according to socioeconomic stratum among older persons and their household contexts. Differences in dietary diversity and food insecurity among older persons were also found, when data were disaggregated by monetarytransfer eligibility status. The old-age intervention analysed in this thesis showed little impact on access to food and other indicators of well-being at household level. There was, however, a high prevalence of people being overweight and obese among the older population under study. Given that this thesis is the first approach to food insecurity ever carried out among urban older populations in Mexico and Latin America, the conclusions emphasise the magnitude of uncertain access to food during old age, and they suggest guidelines for policy makers at different levels of government, stimulating further research on issues related to old age in the region.