Public assistance program and food diversity among older people: a cross-sectional study using the Japan Gerontological Evaluation Study data Subheadings: Public assistance program and food diversity

Abstract Background Food diversity plays an important role in people’s healthy and affluent lives. However, poverty and eating alone can create multi-dimensional barriers to their food diversity. Although public assistance programs guarantee a minimum income to those in need, financial support alone may not be sufficient to support the health of people in poverty. Methods This cross-sectional study utilized data from the Japanese Gerontological Evaluation Study (2022), involving 14,467 participants aged 65 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 dietary variety score, 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. Results Men recipients of public assistance had lower DVS, even after adjusting for sociodemographic factors (adjusted β: -0.72, p = 0.04). For women, there was no association between receiving public assistance and lower DVS (adjusted β: -0.19, p = 0.66). There tended to be an interaction toward a higher DVS by public assistance and eating together among only men (p = 0.07). Conclusions Even after adjusting for sociodemographic factors, men recipients of public assistance have less food diversity than non-recipients. Men recipients were more likely to increase their food diversity by eating together. To ensure recipients’ rights to food security, the public assistance program may be effective in providing additional support to integrate recipients into communities that enable them to eat together in addition to financial support.