This story first appeared in How We Care, a weekly newsletter by Spotlight PA featuring original reporting and perspectives on how we care for one another at all stages of life. Sign up for free here.
PITTSBURGH — The staff at the South Hills Salvation Army works hard to make people feel welcome during its weekly food pantry.
The week before Thanksgiving, Theresa, 85, enjoyed the buoyant atmosphere as she caught up with friends and sipped refreshments.
The spunky Pittsburgh native was eager to snag a block of yellow cheese, which she planned to melt and mix into macaroni. The cheese comes with a parcel of nonperishable foods that’s packed at the Greater Pittsburgh Community Food Bank as part of the Senior Food Box Program.
The initiative, jointly funded by the state and U.S. Department of Agriculture, provides low-income older adults with a monthly supply that includes pasta, juice, cereals and a variety of canned foods. To qualify, a person must be at least 60 years old and have an annual income of no more than 130% of the federal poverty level, which amounts to less than $20,000 for an individual.
Pennsylvania’s Department of Agriculture told Spotlight PA that 18 food banks distribute these boxes to nearly 40,000 people every month — though some 343,000 Pennsylvanians qualify for the program. That number will jump to a projected 645,000 when the state raises the income limit by roughly $3,000 next spring.
“We’re really excited about that,” said Colleen Young, the Pittsburgh food bank’s director of government affairs.
Young explained that boxes serve older people who might use other government programs and still struggle with accessing nutritious food. A healthy diet is crucial when managing chronic medical conditions like diabetes or hypertension, which are more common among people 65 and older.
Theresa said she signed up for a senior box in 2023, the same year she started shopping at the food pantry. She was having a hard time affording the protein drinks prescribed to her by a dietitian at her dialysis clinic. Back then she was mostly eating hot dogs and ground meat, which was what she could afford. Because of her improved diet, she now feels healthier and has more energy.
Spotlight PA is only using Theresa’s first name because she doesn’t want her neighbors to know that she relies on public support to eat. The pantry staples provided by the senior boxes free her from having to choose between buying food and getting enough protein.
“Otherwise, I wouldn’t be able to do it. I really wouldn’t. Because I just live on social security,” Theresa said.
According to the USDA, in 2023 some 18 million households nationwide dealt with food insecurity, which is defined as not having reliable access to sufficient qualities of nutritious food. As a result, people might skip meals, eat less than they need or consume unhealthy foods that cost less but lack nutrients.
Cindy Leung, an assistant professor of public health at Harvard, said children’s struggles with food insecurity get far more research attention than the challenges faced by older adults. One of Leung’s recent studies found that between 1999 and 2003, 12.5% of households with older adults dealt with at least one instance of food insecurity. When the survey was repeated between 2015 and 2019, the rate jumped to 23.1%.
For older adults, barriers to balanced meals can include physical limitations that make it difficult to cook or get to a grocery store, Leung said. The AARP Pennsylvania told Spotlight PA that these challenges are compounded by climbing food costs and many retirees having fixed incomes.
In addition to senior food boxes, other forms of public support, such as SNAP (formerly known as food stamps), address hunger. But as Allegheny County’s Area Agency on Aging explained, older adults can find the sign-up process confusing. Others might be reluctant to seek out assistance due to stigma or embarrassment.
Back at the South Hills Salvation Army, Theresa deposited the box into her trunk, then returned inside to a large room buzzing with caffeinated chatter. Volunteers and staff had set up a makeshift market stocked by the food bank and donations from restaurants and grocers.
Theresa gathered a range of foods as she browsed the impressive selection: frozen vegetables, eggs, pre-made salad, a small vanilla cake, fresh produce, Italian sausage and six fragrant cinnamon raisin bagels.
The Pittsburgh food bank prefers that older adults collect their boxes in person at distribution sites, like the Salvation Army. This creates opportunities to connect low-income adults to other services such as SNAP or the Low Income Home Energy Assistance Program, which provides grants to subsidize Pennsylvanians’ heating bills.
Another benefit of a face-to-face pickup is that it’s social. The USDA reports that older adults who live alone are more likely to be food insecure, and one 2024 study found that food insecurity is “significantly associated” with isolation and loneliness.
Isolation is also a risk factor for developing dementia, the neurological condition that affects nearly 1 in 10 Americans older than 65. A recent publication of Leung’s found the same is true for food insecurity: The likelihood of dementia increases twofold among older adults who lack adequate nutrition.
“One of the biggest concerns that they probably have is being able to preserve their cognition as they age,” Leung said.
Other studies have also found a correlation between food insecurity and cognitive decline. Though this research doesn’t prove that poor nutrition causes dementia, Leung said there’s a clear association — even after considering factors like educational attainment and income.
This overlap of cognitive health, loneliness and food makes sense because eating is more than nourishment. It’s cultural, emotional and often how we show people we care.
Theresa felt that connection when the Salvation Army staff offered her a surprise: They’d set aside about two dozen of the pricey protein drinks for her.
Her voice faltered as she stared down at the crate of white bottles. “It makes you want to cry.”
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