Testimony to City Council: Home Delivered and Emergency Meal Services for Seniors through DFTA’s HDM Program and GetFoodNYC

by NYC Food Policy Editor
Testimony of Charles Platkin, Ph.D., J.D., M.P.H., Distinguished Lecturer, Hunter College, CUNY; Executive Director, Hunter College New York City Food Policy Center
Title of hearing: Home Delivered and Emergency Meal Services for Seniors Through DFTA’s HDM Program and GetFoodNYC
September 20, 2021

Thank you to Chairperson Vallone and the members of the Committee on Economic Development for the opportunity to submit written testimony regarding “Home Delivered and Emergency Meal Services for Seniors through DFTA’s HDM Program and GetFoodNYC.” 

I am providing this testimony on behalf of the Hunter College New York City Food Policy Center, of which I am the executive director. The Center was created in 2012 to develop collaborative, innovative and evidence-based solutions to prevent diet-related diseases, promote healthy eating and reduce food insecurity in New York City and other urban centers. The Center works with policy makers, community organizations, advocates and the public to create healthier, more sustainable food environments. We thank the City Council and the Speaker’s office for their support of our Center.

“Where is my next meal coming from?” It’s a question that more than a million New Yorkers, many of them senior citizens, asked themselves before the pandemic, are asking themselves today, and will, unfortunately, be asking themselves tomorrow. It’s a question no one should ever need to ask in one of the world’s wealthiest cities. Healthy food is a basic human right, and no New Yorker should ever have to experience hunger and/or food insecurity and not know where their next meal is coming from. 

Defining Hunger and Food Insecurity 

Before examining how hunger and food insecurity are afflicting New York City residents, it is important to understand the distinction between the two concepts. 

The USDA defines food insecurity as the “limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways,” and adds that food-insecure households report three specific conditions:

  1. Worrying whether their food will run out before they are able to buy more
  2. The food they bought didn’t last and they didn’t have money to get more
  3. They can’t afford to eat balanced meals.[1]

Furthermore, the USDA describes individuals who see regular disruptions to their food intake, often forgoing meals because they lack the resources to acquire them, as experiencing Very Low Food Security (VLFS).[2] These are different from hunger, which can be a consequence of food insecurity and refers to a physiological sensation, as opposed to an economic and/or social situation. Individuals who are experiencing hunger may be experiencing food insecurity as well; however, hunger can result from missing a meal or meals for reasons other than food insecurity.[3]

While the definition of food insecurity and VLFS may be clear to academics, politicians and government staffers, a study reported by this Center in 2018 demonstrated that, even among New Yorkers who are food insecure, many struggle to define what that actually means — in fact, more than two thirds of those surveyed were unable to define food insecurity.[4]

Why is this significant? Because, in order to design appropriate interventions with successful outcomes for the diverse populations we are trying to serve, everyone involved must have the same understanding of the terminology and the problem. The existing differences in understanding (or lack thereof), especially among those who are food insecure, suggest the need for a greater emphasis on food-policy education, including the establishment of a commonly accepted terminology.

Hunger and Food Insecurity Among Seniors in New York City and Beyond

In the United States, more than 5 million seniors (roughly one out of every 14 over the age of 65, or 7.1 percent) face hunger and/or food insecurity.[5,6] In New York City, hunger and food insecurity are pervasive and impacted more than a million New Yorkers even before the COVID-19 pandemic reached the City. This number rose to nearly 2 million during the height of COVID-19.[7,8] The number of food insecure individuals during this time included approximately 200,000 seniors, or 11 percent of NYC’s senior population.[9,10] Furthermore, the most recent Current Population Survey (CPS) indicated that the number of VLFS seniors had increased 213 percent between 2001 and 2019.[11]

Hunger, food insecurity and access to nutritious, nutrient-dense food (e.g., fresh produce, whole grains and lean proteins) are public health crises across America that impact our country’s seniors in a uniquely devastating way. Seniors confront many unique food accessibility challenges, including being isolated and/or medically vulnerable, which restricts their mobility. Many seniors live with limitations on their physical ability to perform certain functions, such as walking up stairs or carrying heavy items like grocery bags.[12] These functional limitations are connected to food insecurity, according to a 2021 study of Americans aged 65 and older titled Food Security Status among U.S. Older Adults: Functional Limitations Matter, that used data from the National Health Interview Survey (NHIS).[13] The study also found that food insecurity is higher among women, those over the age of 70, Hispanic seniors, and those who do not have health insurance.[14]

Additionally, many seniors live on reduced, limited, or nonexistent incomes, especially those who rely on public assistance such as SNAP benefits and social security payments.[15] Seniors who rely on public assistance programs generally have less money to purchase food at the end of the month as compared to the beginning.[16] Furthermore, the lack of technological skills and/or ability among many seniors can leave them unable to efficiently access many online resources, including enrolling for SNAP online, and finding food-related resources (e.g., food pantries, soup kitchens).[17] All these challenges are more acute among non-White seniors, seniors in rural areas,[18] and those who live alone.[19] Food insecurity is three times more common among divorced or separated seniors than those who are married.[20]

Low rates of Supplemental Nutrition Assistance Program (SNAP) enrollment among qualifying seniors can compound these challenges.[21] And even seniors who do enroll in assistance programs can experience a gap in between applying for benefits and receiving services such as SNAP and Meals on Wheels. During this time seniors are referred to other food resources, including grocery store options, food pantries, and available Senior Dining Program meal sites. Those who have mobility issues and are homebound may struggle to access food at these locations. A longitudinal study of individuals experiencing food insecurity who were SNAP benefit recipients from 1998 to 2014 found that SNAP beneficiaries, particularly seniors, were more likely to experience low self-esteem and depressive symptoms.[22]

In 2017, the New York City Council passed Local Law 134, which requires all senior centers to offer SNAP enrollment and recertification of SNAP benefits[23] (SNAP recipients are required to recertify for benefits every 6, 12, or 24 months depending on household circumstances). Still, less than half of eligible seniors in NYC receive SNAP benefits,[24] leaving a majority of impoverished seniors without the assistance in purchasing nutritious groceries that the program provides.[25] These rates are even lower in immigrant communities, where language barriers and fears of deportation prevent many who qualify from enrolling in SNAP.[26]

Nutrient-deficient diets caused by a lack of access to healthy foods and food insecurity can lead to diet-related disease.[27] Seniors generally have higher rates of these chronic diet-related diseases, such as diabetes and hypertension, than adults under the age of 65.[28,29] Furthermore, diabetes and hypertension are considered comorbidities with COVID-19, as patients with either of these diseases who contract COVID-19 are more likely to develop a severe case or die.[30] Seniors, especially those with comorbidities from diet-related disease, have been admitted to hospitals and intensive care units (ICUs) at higher rates than other patients, and are more likely to die from COVID-19.[31] To combat the prevalence of diet-related disease among the senior population, the USDA runs the Seniors Farmers’ Market Nutrition Program. Low-income seniors in this program are provided with coupons to purchase locally-grown fruits, vegetables, honey, and herbs.[32] However, mobility restrictions[33] can make it difficult for seniors to shop at bustling farmers’ markets.

Despite the food access and health challenges many seniors experience, they are often overlooked by food programs.[34] Approximately 425,000 or 28.9 percent of New York City residents over the age of 65 live alone.[35] Identifying seniors in need and connecting them with resources can be challenging, particularly because they often decline or are unable to seek the support they need.[36,37] Out of pride or an inability to recognize the extent of their physical or mental decline, many senior citizens do not ask for assistance.[38] “As people age, they don’t expect to need assistance. Then they become more physically and mentally disabled and we don’t necessarily learn about them,” said David Nocenti, JD, Executive Director of Union Settlement, in a panel called Nutrition and Aging, which was hosted by the Hunter College NYC Food Policy Center in 2019.[39]

Concerns about the stigma associated with receiving government assistance might be a reason many seniors do not enroll in food assistance programs such as SNAP, even if they are eligible.[40,41]

Meals Services for Seniors

The two most significant nutrition services provided to seniors across the country, as established by the Older Americans Act, are congregate meals and home-delivered meals.[42] Congregate meals are hot meals served at public institutions such as senior centers throughout the United States. Approximately 900,000 congregate meals were served each day before the COVID-19 pandemic.[43] (The number of congregate meals served during the pandemic has not been calculated and released publicly yet.)[44] Home-delivered meals, on the other hand, are meals delivered straight to seniors who are homebound or otherwise unable to go to institutions serving congregate meals.[45] Seniors do not always have the same physical capacity to access transportation, walk to grocery stores, or carry heavy items as younger individuals. Meal services therefore should be tailored to address older adults’ specific food accessibility needs. 

In addition to accounting for physical limitations, food programs that serve seniors must also pay greater attention to the nutritional quality of their offerings.[46] Given the significant food access challenges encountered by some New York City seniors, the meals they receive from community centers and delivery services may provide the bulk of their food intake on any given day. Care must be taken, therefore, to ensure that these meals are well-balanced and provide nutrient-rich diets to the City’s older adults.[47] Providers should increase the amount of nutrient-rich ingredients, including fruits, vegetables, lean proteins, and whole grains, used in their meals.[48

Lenox Hill Neighborhood House in Manhattan, which has been offering more plant-based meals to its clients since 2011, is a successful example of an organization that provides high-quality, nutrient-rich meals to its older adult clients.[49] The change occurred after the settlement house hired Lynn Loflin, a former Manhattan chef and the owner of the Newton Farm Cooperative in the Catskills, to serve healthier food, sourced locally wherever possible.[50,51] Loflin transformed their Food Services to a farm-to-institution model serving 400,000 healthy meals annually using more than 90 percent fresh produce and with a focus on plant-forward recipes, scratch cooking, local sourcing and diverse local whole grains.[52] In addition to operating two senior centers, the organization’s programs, which include Geriatric Care Management, Caregivers Program, Adult Education, Visual and Performing Arts, Friendly Visiting and the CARE program for older adults living with late-stage dementia, altogether serve 10,000 older adults annually.[53]

The Impact of COVID-19 on Hunger and Food Insecurity among NYC’s Seniors

The COVID-19 pandemic has greatly impacted the senior population of New York City.[54,55] While New York City worked quickly and aggressively to develop programs to address the increase in food insecurity brought on by the pandemic, many City agencies struggled to adapt and expand their food-provision programs to meet specific cultural and/or dietary needs.[56] Many of the solutions spearheaded by the City government were not designed to continue indefinitely; in fact, many have already come to a close despite continued need in the community.[57] Now, more than a year into the pandemic, NYC is still struggling to reduce food insecurity, hunger, and diet-related diseases.[58]

While clearly acknowledging the extent of the City’s food insecurity and hunger problems, officials have yet to provide the financial transparency (e.g. costs of food delivery programs and administration) and information that would allow NYC to determine what lessons have been learned, specifically around increasing access to healthy food during the pandemic, and whether or not officials enlisted the partnership of knowledgeable neighborhood organizations. 

Until there are extensive studies on the impact of COVID-19 on the food system, the number of New Yorkers experiencing food insecurity will remain difficult to assess. Early data, however, suggests that the number of people in the City who are facing hunger and food insecurity has almost doubled to include as many as 1.5 to 2 million residents.[59,60] Diet quality for many New Yorkers has also suffered.[61] Nearly 11 percent of NYC’s seniors were experiencing food insecurity before the pandemic,[62] and it is reasonable to assume that this number has increased as well. According to research conducted by the Food Bank for New York City, visits to emergency food relief programs by seniors increased by 56 percent in April 2020 compared to the monthly average before the pandemic.[63] One senior service organization, Encore Community Services, saw a 45 percent increase in demand for their home-delivered meal program in the first weeks of the pandemic.[64]

Programs that existed before the pandemic were ill-equipped to handle the massive increase in demand that accompanied the COVID-19 pandemic. Reports from food pantries and other emergency food providers suggest that funding and food supplies may not have been adequate to cover their needs.[65] Three out of four food pantries and soup kitchens saw an increase in the total number of visitors compared to the previous year,[66] including a 59 percent increase in undocumented immigrant clients.[67] And two of the largest emergency feeding programs, City Harvest and the Food Bank For New York City, have reported significant strain on their systems.[68]

Paradoxically, at the same time that COVID-19 caused increased food insecurity among New Yorkers, it also decreased many of the resources available to serve those in need.[69,70] Seniors and retirees, for whom a case of COVID-19 would pose serious health risks,[71] typically make up a large portion of senior center volunteers.[72] And as fears of infection kept many volunteers home, NYC’s senior centers and food pantries had to reduce their meal services or close their doors.[73]

NYC’s 59 unique neighborhoods are vibrant and racially, religiously, and culturally diverse, meaning that different neighborhoods and groups have different food needs, many of which were not met immediately by the programs offered by City agencies during COVID. In response to the COVID-19 pandemic, the Hunter College NYC Food Policy Center, collaborating with NYC agencies and community-based organizations, developed Coronavirus NYC Neighborhood Food Resource Guides for each and every of NYC’s 59 community districts to address these concerns.[74] These guides are the most comprehensive public database to provide NYC residents with an up-to-date overview of the various food and social service resources available to them in their community.

In order to find culturally appropriate food, many New Yorkers had to rely on local mutual aid networks and community-based organizations rather than turning to city programs. While these grassroots efforts are valuable, they are unsustainable as a long-term solution to hunger and food insecurity. City agencies should communicate more effectively with these groups and use their insights to better tailor food relief efforts to the needs of particular households and communities.

Disparities in the Food System Among New York City Communities

As the pandemic recedes to a degree, many New Yorkers, including seniors, still suffer from isolation, homelessness, joblessness, food insecurity, and hunger. Demand at food pantries across the City is still higher than it was before the pandemic.[75] Therefore, ensuring that NYC seniors have enough food, and that the food is high-quality and nutritionally dense, continues to be of critical importance, especially in light of the impact nutrition has on diet-related diseases and outcomes of COVID-19. 

The NYC economy is recovering, yet the number of New York City seniors experiencing hunger and food insecurity is still high, especially among residents of color who have not seen the same level of economic recovery as other communities.[76,77] Some of this increased need can be explained by larger problems, including limited benefits, low wages and structural racism.[78] Emergency food relief programs respond to issues of hunger and food insecurity but do not address the underlying issues of aging, poverty and social inequity. In order to eliminate hunger and food insecurity in the New York City food system, we must develop innovative solutions that address their root causes.

Gaps that existed before the pandemic between affluent and underserved communities were widened by COVID-19.[79,80] Healthy, affordable food is not distributed equitably throughout the City, and many underserved communities (particularly marginalized communities of color) do not have adequate access to healthy, affordable options.[81,82] These communities are sometimes known as “food deserts,” but that is not an accurate term — food is available in these communities, but it is often highly processed and unhealthy.[83] A more accurate way to refer to the disparity in food access among New York City neighborhoods would be to call it “food apartheid,” a phrase that draws attention to the systemic social and racial inequities that cause unequal access to healthy food.[84

Communities affected by food apartheid are those in which racially discriminatory policies and systems limit access to healthy food.[85] The lack of healthy food options in these communities is a systemic issue that will require innovative, community-driven interventions to correct.[86] A June 2021 report from the New York State Health Foundation reported that in March 2021 approximately 20 percent of Hispanic adults and 12 percent of Black adults accessed free meals or groceries, compared to 8 percent of Asian adults and 4 percent of White adults.[87

Food apartheid contributes to disparaties in the health outcomes of minority seniors as compared to their White peers.[88] Black and Latinx seniors suffer higher rates of diet-related diseases, including heart disease, diabetes, hypertension, and obesity.[89] During the pandemic, these underlying health conditions have placed minority seniors at increased risk for experiencing a severe or fatal case of COVID-19.[90,91]

Although Asian Americans as a whole experience food insecurity at lower rates than other minority populations, some of the City’s older Asian American adults face significant food insecurity challenges exacerbated by the pandemic, including poverty and difficulty accessing culturally-appropriate foods.[92] The poverty rate among New York City Asian Americans is 15 to 25 percent higher than the NYC average and saw the greatest increase of all major ethnic and racial groups during the pandemic.[93]

The older Asian American population of New York City includes a large number of immigrants, some of them with minimal English language skills.[94] Language barriers and undocumented immigration status prevent some of the most vulnerable Asian American seniors from enrolling in SNAP, leaving them without federal food aid, and during the pandemic, older Asian Americans have also struggled to access private food aid.[95] The increase in anti-Asian violence over the last eighteen months, including a more than nine-fold increase in hate crimes against Asians in New York City, has discouraged some Asian American seniors from going out, even to acquire groceries.[96] And those who do make it to food pantries and other private sources of food aid often find that these charities do not offer culturally appropriate foods.[97

LGBTQ+ seniors are another group uniquely affected by issues of poverty, hunger, food insecurity, and the COVID-19 pandemic.[98] As the lifespans of LGBTQ+ seniors increase, they represent a growing share of New York City’s senior population.[99] More likely to live alone and less likely to seek out social services than non-LGBTQ+ seniors, they often do not receive the help they need to access nutritious food.[100,101] Historical discrimination against LGBTQ+ individuals has contributed to a lack of trust in the social safety net leaving many LGBTQ+ seniors less likely than non-LGBTQ+ seniors to reach out to senior centers and meal providers.[102] Furthermore, many LGBTQ+ individuals hesitate going to churches and other religious buildings due to many religions’ histories of poor treatment and discrimination towards LGBTQ+ individuals.[103] LGBTQ+ seniors’ aversion to places of worship can reduce their access to the many food pantries run by religious organizations across the city.[104,105] The Love Wins Food Pantry, based in Jackson Heights, was founded by activist Daniel Puerto during the COVID-19 pandemic to provide a welcoming and safe space for the LGBTQ+ community, including seniors, to access food.[106] The City needs more organizations such as these to ensure that seniors from all backgrounds have safe and comfortable places to access food when needed.

Additionally, the emergence of the COVID-19 pandemic compounded the already existing HIV global epidemic, which has had a particularly devastating impact on the LGBTQ+ community,[107] and LGBTQ+ seniors in particular. In 2018, more than half of people living with HIV in the United States were age 50 or older,[108] including both newly diagnosed people living with HIV as well as those who were diagnosed early on — in the 1980s and 1990s — who are now the first cohort of people aging with HIV.[109] People living with HIV are also more likely to experience food insecurity, and food insecurity contributes to a higher likelihood of adverse HIV-related health outcomes.[110] This relationship is often characterized as a debilitating and vicious cycle.[111] Many of the country’s leading medically-tailored meal delivery services, including the NYC-based God’s Love We Deliver, began by providing services to people living with HIV in the 1990s.[112] While that organization has since expanded to provide meals to people with other chronic diseases including cancer, renal failure, Alzheimer’s, and more,[113] it is imperative that NYC’s seniors living with HIV not be left by the wayside.

What Has Been Done to Help Feed NYC’s Seniors During COVID-19, and What Remains to be Done

Many programs and organizations emerged as a direct result of the COVID-19 pandemic to help New Yorkers most in need. Some emergency food relief programs and initiatives that began as a result of the pandemic have now become permanent, while others are set to end in the coming months, even though hunger and food insecurity are still problems facing thousands of older New Yorkers.

Funding from federal,[114] state[115] and local[116] governments was quickly poured into the NYC food system to feed hungry residents, but at times it was still not enough to get every single person an appropriate amount and variety of food. This caused problems for some government-led food delivery initiatives, including complaints about foods being spoiled, unhealthy, or not culturally appropriate.[117,118] These complaints are not new — participants in food assistance programs are often expected to be grateful for the food they receive and not complain about any food they are dissatisfied with; the frustration of receiving poor quality food compounded with the embarrassment that is so often felt by those receiving help can make these programs an undignified experience.[119]

During the pandemic, many community organizations and individuals pivoted to focus on filling in the food gaps by connecting seniors in need with food resources in their neighborhoods. Faith-based organizations, community centers, restaurants, and nonprofits became hubs for food and meal distribution.[120] Unfortunately, residents, including seniors, sometimes waited in lines for hours to receive kitchen staples such as rice and canned goods, and many struggled to feed themselves adequately on diets lacking in fiber, protein and other fresh foods.[121] While the work done by these organizations was impressive and necessary, many did not have the resources required to meet the needs of all residents, including the City’s seniors. 

Furthermore, emergency food relief is not a long-term solution to the hunger and food insecurity crisis, and New York City seniors cannot permanently depend on pop-up emergency programs to keep themselves fed. Emergency food should be just that — food provided during an emergency. It should not be a system that New York City’s seniors in need have to rely on every day. We need increased SNAP enrollment and benefits, livable wages for those still working, and creative solutions from our local government to ensure that all of the City’s seniors have agency and access to nutritious, age-appropriate and culturally-sensitive food. 

Meal Delivery for Seniors Before and During the Pandemic

Prior to the pandemic, DFTA’s Home Delivered Meals (HDM) program served approximately 4.5 million meals annually, 87 percent fresh and 13 percent frozen, to roughly 18,000 homebound seniors.[122] Eligibility extends to people over age 60 whose frailty prevents them from attending congregate meals, who lack another formal or informal source of meals, and who cannot cook or grocery shop independently.[123] Seniors, however, cannot enroll in the program directly. Instead, DFTA’s Case Management Agencies (CMA) identifies and refers qualifying seniors after conducting extensive assessments of their needs.[124]

The HDM program, which aims to provide nutritious and culturally appropriate meals to NYC seniors, relies on a network of food providers. DFTA sources the HDM meals through partnerships with contractors and subcontractors.[125] All contracted providers agree to create a varied, pre-approved menu of meals reflective of NYC food standards and affording seniors one-third of the Daily Recommended Intake for adults.[126] In 2019, kosher meals, which are offered city-wide, were chosen by more than 18 percent of participants.[127] In eighteen out of the twenty-three geographic areas served by the HDM program, DFTA offers seniors additional culturally or religiously appropriate options, and, again in 2019, four percent of HDM recipients chose among Chinese, Korean, Polish, Halal, Caribbean, and vegetarian options.[128]

At the beginning of the COVID-19 pandemic, concerns regarding increased risk of severe disease or death from COVID-19 led some previously mobile seniors to stay home.[129] At the same time, many seniors lost access to forms of support they had previously relied on to meet their food needs, including congregate meals and family visits.[130] This left a number of seniors confronting food security challenges they had not faced previously.[131] In response to these issues, NYC launched GetFoodNYC in March 2020, a delivery program for residents who could not acquire food on their own.[132] Eligibility for GetFoodNYC relied on largely the same criteria used to screen seniors for the HDM program.[133] The initiative targeted New Yorkers unable to go out who could not afford food delivery, lacked a household member or neighbor to source food for them, and did not already receive meals from another food aid program.[134]

In May 2020, DFTA began to direct new enrollees to HDM to GetFoodNYC’s Emergency Home Food Delivery Program (EFD) instead.[135,136] The decision was criticized, as it forced many non-tech-savvy seniors to relearn how to use a completely different online platform than the one to which they had become accustomed.[137,138] Participants in EFD received two deliveries a week, each providing enough food for three meals a day for three days,[139] a notable increase over the single daily meal provided to seniors through HDM.[140] Because of high demand, GetFoodNYC capped the number of individuals eligible to receive food at two people per household and could offer only a broad delivery window of 8 am to 5 pm on scheduled drop-off days.[141] Recipients could either place their orders one at a time or schedule two weeks of recurring deliveries.[142] The meals, prepared by a diverse group of vendors contracted by the city, tried to cater to religious and cultural needs.[143] Options included Kosher, Halal, and vegetarian as well as limited numbers of pan-Asian and Latin American meals.[144] The format of these dishes varied, but most arrived fresh or frozen, requiring minimal preparation using an oven or a microwave.[145]

The program, however, was not without problems: numerous complaints were raised to reporters and city officials about the quality of the food delivered,[146,147] and there were reports of food being delivered to incorrect addresses.[148] Some people thought that the food was inequitably distributed among communities, as some recipients were given high quality meals while others received boxes full of snack foods.[149] Furthermore, in the summer of 2020, NYC’s GetFoodNYC program changed their enrollment procedures, which caused difficulty accessing the program for many of the City’s less-than-tech-savvy seniors.[150] The good news is that the one year after the program began, the City had delivered more than 200 million meals to New Yorkers in need,[151] many of whom were seniors. The program will conclude in October of 2021, leaving thousands of recipients potentially without a viable food resource they have come to rely on for more than a year.[152] The City reported that “​​The De Blasio administration is working to make sure the people covered by the program are taken care of by other food assistance programs including meals served at senior centers, according to city officials and advocates.”[153]

Despite the shortcomings of GetFoodNYC, signs indicate that the HDM program alone will not be able to handle the increased demand for senior meals without significant funding for infrastructure and staffing increases. HDM had to redirect many of its participants to GetFoodNYC because it lacked the funding to provide for them.[154] And because it offers only one meal a day instead of GetFoodNYC’s three, HDM is not in a position to fill the food insecurity gap left by the termination of the emergency program.[155]

Changes to the Ways Seniors Shop for Food

The pandemic also brought about a major increase in the use of online food shopping, both for in-store pickup and delivery.[156,157] Online ordering is a particularly effective way to access food for people who are unable or unwilling to leave their homes, such as the immunocompromised and those with comorbidities.[158] Furthermore, delivery is especially helpful for people with difficulty accessing reliable transportation to and from a grocery store.[159] However, the expanded popularity and use of online shopping was not beneficial to all. Some seniors did increase their use of online platforms, but many still struggle to navigate the internet due to inexperience, lack of computer education, and cognitive issues.[160]

Furthermore, many seniors face the added difficulty of attempting to purchase groceries online using their SNAP benefits. In recent years many retailers, such as Walmart,[161] Amazon Fresh,[162] and Stop & Shop, have begun accepting SNAP benefits for online orders,[163] and while the USDA does not allow SNAP benefits to be used to cover delivery fees for online grocery shopping, many retailers have waived the fee for people using EBT to purchase online.[164] This is, however, still a fairly recent development, and many SNAP recipients, especially seniors, do not have experience with online grocery shopping.[165]

Additionally, some food pantries and grocery stores responded to the fears from older clientele by offering seniors-only shopping hours,[166,167,168,169] thus reducing the number of people allowed in the store or pantry at a time in order to help seniors feel more protected and comfortable.[170]

Other Initiatives to Feed All New Yorkers In Need, Including Seniors

In addition to the expansions to food and meal delivery for seniors, federal, state and city governments acted quickly to expand and improve the emergency food system, increasing access for all New Yorkers, regardless of age.

Nourish New York, an initiative instituted by former Governor Andrew Cuomo in April 2020,[171] is intended to connect surplus food from New York farms with state residents experiencing hunger and food insecurity. The purpose of the program is to purchase excess food from NY State farmers and deliver it to food banks across the state. In May 2021, the New York State Legislature unanimously passed a bill to make Nourish New York permanent, which will support farmers while also improving food security in urban and rural areas.[172] Furthermore, in September 2021 Governor Kathy Hochul announced a fourth round of funding to the program, in the amount of $25 million.[173] The program is vital to promoting the success of New York-grown produce and encouraging statewide connections between food producers and consumers.

Food pantries in NYC received an emergency $25 million from the City in April 2020,[174] but these funds ran out by the end of the year. Activists called on the Mayor’s office to renew the funding in 2021, but the renewal has not taken place. In June 2021,[175] however, the USDA announced funding for the country’s food bank network that would include money to support local, regional, and socially disadvantaged farmers in order to address racial inequality in the country’s food system.[176] In order to alleviate hunger, government policy must acknowledge and actively confront the racial, age-based, and disparities that already exist.

When schools closed in March of 2020, the NYC Department of Education moved quickly to provide take-out meals to ensure that students who relied on school meals were not left hungry.[177] In addition, community members in need who were not students or family of students, including senior citizens, were able to go to specific schools to pick up meals without any registration or identification.[178] However, grab-and-go community meals ended on September 10, 2021,[179] and outreach must be done to ensure that communities are aware of the other resources available to them.[180]

We applaud City agencies, community organizations, and residents for their quick response to the food crisis exacerbated by the COVID-19 pandemic. However, we must now reflect on mistakes made in order to see how we can do better for the people of NYC going forward. We must create strategies to eliminate hunger, food insecurity, and diet-related disease and give people the basic human right to healthy food for every meal.

The goal cannot be to return to the pre-pandemic normal, as that would still leave approximately 1.2 million people, almost 200,000 of them seniors,[181] hungry and food insecure.[182] In order to eliminate hunger in NYC, we need long-term solutions to ensure that all New Yorkers have access to healthy, nutritious meals. And in order to ensure this, we cannot leave our food insecure seniors behind.

Hunger, food insecurity, food justice, and reducing diet-related disease should be amongst the top issues in the next mayoral election and a key priority for the next mayor. In fact, we suggest creating a new position in the City Hall team — a Deputy Mayor for Food and Water, who would be responsible for hunger and food insecurity initiatives, diet-related chronic disease reduction, and coordination of these programs across agencies and communities. He or she would be a crucial public presence to demonstrate to New Yorkers that the City is prepared to meet the needs of its most vulnerable residents and ensure the right to healthy and nutritious food for all.

Every New Yorker deserves access to healthy, affordable food. And when food insecurity, hunger, and diet-related disease persist, the city government needs to intervene in order to make sure that no New Yorker ever has to think: “Where is my next meal coming from?” 


  1. Simplify Enrollment Processes for the Supplemental Nutrition Assistance Program (SNAP) and make sure both online and telephone options are expanded. 
    • Staff SNAP enrollment centers with employees specially trained to assist older adults.
    • Improve awareness and use of the Get the Good Stuff[183] program through education at senior centers and expand the program to additional stores.
    • Send out health workers to go to seniors homes to encourage SNAP enrollment and have health workers provide enrollment door-to-door. 
  2. Expand and create new healthy food incentive programs for seniors to purchase healthy foods, and even healthy prepared foods. 
    • Improve awareness and use of the Seniors Farmers’ Market Nutrition Program through education at senior centers and senior living facilities.
  3. There should be financial incentive programs specifically for seniors to purchase healthy foods and healthy prepared foods beyond what is currently available with Health Bucks and other City-led incentive programs. 
  4. Avoid the “Get What You Get and Do Not Get Upset” Syndrome
    • Delivered meals must be healthy, and include fresh fruits and vegetables.
    • Those receiving public assistance should receive nutritious, culturally and age-sensitive food in a dignified manner. 
  5. Improve Communication and Accessibility to Information for Food Resources
    • Send letters via mail to seniors informing them of programs they are eligible for.
    • Expand the reach and improve the readability of informational materials.
    • Expand the certification period for SNAP to ensure that seniors don’t experience a lapse in benefits. Currently the maximum certification period for households with all elderly or disabled members is 24 months, but Texas and Arkansas have been permitted to waive this limit and provide 36 month certification periods to these households.[184]
  6. Improve At Home Grocery Store Delivery 
    • Provide incentive vouchers/incentives for fruits, vegetables, grains, etc.
    • Train community workers to provide assistance to seniors so they can order food delivered to their door from a phone or NYC-provided tablet. 
  7. Continue to Serve Meals while Providing Transparency 
    • The City reports that it provided more than 200 million meals to NYC residents in need during the pandemic.[185] The public needs to know where those funds came from and how they were allocated.
    • Include publicly-available information about how many meals were served to seniors and how the meals were served (delivery or congregate).
  8. Create More Senior Center Food Pantries 
    • Some senior centers, such as the BronxWorks Heights Senior Center (currently closed due to the COVID-19 pandemic), have provided bags of groceries to older adults.[186] Providing pantry goods in addition to hot meals can help seniors who are able to cook for themselves feel more independent and create meals that suit their cultural needs and personal preferences. 
    • Seniors centers should be provided with funding to distribute grocery items to clients.
  9. Expand Food Options to Reflect Variations in Ability Among Seniors 
    • Seniors vary in their physical ability to prepare meals and access kitchen equipment. Some are capable of cooking their own meals and are interested in doing so. Others, cannot use or access the essential equipment required to reheat a fresh or frozen meal. 
    • The City should expand its food aid to seniors to broaden the range of nutritious options, including produce boxes and shelf-stable meals that cater to seniors’ varied food needs, preferences and cooking abilities.
    • Fridges, freezers, stoves and storage for food should be assessed at seniors’ homes. 
  10. Increase the Cultural Diversity and Sensitivity of Meals 
    • Fifty percent of HDM recipients surveyed in 2019 reported that culturally specific meals are important to them.[187] The City should work to ensure that culturally and religiously appropriate meals are consistently available to all older New Yorkers by establishing culturally-specific contracts.
    • Many older immigrant adults have low English proficiency. Ensure that all information about free meals is available in languages understood by the seniors receiving them.
  11. Monitor Food Prices
    • Seniors often live on fixed incomes making it imperative to keep grocery prices low and avoid price gouging, especially in areas that have high populations of seniors. Track food prices (especially the price of produce and basic necessities) throughout the five boroughs monthly and report those results to the public to ensure that food prices are kept fair and affordable and that there is no price gouging.
  12. Increase and Expand Emergency Food Funding
    • The City allocated funds to a very small number of major emergency food providers during the height of the COVID-19 pandemic. It could be beneficial to allocate those funds to a greater number of smaller providers (e.g. small food pantries, faith-based food relief efforts, senior center food pantries, mutual aid groups) throughout the city, particularly in neighborhoods that are experiencing high rates of food insecurity and are farther away from the City’s larger food pantries.
    • Help community-based emergency food-relief organizations and programs connect to sustainable funding sources to allow those who are food insecure to access nutritious food.
  13. Improve Funding for Senior Centers
    • Many of NYC’s elderly rely on hot meals provided by the nearly 250 senior centers throughout the city. Better funding to these institutions would help them provide a more varied selection of hot meals from quality ingredients so that all cultural and dietary needs are met.
  14. Improve Communication about Food Resources
    • The lack of coordination among and communication about available food resources has slowed food distribution efforts to NYC residents in need. Information about openings and closings of food pantries and retail food outlets, and about the availability of emergency food is not centralized in one easy-to-access location (other than the 59 Hunter College NYC Food Policy Center Neighborhood Food Resource Guides . Furthermore, seniors may need to access information in different methods than other groups throughout the City. Send out weekly letters to seniors letting them know what food resources are available in their neighborhood, and promoting those resources within that neighborhood (e.g., posters, flyers, announcements).
    • The City needs to create a detailed list of emergency food options, including a map of all food distributed (e.g., Grab-and-Go sites and home delivered meals/food). These maps can then be distributed at senior centers and by community organizations helping the senior population.
  15. Create a Live Database of Emergency Food Providers’ Inventory and Accessibility
    • Add each food pantry’s inventory to a live, public database to ensure that food banks, community organizations, and the City are supplementing low inventory and meeting high demand. Keep track of which inventory items are the most in-demand in specific communities and tailor food-relief efforts accordingly. Have a specific section for seniors on which food pantry locations are wheelchair accessible, have age-sensitive items, and offer senior hours.
  16. Examine the Nutritional Profile of Public Emergency Meals
    • Analyze the nutritional quality and the proportion of “healthy” and “unhealthy foods” offered by emergency food providers and institutional food programs.
    • Ensure nutritional profile of emergency meals meets the dietary needs of older adults and the chronic diseases they might be managing.
  17. Create a More Dignified Approach to Accessing Emergency Food
    • Many seniors struggle with the stigma that is too often associated with accessing emergency food and receiving assistance (such as SNAP). To improve their experience with these services, we must consider new, more dignified methods to provide those in need with food (e.g. expand food delivery options for those receiving SNAP benefits).
    • Require food delivery services such as Fresh Direct, Amazon Fresh, Instacart, and Target to accept SNAP benefits.
  18. Improve Use of Online Shopping Among Seniors
    • Many seniors struggle when trying to purchase food online.[188] Platforms for purchasing groceries for pickup or delivery should be streamlined and made easier to navigate.
    • Staff senior centers with people trained to assist residents with online food purchases and problems they may have obtaining healthy food. 
  19. Conduct Surveys and Research into Hunger and Food Insecurity Rates Among the Various Communities of NYC
    • We need to get an accurate picture of how many New Yorkers, including seniors were negatively impacted by the COVID-19 pandemic in order to design appropriate, targeted interventions.
    • Include geographic and demographic information about hunger and food insecurity during the pandemic in reports that will be accessible to the public.
    • Include senior-specific information to pinpoint gaps in service for older adults and determine the best ways to support the homebound and isolated.
  20. Appoint a Deputy Mayor for Food and Water
    • This individual will have a thorough understanding of the food needs of different New York City populations and will be the face of the food system for New Yorkers.
    • Provide adequate funding and staff to the Office of Food Policy so the City can better meet the needs of the people.
    • Staff under this Deputy Mayor should include personnel knowledgeable about the specific problems faced by seniors in accessing food.
  21. Increase the Number of Fruit and Vegetable Carts designated to Naturally Occurring Retirement Community (NORC)
    • Expand the City’s Green Carts program, especially in underserved areas, by easing restrictions and streamlining the application process. 
    • Ensure that existing Green Cart vendors are allowing the use of EBT cards. 
    • Allow other fruit and vegetable vendors that are not part of the Green Carts program to take EBT funds as well. 
  22. Subsidize Nutritious Food Boxes for all Senior Centers
    • Partner with GrowNYC and other food-related community-based organizations to create a nutritious food-box delivery to every single NYC senior.
  23. Establish Participatory and Grow Gardens at Senior Centers and in NYCHA Housing and Senior Centers
    • Turn senior centers, spaces already frequented by older New Yorkers, into sources of fresh produce by creating participatory gardens. 
    • Involve low-income seniors in the gardening process to offer them a social outlet and encourage them to eat what they grow.
  24. Improve Accessibility of Public Spaces Where Food is Available
    • Ensure that parks and buildings providing food and food assistance, such as farmers’ markets and SNAP enrollment centers, are equipped with ramps, handrails, and anything else needed for less-mobile seniors to have easy access to these spaces.

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