Peter Gillespie ’25

The risks of malnutrition are extensive,  especially within the elderly population. Social factors such as poverty, race, illiteracy, and poor access to healthcare have been shown to increase risk of malnutrition among older adults. However, a recent publication from Dr. Mark J. Sedler, founder of the Stony Brook University Office of Global Medical Education, and his colleagues proposes an additional social determinant of health: social isolation. 

Sedler and his colleagues assessed the social determinants of health, or the presence of social factors that lead to poor health outcomes, in a cohort of 295 elderly individuals (with a mean age of 72) from rural Ecuador. The team used the Mini Nutrition Assessment to evaluate each individual’s nutritional status and the Depression-Anxiety-Stress Scale-21 to identify depressive symptoms in participants. Results show that as adverse social determinants of health increase for an individual, their scores on the Mini Nutrition Assessment decrease. In other words, an individual was at greater risk for malnutrition as social factors that pose health risks increased. More notably, the social determinants that strongly contributed to this increased risk of malnutrition were those related to social isolation – namely difficult family situations, poor social relationships, and inadequate support networks. Perceived social isolation does not necessarily refer to an individual being alone, but rather how supported they feel by others during difficult times. Feelings of being socially isolated significantly contribute to malnutrition  despite the population’s access to affordable and nutritious foods such as oily fish. This suggests that the impact of financial need may not supersede the impact of social isolation on malnutrition. Feelings of loneliness already worsen quality of life, but this decline in quality of life is further exacerbated by malnutrition, sending individuals down a spiral of continuous detriments to quality of life.  

This study offers important insight on social factors that contribute to malnutrition and highlights that prevalence of malnutrition in the elderly may not be solely due to race, income, and healthcare access – all of which were the same in this population. This work also proposes a new avenue for decreasing the risk of malnutrition for the rural elderly population by mitigating social risk, perhaps, as suggested by the investigators, through an increased emphasis on networking and social interaction within the community.

Works Cited

[1] O. Del Brutto, et al., Social determinants of health (social risk) and nutritional status among community-dwelling older adults living in a rural setting: the Atahualpa project. Journal of Primary Care and Community Health 13, 1-5 (2022). doi: 10.1177/21501319221087866.

[2] Images retrieved from: https://commons.wikimedia.org/wiki/File:Entrega_do_Pr%C3%AAmio_Cam%C3%B5es_de_Literatura_(32195643934).jpg