Food Insecurity Among Older Adults: A Multilevel Analysis of State-Level Interventions.

Objective: To analyze whether state-level social programs for older adults (OAs) in Mexico are associated with a reduction: (a) in the prevalence of severe food insecurity (SFI) and (b) in the magnitude of the effect of municipal marginalization on SFI. Method: Cross-sectional study based on urban OAs (65-100 years) from the 2010 census. Three-level logistic multilevel regression models were estimated to explain SFI. Results: Controlling for individual and municipal characteristics, states with social programs for OAs are generally associated with lower SFI prevalences (odds ratio [OR] = 0.68 [0.48, 0.95]) and mitigate the effect of marginalization on SFI when compared with states with no programs. Compared with in-kind food programs and voucher-based programs, monetary transfers are associated with a significant reduction in SFI prevalence (OR = 0.68 [0.46, 0.99]). Conclusion: States with programs for OAs, mainly monetary transfers, are associated with lower SFI prevalences.