A May research study from the University of Iowa highlights restricted access to nutritious food and poverty could cause faster cognitive decline in older adults. 

According to data compiled by the State of Iowa, 4,595 households, or 9,864 individuals, rely on the food assistance program in Johnson County as of Sept. 1. Additionally, a 2024 HealthyJoCo Food Security Assessment report found that 49 percent of survey respondents visit a food pantry weekly. 

The Supplemental Nutrition Assistance Program, or SNAP, under the U.S. Department of Agriculture, will not be able to provide its routine monthly assistance for low-income individuals to purchase food this November due to the government shutdown. 

Boeun Kim, assistant professor at the University of Iowa College of Nursing, and her research team explored the health impacts of food and poverty in a recent study published in BMC Medicine. 

The study found adults aged 65 and older in low-income neighborhoods with restricted access to healthy food experienced faster cognitive declines than others in better-resourced neighborhoods. 

The research analyzed data from nearly 4,800 adults across the U.S., combining information from the U.S. Department of Agriculture’s Food Access Research Atlas and the National Health and Aging Trends Study.

The study was associative and not causational, which means researchers couldn’t definitively say that the older adults were experiencing cognitive decline directly because of their place in food-insecure, low-income neighborhoods.

Kim said she was well aware that many cognitive issues, such as dementia, don’t have a known cure, so she decided to analyze factors that plant the seeds of cognitive decline, hoping to catch them before they advance. 

“Right now we don’t have any prefectures or treatments for dementia,” she said. “I really want to focus on the prevention level, looking at lifestyle factors. So one of the important lifestyle factors for cognitive health or dementia is food, because food is a medicine.”

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Kim started the study looking at how low food access correlates with a greater decline in cognitive function over time, but soon found she needed to add another factor to formulate a clearer associative pattern. 

“I realized that even if they have some resources for food, their environments are not affordable or accessible,” she said. “That environment really increases the food insecurity level and also affects the cognitive function or dementia outcome.”

Kim and her team submitted grant requests over the course of October, ranging from $200,000 to $3 million to develop a better measurement of subjects’ food environments. 

Further research would enable the team to establish a causal link between food insecurity and cognitive decline rather than the associative relationship identified in the study. Kim expects to hear back on the grant requests in April. 

She said she hopes the study raises awareness of the real effects of where people live can have on brain health. 

Kim said one immediate solution would be for the government to focus more funding on SNAP. The program provides monthly assistance for low-income individuals to purchase food. 

Over the long term, Kim said there were a number of ways for policymakers to fight disparities in cognitive decline.

“They have to identify the areas that lack the access to healthy and affordable food, and then they can expand the affordable healthy food options through grants to grocery stores or through mobile markets, or simply support existing small retailers and local markets,” she said. 

Nick Smithberg, executive director of Iowa Legal Aid, said he was unsurprised by the study’s findings.

Iowa Legal Aid provides free legal assistance and advocacy to low-income Iowans and assists them with problems related to housing, health care, family, and other basic needs. Smithberg said the negative health effects of poverty found in the study highlight a factor often overlooked in the conversation of public health: housing instability.

“Eviction rates in the state are at pretty much at or near an all-time high every year at this point,” he said. “People don’t think of that as a public health issue, but it really is. When people get evicted, they literally have a lower life expectancy.”

Smithberg said long-term exposure to substandard housing after evictions leaves families exposed to mold, vermin, and lead paint, all of which could bring about cognitive issues. 

He cited a United Way’s 2023 estimation that 37 percent of Iowan households either earned less than the federal poverty level or were Asset Limited, Income Constrained, Employed, or ALICE, meaning a significant portion of the population faces persistent economic barriers to accessing healthy food.

“It’s not surprising to hear this data, because the mental and physical health impacts of poverty are pretty pervasive,” he said. “ From our experience with our clients, that absolutely is a pervasive issue. Toxic stress and trauma are just inextricably linked to the experience of poverty.”