The Case for Meals on Wheels: An Evidence-Based Solution to Senior Hunger and Isolation

Nearly 13 million¹ older Americans face hunger or the threat of it and 1 in 4² lives alone. Additionally, almost 95% of older adults have at least one chronic condition, with almost 80% having two or more.³

Seniors experiencing food insecurity report being in poor physical or mental health for an additional three days per month compared to their food-secure peers. Lack of access to regular, nutritious meals contributes to higher rates of depression, gum disease, asthma, diabetes, congestive heart failure and heart attacks.⁴ Lack of social connection, too, brings its own set of dangers associated with increased risks of heart disease,⁵ stroke⁶ and even death.^{7 8} Combined, these health risks result in significant care costs for seniors themselves, as well as for Medicare, taxpayers and the health care⁹ industry as a whole.¹⁰ The growing population of Americans aged 60 or older, rising health care costs and ongoing inflation¹¹ make it more important than ever to address the escalating crisis around food access and loneliness.

For more than 50 years, Meals on Wheels has supported our nation’s seniors through a network of local community-based programs. These providers serve as a lifeline to those struggling with food insecurity, nutrition challenges, mobility, loneliness and countless other difficulties of aging. Each day, we hear anecdotes of how Meals on Wheels has touched people’s lives. And for every positive story, there’s an opportunity to apply real numbers to the impact Meals on Wheels has on those who benefit from services. Yet funding for Meals on Wheels services has not kept pace with the growing need. We looked at 38 research publications conducted between 1996 and 2023, and from them, we can draw strong associations between receiving Meals on Wheels and experiencing positive health and well-being outcomes that affect health. These findings suggest that if our nation continues to underfund Meals on Wheels, health care costs will increase.

Key Findings

The review of 38 selected studies found a link between receiving Meals on Wheels and experiencing the following primary health and well-being outcomes:

1. Reduced use of costly health care services
2. Reduced nursing home use and increased ability to age in place
3. Reduced health care costs attributed to reduced hospital and nursing home spending
4. Increased food security
5. Improved diet quality
6. Reduced or slowed decline in nutritional risk
7. Reduced social isolation and loneliness
8. Reduced falls and increased home safety

The review also found evidence from a smaller number of studies that participants enjoyed greater physical health, improved mental health and well-being, and greater financial security. Some studies also identified positive benefits for staff and volunteers.

This comprehensive review of 38 studies establishes Meals on Wheels as an evidence-based, cost-effective solution that reduces the use of health care services, prevents nursing home admissions and generates substantial health care cost savings to individuals and U.S. taxpayers. By delivering nutritious meals, fostering social connections and providing safety checks, Meals on Wheels helps older adults maintain their health and independence.

Looking Ahead

Study recommendations outlined in the report provide guidance for program planning, encourage the expansion and enhancement of services, and offer inspiration for future studies. Several studies noted the need for government investment in Meals on Wheels, including sustained Older American Act (OAA) funding, expanded OAA funding to cover more older adults who need Meals on Wheels and those on waitlists, and federal and state investment in Meals on Wheels generally.

Additionally, several of the reviewed studies highlighted the cost savings of strengthening partnerships with health care organizations, emphasizing their potential to enhance clients’ well-being. By fostering these health care partnerships, Meals on Wheels can further extend its impact and contribute to better outcomes for older adults while reducing the burden on the health care system. 

Meals on Wheels America is committed to updating and expanding on these findings, and conducting further research to explore the life-changing  impact our organization’s services have on the lives of the older adults we serve.

In reproducing any excerpts of this report, please provide a credit that recognizes Meals on Wheels America, such as: Meals on Wheels America. (2023). The Case for Meals on Wheels: An Evidence-Based Solution to Senior Hunger and Isolation. https://www.mealsonwheelsamerica.org/research/the-case-for-meals-on-wheels/

External Publications

Health and Well-Being Outcomes of Meals on Wheels: A Systematic Review for a Complex Intervention, Wright, B., Owens, V., & Wilson, S., Innovation in Aging, 2024.