From 2020 to 2024, the number of older adults in the U.S. climbed by 13%. Meanwhile, the number of working-age adults—ages 18 to 64—grew by just 1.4% and the number of children declined by nearly 2%. As the nation’s population continues to age, and as more older adults are homebound, home-delivered meals provided by programs like Meals on Wheels can be a lifeline.
Roughly one-third of meals provided by Meals on Wheels are funded through the Older Americans Act Nutrition Program (OAA) of 1972. Despite its clear benefits, 86% of older, low-income and food-insecure adults today have no access to home-delivered meals and potential cuts to the OAA would likely worsen the situation.
Brown researchers have long examined how home-delivered meals support the physical and emotional health of older adults. A new study confirms that home-delivered meals reduce hunger, food insecurity and social isolation; improve physical and emotional well-being; and help participants maintain independence and remain in their own homes. The study also found that these services ease stress and financial strain for family caregivers.
Em Balkan, a doctoral candidate at Brown, led the study with co-authors Emily Gadbois, assistant professor of health services, policy and practice, Emma Tucher, a 2024 graduate of the program, Kim Bernard, senior research scientist, and Kali Thomas, associate director of health services research at the Johns Hopkins School of Nursing and adjunct professor at Brown. As part of a larger Deliver-EE clinical trial, the team conducted in-depth interviews with 54 participants of the Meals on Wheels program, finding that these services “not only achieve their intended outcomes but also yield meaningful health-related benefits beyond their stated purpose that remain to be quantified.”
Balkan’s personal academic research focuses on Medicare Advantage and access to Medicaid benefits for older adults, as well as healthcare access for transgender adults. A native of Queens, they worked at the New York City Council as the senior policy analyst in the legislative division for the Health Committee and Hospitals Committee. In 2020, they also worked on the COVID committee, specifically on pandemic-related policy issues.
We spoke with Balkan about their new study, the unexpected health benefits of Meals on Wheels, and why fully funding the OAA matters.
Most of us are familiar with Meals on Wheels, which delivers meals with obvious nutritional benefits for recipients. But you also found benefits for caregivers in your study. Can you explain how home-delivered meals help ease the burden on caregivers?
Some recipients of Meals on Wheels are caregivers themselves. It’s kind of a double impact. For example, one interviewee was both an older adult receiving meals and a caregiver to their sibling, who also received meals. Hearing them talk about how the program helped both of them was really moving.
Their sibling’s appetite was unpredictable–they’d often just want a snack instead of a full meal–so having one dependable, balanced meal every day was a huge relief. It helped emotionally and financially, since trying to keep up with unpredictable eating habits can be exhausting and expensive.
We also heard from many people who relied on others for food and found the program gave them more autonomy. I don’t think people always realize how physically demanding it is to go grocery shopping, carry groceries, prep and cook food, and clean up afterward. For many, having meals delivered made them feel more independent, and some even said that having this kind of support is what allows them to keep living at home.
One participant talked about how their son is their main caregiver, but they really don’t want to move in with him; they want to stay in their own home. At the same time, their appetite fluctuates, so they don’t want to ask for groceries on a set schedule because the food might go to waste. The meals helped them navigate that balance, to maintain independence without feeling like a burden. So overall, it’s a twofold benefit: the program supports caregivers as well as the people who rely on them, and it really enhances quality of life on both sides.
