Exploring the role of social capital in managing food insecurity among older women in the United States.

Food insecurity, which affects 37 million individuals in the United States (U.S.) and disproportionately burdens women, minorities and older adults, is a well-established determinant of poor health. Previous studies suggest social capital, defined as the material and social benefits arising from relationships among individuals within and between groups, may be protective against food insecurity. Drawing on this evidence, calls have been made for interventions and policies to promote social capital to address food insecurity. However, limited research has explored in-depth how social capital shapes the lived experience of food insecurity in the U.S. We explored how older women from three settings in the U.S. used forms of social capital to navigate their food environments. Between November 2017-July 2018, we conducted 38 semi-structured interviews with food-insecure women aged 50 years or older enrolled in the Northern California, Georgia, and North Carolina sites of the Women's Interagency HIV study, an ongoing cohort study of women living with and at risk of HIV. Interviews were analyzed using an inductive-deductive approach. Women from the three sites explained how they drew upon different forms of capital to access food. Women in Georgia and North Carolina depended on support from members within their social group (bonding social capital) to address food insecurity but described limited opportunities to build relationships with members from other social groups (bridging social capital) or representatives of institutions (linking social capital). In contrast, women from Northern California frequently used bridging and linking social capital to access food but described limited bonding social capital. Findings show how the role of social capital in protecting against food insecurity is diverse, complex, and structurally determined. Intervention implications are discussed.