Sangkla J.Phulkerd S.Sujaritpong S.Gray R.S.Chamratrithirong A.Pattaravanich U.Mahidol University2026-04-092026-04-092026-12-01BMC Geriatrics Vol.26 No.1 (2026)https://repository.li.mahidol.ac.th/handle/123456789/115962Background: Food access is a critical public health issue closely associated with the growing problem of food insecurity (FI), which has shown a steady increase, particularly among older adults, a population group considered especially vulnerable. This study aimed to examine the situation and the influence of food access determinants at the individual, household, and community levels on the severity of food insecurity among Thai older adults. Methods: This cross-sectional study utilised secondary data from the 2022–2023 round of the Survey on Food Consumption, Food Security, and Food Literacy in Thailand. The survey employed a multi-stage sampling design covering the four main geographic regions and Bangkok. Data were collected from all household members who met the inclusion criteria. For this analysis, the data were weighted and restricted to a sample of 2,641 individuals aged 60 years or older. Food insecurity (FI) was assessed using the Food Insecurity Experience Scale (FIES) and categorised into three severity levels. Predictor variables included socio-demographic characteristics, household-level food access, and community-level food access, all derived from the survey questionnaire. Ordered logistic regression was applied to examine the associations between the predictors and the severity of FI. Results: Approximately one in four older adults (26.9%) experienced FI (i.e., 25.3% mild, 1.6% moderate-to-severe), while 73.1% reported none. Food access across individual, household, and community levels significantly predicted FI severity. Older Thais with low income and limited education were 1.84 and 3.45 times more likely to face severe FI. Receiving healthy food prepared by a household member reduced FI risk by 50%. Living in a rural area and having limited access to food outlet diversity increased severe FI risk by 1.30 and 2.88 times, respectively. Conclusions: Improving food access for older adults requires a multilevel approach. The government should ensure inclusive food welfare, while communities should develop local systems to support older adults, especially those facing food shortages.MedicineArticleSCOPUS10.1186/s12877-026-07140-32-s2.0-10503380833814712318