Abstract
Background: Awareness of negative health impacts associated with food insecurity among US veterans is growing. Yet, little research has examined characteristics associated with persistent vs transient food insecurity. Objective: Our aim was to investigate characteristics associated with persistent vs transient food insecurity among US veterans. Design: The study used a retrospective, observational design to examine data from Veterans Health Administration electronic medical records. Participants/setting: The sample consisted of veterans (n = 64,789) who screened positive for food insecurity in Veterans Health Administration primary care during fiscal years 2018-2020 and were rescreened within 3 to 5 months. Main outcome measures: Food insecurity was operationalized using the Veterans Health Administration food insecurity screening question. Transient food insecurity was a positive screen followed by a consecutive negative screen within 3 to 15 months. Persistent food insecurity was a positive screen followed by a consecutive positive screen within 3 to 15 months. Statistical analyses performed: A multivariable logistic regression model was used to assess characteristics (eg, demographic characteristics, disability rating, homelessness, and physical and mental health conditions) associated with persistent vs transient food insecurity. Results: Veterans with increased odds of persistent vs transient food insecurity included men (adjusted odds ratio [AOR] 1.08; 95% CI 1.01 to 1.15) and those from Hispanic (AOR 1.27; 95% CI 1.18 to 1.37) or Native American (AOR 1.30; 95% CI 1.11 to 1.53) racial and ethnic groups. Psychosis (AOR 1.16; 95% CI 1.06 to 1.26); substance use disorder, excluding tobacco and alcohol (AOR 1.11; 95% CI 1.03 to 1.20); and homelessness (AOR 1.32; 95% CI 1.26 to 1.39) were associated with increased odds of persistent vs transient food insecurity. Veterans who were married (AOR 0.87; 95% CI 0.83 to 0.92) or had a service-connected disability rating of 70% to 99% (AOR 0.85; 95% CI 0.79 to 0.90) or 100% (AOR 0.77; 95% CI 0.71 to 0.83) had lower odds of persistent vs transient food insecurity. Conclusions: Veterans at risk for persistent vs transient food insecurity may struggle with underlying issues like psychosis, substance use, and homelessness in addition to racial and ethnic inequities and gender differences. More research is needed to understand the characteristics and mechanisms that increase risk for persistent vs transient food insecurity among veterans.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1044-1052.e5 |
| Journal | Journal of the Academy of Nutrition and Dietetics |
| Volume | 123 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2023 |
Bibliographical note
Funding Information:FUNDING/SUPPORT The research reported here was supported in part by the US Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Center for Innovations grant (CIN13-413). The views expressed in this article do not represent the views of the US Department of Veterans Affairs or the US Government.
Funding Information:
FUNDING/SUPPORT The research reported here was supported in part by the US Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, Center for Innovations grant (CIN13-413). The views expressed in this article do not represent the views of the US Department of Veterans Affairs or the US Government.
Publisher Copyright:
© 2023 Academy of Nutrition and Dietetics
Keywords
- Food security
- Homeless
- Mental health
- Military
- Primary care
- Social determinant
PubMed: MeSH publication types
- Journal Article
- Research Support, U.S. Gov't, Non-P.H.S.
