Comparing Food Insecurity between Veterans and non-Veterans
Poor and inconsistent access to healthful nutrition is associated with a multitude of adverse health outcomes including cardiovascular disease, diabetes, mental illness, and poor overall health. Given that food insecurity affects at least 14% of U.S. households, the ensuing disease burden is significant. Recent studies have identified increasing age as a risk factor for food insecurity. During the next decade, there will be a 12% growth in the number of Veterans using VA healthcare that are over age 65, yet our understanding of the prevalence of food insecurity among older Veterans and how it compares to older non-Veterans is limited. Therefore, this study examined the prevalence of food insecurity in an older male population. Investigators used data from the 2012 Health and Retirement Study (HRS) and the 2013 HRS Health Care and Nutrition Mail Survey of 2,560 male participants (1,254 Veterans) to estimate prevalence and identify any significant predictors of food insecurity.
- There was a significantly lower prevalence of food insecurity among male Veterans compared to non-Veterans (6% vs. 12%, respectively). Nevertheless, several factors predisposed male Veterans to a higher risk for being food insecure.
- Younger Veterans (aged 50-64) were more likely to be food insecure and had nearly three times the prevalence of food insecurity compared to Veterans aged 65+ (12% vs. 4%, respectively).
- Overall, having a psychiatric diagnosis, self-reporting symptoms consistent with clinical depression, smoking, and experiencing any difficulty with activities of daily living (ADLs) were all significantly associated with increased odds of being food insecure, even after adjustment for demographics, medical comorbidities, and economic status.
- Veterans aged 50-64 are not yet eligible for Social Security benefits, and particular attention should be paid to their psychological and functional status.This group in particular should be screened for food insecurity.
- While older Veterans (65+) are less likely than their younger counterparts to be food insecure, depression was highly prevalent, and was a significant risk factor for food insecurity. Special attention should be paid to the atypical symptoms of depression that can manifest in the elderly.
- As a cross-sectional study of survey responses, findings cannot be used to establish causality or to surmise if or how food security status may change over time.
- Because food security was assessed via self-report, investigators cannot exclude the possibility that recall and social desirability biases may have influenced prevalence rates.
- The HRS only evaluates participants with permanent addresses, thus precluding the assessment of thousands of transient or homeless older Veterans.
This study was supported by a Career Development Award to Dr. Thomas, who is part of HSR&D's Center of Innovation in Long-Term Services and Supports for Vulnerable Veterans, Providence, RI. Dr. Brostow and Ms. Gunzburger are part of HSR&D's Center of Innovation for Veteran-Centered and Value-Driven Care, Denver, CO.
Brostow DP, Gunzburger E, and Thomas KS. Food Insecurity among Veterans: Findings from the Health and Retirement Study. The Journal of Nutrition, Health & Aging. March 23, 2017;Epub ahead of print.