Food Insecurity in US Military Veterans

Abstract

Background: Food insecurity (FI) is an important public health issue for US veterans. For many veterans, civilian life is fraught with service-incurred health issues and socioeconomic challenges, each risk factors for FI. The FI literature on veterans is limited due to insufficient coverage of the topic’s complexity and the methods used to study it in this population. No published analysis has evaluated how FI has been examined in US veterans. Objectives: We assessed how FI has been examined in US military veterans by identifying (1) the major content areas, or domains, studied in association with FI and (2) the existing research gaps. Methods: A scoping literature review was conducted to map the main research domains of the FI literature and identify knowledge gaps. Electronic database and hand searches identified potentially relevant studies (n = 61). Data extraction, utilizing a standardized set of design parameters, was completed. Duplicate removal and application of inclusion/exclusion criteria resulted in the studies (n = 21) selected for critical review. Results: Eight research domains were determined: FI prevalence, health status, dietary practices, health care utilization, economic instability, homelessness/housing instability, food program participation, and community/emergency preparedness—the most dominant was health status and the least dominant were social determinants (ie, homelessness/housing instability, food program participation). Research on validity and usability of FI assessment methods in veterans was virtually absent. Military service factors, longitudinal effects, FI among women, intervention effectiveness, and other areas lacked sufficient inquiry. Conclusion: Research is required on lesser examined content areas and methodology to optimize surveillance and policy for veteran FI.

Prevalence and socio-economic determinates of food insecurity in Veterans: findings from National Health and Nutrition Examination Survey

“…In addition to the various classification schemes, studies examining food security status in Veterans use a wide variation of surveys, sample populations and covariates (35) . A recent review by Cypel et al reported that twenty out of twenty-one articles examining food insecurities among Veterans used different data sources (nationwide population-based surveys, Veterans Health Administration (VHA) surveys, focus groups and pilot studies), baseline characteristics and terminology to define 'food insecurity' (35) . The design structure of both nationwide population and Veteran Affairs (VA)-based surveys are fundamentally limited in their ability to fully capture or represent the entire US Veteran population.…”

“…In addition to the various classification schemes, studies examining food security status in Veterans use a wide variation of surveys, sample populations and covariates ( 35 ) . A recent review by Cypel et al .…”

Food desert residence has limited impact on veteran fecal microbiome composition: a U.S. Veteran Microbiome Project study

“…A factor worthy of future exploration is food insecurity. A financially driven condition of limited or inadequate access to sufficient nutrition ( 51 ), food insecurity is associated with an increased risk of adverse health outcomes, including cardiovascular disease, diabetes, and psychiatric illness ( 52 – 54 ). Of note, food insecurity differs from food desert status in that it comprises all of the financial and interpersonal resources that shape access to food, independently or in addition to geographic access.…”

Food Insecurity Among U.K. Veterans

“…Research on the impact of gender, veteran status, and food insecurity is also revealing. Female veterans have higher levels of food insecurity than male veterans (Cypel et al, 2020; Narain et al, 2018). These persistent gender findings exist despite controls for income.…”