September 30, 2022


Devoted to Quality Health

People of color, women and those with health conditions among veterans at high risk of food insecurity

Between July 2017 and December 2018, 44,298 veterans screened positive for food insecurity. In their analysis, the researchers found that food insecurity was associated with identifying as non-Hispanic Black or Hispanic, non-married or partnered, and low-income. Veterans were also at higher risk for food insecurity if they had experienced homelessness or housing instability in the prior year, or if they had a diagnosis of diabetes, depression, and/or PTSD .

Prior military sexual trauma was associated with a significantly higher risk of food insecurity among both men and women. Notably, though, women screening positive for food insecurity were eight times more likely than men to have experienced military sexual trauma (49{f9a9d0c078b99c5035c80896b16d2b484abb346d07724230e395ff1864e1808b} of women vs. 6{f9a9d0c078b99c5035c80896b16d2b484abb346d07724230e395ff1864e1808b} of men).  This is a strong example of how sexual trauma experienced while in the service can have a range of serious downstream effects for veterans, Cohen said. “And as these results show, women bear a much higher burden.”

As a clinician who treats veterans, Cohen is familiar with how not having reliable access to nutritious food can cause serious health problems and exacerbate existing conditions. “I regularly see the negative impacts of food insecurity on my patients,” she said.

Some of the very factors that make veterans susceptible to food insecurity, like diabetes or depression, can be worsened by not having healthy food to eat, Cohen noted. The stress of not being able to afford food for oneself or one’s family compounds the situation.

The study findings can inform the development of tailored, comprehensive interventions to address food insecurity among veterans, Cohen said. For example, if a clinician is treating a veteran with diabetes who is experiencing food insecurity, they can review the patient’s medical history to see if there are any medications they might have difficulty affording or that might put the veteran at risk for low blood sugar. In a team-based model of care, the clinician can refer the patient to a dietitian to provide nutritional counseling based on the patient’s medical and social circumstances. V.A. social workers can help meet a veteran’s immediate food need the day of their visit by providing a meal ticket or referring them to a food pantry, as well as provide assistance applying for any benefits for which they may qualify, such as federal food assistance programs.

The findings can also help start a conversation about refining screening practices, Cohen said: “For example, they may help us identify specific groups that would benefit from more targeted or more frequent screening for food insecurity, as well as expanding where we conduct routine food insecurity screening to include settings like mental health clinics.”

The accepted manuscript was published online in Public Health Nutrition ahead of the final version of the study that will appear in a print issue of the journal.

In addition to Cohen, other Brown faculty who contributed to this research included David Dosa, James Rudolph and Kali Thomas.

This work was supported by grant CIN 13-419 from the V.A. Health Services Research and Development Center of Innovation in Long Term Services and Supports, as well as Department of Veterans Affairs Health Services Research and Development grants CDA 20-037and CDA 14-422, and grant P30DK092926 from the National Institute of Diabetes and Digestive and Kidney Diseases.