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Publication Briefs
 

Study Shows Food Insecurity in Veterans is Associated with Increased Depression Symptoms and Suicidal Ideation


BACKGROUND:
Since 2005, the prevalence of suicide among Veterans has steadily increased. Among the strategies and approaches to prevent suicide, the Centers for Disease Control and Prevention (CDC) includes the need to identify and support people at risk. VA also emphasizes the need to identify risk factors. A growing but limited body of evidence suggests that social determinants of health resulting in economic disparities may contribute to suicidal behaviors – and may be as relevant as medical factors such as depression for suicide prevention and treatment. This study sought to investigate the association between food insecurity and suicidal ideation. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2007-2008 through 2015-2016, investigators identified 2,630 Veterans who had participated in the survey. Investigators then examined the association between food insecurity with depression and suicidal ideation while controlling for gender, age, income-to-poverty ratio, race/ethnicity, and education level.

FINDINGS:

  • Food insecurity in Veterans was associated with increased depression symptoms and suicidal ideation. The odds for suicidal ideation among Veterans with very low food security – the most severe level of food insecurity – increased by nearly four-fold compared to those who were food secure. Adjusted results show:
    • Veterans with marginal, low, or very low food security had statistically significant increased depression screening scores compared to Veterans who had full food security.
    • Veterans with low or very low food security had statistically significant increased odds for suicidal ideation compared to Veterans with full food security.
  • Food insecurity affected 12% of the Veterans surveyed. The average depression screening score was 2.86, and 4% of Veterans endorsed suicidal ideation.

IMPLICATIONS:

  • Given this evidence supporting the relationship between food insecurity and depression, organizations serving Veterans should integrate prevention, mitigation and treatment efforts for food insecurity, depression, and suicidal ideation.  

LIMITATIONS:

  • Investigators were unable to control for other mental health conditions (i.e., substance use disorders) and other social determinants (i.e., housing security), which are also risk factors for suicidal behavior.
  • Data used in this analysis were subject to self-report bias.

AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D. Drs. Kamdar, Uzdavines, Helmer, and Hundt are part of HSR&D’s Center for Innovations in Quality, Effectiveness and Safety (IQuESt) in Houston, TX.


Kamdar N, Horning M, Geraci J, Uzdavines A, Helmer D, and Hundt N. Risk for Depression and Suicidal Ideation among Food Insecure US Veterans: Data from the National Health and Nutrition Examination Study. Social Psychiatry and Psychiatric Epidemiology. March 26, 2021. Online ahead of print.

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HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.


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