Food insecurity and health: data from the Veterans Aging Cohort Study.
OBJECTIVE
Food insecurity may be a modifiable and independent risk factor for worse control of medical conditions, but it has not been explored among veterans. We determined the prevalence of, and factors independently associated with, food insecurity among veterans in the Veterans Aging Cohort Study (VACS).


METHODS
Using data from VACS from 2002-2008, we determined the prevalence of food insecurity among veterans who have accessed health care in the Veterans Health Administration (VA) as defined by "concern about having enough food for you or your family in the past month." We used multivariable logistic regression to determine factors independently associated with food insecurity and tests of trend to measure the association between food insecurity and control of hypertension, diabetes, HIV, and depression.


RESULTS
Of the 6,709 veterans enrolled in VACS, 1,624 (24%) reported being food insecure. Food insecurity was independently associated with being African American, earning <$25,000/year, recent homelessness, marijuana use, and depression. Being food insecure was also associated with worse control of hypertension, diabetes, HIV, and depression (p<0.001).


CONCLUSIONS
Food insecurity is prevalent and associated with worse control of medical conditions among veterans who have accessed care in the VA.
Yale University School of Medicine, Department of Internal Medicine, New Haven, CT.
Emily A
EA
Wang
VA Connecticut Healthcare System, West Haven, CT.
Kathleen A
KA
McGinnis
Yale University School of Medicine, Department of Internal Medicine, New Haven, CT ; VA Connecticut Healthcare System, West Haven, CT.
Joseph
J
Goulet
National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD.
Kendall
K
Bryant
VA Medical Center and George Washington University Medical Center, Washington, DC.
Cynthia
C
Gibert
VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA, Los Angeles, CA.
David A
DA
Leaf
VA Central Western Massachusetts, Northampton, MA ; University of Massachusetts Medical School, Worcester, MA.
Kristin
K
Mattocks
Yale University School of Medicine, Department of Internal Medicine, New Haven, CT.
Lynn E
LE
Fiellin
Hennepin County Medical Center, Minneapolis, MN.
Nicholas
N
Vogenthaler
Yale University School of Medicine, Department of Internal Medicine, New Haven, CT ; VA Connecticut Healthcare System, West Haven, CT ; Yale University School of Public Health, Center for Interdisciplinary Research on AIDS, New Haven, CT.
Amy C
AC
Justice
Yale University School of Medicine, Department of Internal Medicine, New Haven, CT ; Yale University School of Public Health, Center for Interdisciplinary Research on AIDS, New Haven, CT.
David A
DA
Fiellin
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006304:Health Status; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*