Risk for depression and suicidal ideation among food insecure US veterans: data from the National Health and Nutrition Examination Study

Nipa P. Kamdar, Melissa L. Horning, Joseph C. Geraci, Alexander W. Uzdavines, Drew A. Helmer, Natalie E. Hundt

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Suicide and food insecurity (i.e., lack of access to food) are two major issues that affect US Veterans. Purpose: Using a US-based sample, we evaluated the association between food insecurity and suicidal ideation among Veterans. Because depression often precedes suicide, we also examined the association between food insecurity and depression. Methods: Using data from 2630 Veterans who participated in the National Health and Nutrition Examination Survey 2007–2016, we conducted an adjusted linear regression model to evaluate the association between food insecurity (measured using 18-item Household Food Security Survey) and depression (measured using PHQ-9) and an adjusted binary logistic regression model to evaluate the association between food insecurity and suicidal ideation (measured using PHQ-9 Question 9). Models were adjusted for gender, age, income-to-poverty ratio, race/ethnicity, and education level. Results: Of the sample, 11.5% were food insecure, depression scores averaged 2.86 (SD = 4.28), and 3.7% endorsed suicidal ideation. Veterans with marginal (β = 0.68, 95%CI [0.09,1.28]), low (β = 1.38, 95%CI [0.70,2.05]) or very low food security (β = 3.08, 95%CI [2.34, 3.83]) had significantly increased depression scores compared to food secure Veterans. Veterans with low (OR = 2.15, 95%CI [1.08, 4.27]) or very low food security (OR = 3.84, 95%CI [2.05, 7.20]) had significantly increased odds for suicidal ideation compared to food secure Veterans. Conclusion: Food insecurity in Veterans is associated with increased depression symptoms and suicidal ideation. This association strengthens as food insecurity worsens. Veterans with food insecurity should be screened for depression and suicidal ideation. Simultaneously, depression treatment plans and suicide prevention programs should consider basic needs like food security.

Original languageEnglish (US)
JournalSocial Psychiatry and Psychiatric Epidemiology
Early online dateMar 26 2021
DOIs
StateE-pub ahead of print - Mar 26 2021

Bibliographical note

Funding Information:
This work was supported by the Department of Veteran Affairs Office of Academic Affiliations and in part by the Houston VA Health Services Research & Development Center for Innovations grant (CIN13-413).

Publisher Copyright:
© 2021, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

Keywords

  • Depression
  • Health services
  • Hunger
  • Mental health
  • Military
  • Suicide

PubMed: MeSH publication types

  • Journal Article

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