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

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.

Self-reported Health Predicts Hispanic Women's Weight Perceptions and Concerns

Objectives In this study, we examined how self-reported health is related to low-income, Hispanic women's underestimation and concerns of weight status. Methods Seventy Hispanic women from Houston-area community centers reported their perceptions and concerns about their weight and health. Height and weight were measured to calculate body mass index. Cross-tabulations and Cohen's kappa determined agreement between women's perception of their weight status and measured weight status. Covariate-adjusted OLS regression models analyzed the association between women's self-reported health as a predictor of weight underestimation and concerns about becoming overweight. Results Forty-three percent of women misperceived their weight status [37% (N = 26) underestimated; 6% (N = 4) overestimated]. Overweight and obese women who reported their health as poor had 84% lower odds of underestimating their weight. Women who reported their health as poor health had 52% lower odds of being concerned about becoming overweight. Conclusions Self-reported poor health predicts perceptions of weight and concerns about future weight gain among low-income Hispanic women. Assessing patients' self-reported health status will allow practitioners to identify who may be at risk for underestimating their weight and being unconcerned about becoming overweight. This knowledge may help practitioners identify patients who would benefit from health education.