Food Insecurity in US Military Veterans

Abstract

Background: Food insecurity (FI) is an important public health issue for US veterans. For many veterans, civilian life is fraught with service-incurred health issues and socioeconomic challenges, each risk factors for FI. The FI literature on veterans is limited due to insufficient coverage of the topic’s complexity and the methods used to study it in this population. No published analysis has evaluated how FI has been examined in US veterans. Objectives: We assessed how FI has been examined in US military veterans by identifying (1) the major content areas, or domains, studied in association with FI and (2) the existing research gaps. Methods: A scoping literature review was conducted to map the main research domains of the FI literature and identify knowledge gaps. Electronic database and hand searches identified potentially relevant studies (n = 61). Data extraction, utilizing a standardized set of design parameters, was completed. Duplicate removal and application of inclusion/exclusion criteria resulted in the studies (n = 21) selected for critical review. Results: Eight research domains were determined: FI prevalence, health status, dietary practices, health care utilization, economic instability, homelessness/housing instability, food program participation, and community/emergency preparedness—the most dominant was health status and the least dominant were social determinants (ie, homelessness/housing instability, food program participation). Research on validity and usability of FI assessment methods in veterans was virtually absent. Military service factors, longitudinal effects, FI among women, intervention effectiveness, and other areas lacked sufficient inquiry. Conclusion: Research is required on lesser examined content areas and methodology to optimize surveillance and policy for veteran FI.