Abstract
Background
Food insecurity has been associated with worse health outcomes in the civilian population.
Male veterans of the Gulf Wars have been shown to have a higher prevalence of food
insecurity than similarly situated civilians. Women veterans have more risk factors
for food insecurity, relative to male veterans, yet little is known about the prevalence
of food insecurity in this cohort.
Methods
We used the Women Veterans' Health Utilization and Experience Survey for this analysis.
Our study population consisted of women veterans who had at least three primary care
or women's health visits to 1 of 12 Veteran's Health Administration health care facilities
from December 2013 to November 2014. Multiple logistic regression was used to examine
the relationship between food insufficiency (an inadequate amount of food intake owing
to a lack of money or resources), delayed/missed care, anxiety, depression, and self-reported
fair to poor health, controlling for race/ethnicity, marital status, and employment
status.
Results
The prevalence of food insufficiency among women veterans was 27.6%. Being food insufficient
was associated with 16.4, 15.4, 14.9, and 12.1 percentage point increases in the probability
of delayed/missed care, screening positive for anxiety, screening positive for depression,
and reporting fair to poor health, respectively (p < .05).
Conclusions
The prevalence of food insufficiency in this cohort was associated with delayed access
to health care and worse health outcomes. Interventions addressing Veterans Administration
access and health outcomes will need to examine the potential role of food insufficiency.
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Biography
Kimberly Narain, MD, PhD, MPH, is an Assistant Professor in the Division of General Internal Medicine and Health Services Research at the UCLA David Geffen School of Medicine, exploring the implications of health and social policies for health equity.
Biography
Bevanne Bean-Mayberry, MD, MHS, is a Clinical Associate Professor of Medicine at the VA Greater Los Angeles Healthcare System and UCLA David Geffen School of Medicine. She is a general internist whose research focuses on gender differences in quality measures and patient satisfaction.
Biography
Donna L. Washington, MD, MPH, is Women's Health Focused Research Area Lead, VA HSR&D's Center for the Study of Healthcare Innovation, Implementation and Policy; and Professor of Medicine, UCLA. Her research interests include the health care needs of women, and vulnerable/underserved populations.
Biography
Ismelda A. Canelo, MPA, is a Health Science Specialist, VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy. She has 20 years of experience managing VA primary care and women's health organizational and implementation research.
Biography
Jill E. Darling, PhD, MSHS, is a survey research methodologist whose areas of expertise include the design and conduct of large-scale mixed-methods data collection projects, multi-mode surveys, questionnaire development and design, data analysis, and survey research ethics.
Biography
Elizabeth M. Yano, PhD, MSPH, is Director, VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, and Professor, Health Policy & Management, UCLA Fielding School of Public Health. Her research focuses on primary care and women's healthcare delivery.
Article info
Publication history
Published online: February 20, 2018
Accepted:
January 10,
2018
Received in revised form:
January 5,
2018
Received:
July 26,
2017
Footnotes
Funding Statement: This project was funded by the VA HSR&D Service Women Veterans Healthcare CREATE project on Implementation of Women's Health Patient Aligned Care Teams (Project #CRE 12-026), a cluster randomized trial registered in ClinicalTrials.gov #NCT02039856. Funding for the 12-month patient survey wave was augmented by VA Women's Health Services, Veterans Health Administration, Washington, DC, to increase content for formative feedback to evidence-based quality improvement (EBQI) sites, as well as funding from Dr. Yano's Under Secretary for Health Award (Project # USH 12-216). Dr. Narain's effort was supported by the Advanced Health Services Research Fellowship, Center for Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System. Dr. Yano's effort was supported by a VA HSR&D Senior Research Career Scientist Award (Project #RCS 05-195).
Disclosures: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veteran's Affairs or the United States government.
Identification
Copyright
© 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc.
