VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, 2450 Holcombe Blvd Suite 01Y, Houston, Texas, 77021, US.
University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, Minnesota, 55455, US.
Soc Psychiatry Psychiatr Epidemiol. 2021 Dec;56(12):2175-2184. doi: 10.1007/s00127-021-02071-3. Epub 2021 Mar 26.
Suicide and food insecurity (i.e., lack of access to food) are two major issues that affect US Veterans.
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.
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.
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.
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.
自杀和粮食不安全（即无法获得食物）是影响美国退伍军人的两个主要问题。
我们使用基于美国的样本评估了粮食不安全与退伍军人自杀意念之间的关联。因为抑郁症通常先于自杀，所以我们还检查了粮食不安全与抑郁症之间的关联。
使用参加 2007-2016 年全国健康和营养检查调查的 2630 名退伍军人的数据，我们进行了调整后的线性回归模型，以评估粮食不安全（使用 18 项家庭粮食安全调查测量）与抑郁症（使用 PHQ-9 测量）之间的关联，并进行了调整后的二元逻辑回归模型，以评估粮食不安全与自杀意念（使用 PHQ-9 问题 9 测量）之间的关联。模型根据性别、年龄、收入与贫困比例、种族/民族和教育水平进行了调整。
在样本中，有 11.5%的人粮食不安全，抑郁评分平均为 2.86（SD=4.28），有 3.7%的人有自杀意念。与粮食安全的退伍军人相比，边缘（β=0.68，95%CI [0.09，1.28]）、低（β=1.38，95%CI [0.70，2.05]）或极低粮食安全（β=3.08，95%CI [2.34，3.83]）的退伍军人的抑郁评分显著增加。与粮食安全的退伍军人相比，低（OR=2.15，95%CI [1.08，4.27]）或极低粮食安全（OR=3.84，95%CI [2.05，7.20]）的退伍军人自杀意念的几率显著增加。
退伍军人的粮食不安全与抑郁症状和自杀意念增加有关。这种关联随着粮食不安全状况的恶化而增强。有粮食不安全问题的退伍军人应接受抑郁和自杀意念筛查。同时，抑郁症治疗计划和自杀预防计划应考虑粮食安全等基本需求。
