Health Outcomes Military Exposures, Epidemiology Program, Office of Patient Care Services, US Department of Veterans Affairs, Washington, DC 20420, USA.
San Francisco VA Health Care System, San Francisco, CA 94121, USA.
Int J Environ Res Public Health. 2024 Mar 18;21(3):356. doi: 10.3390/ijerph21030356.
Food and/or housing instability (FHI) has been minimally examined in post-9/11 US veterans. A randomly selected nationally representative sample of men and women veterans (n = 38,633) from the post-9/11 US veteran population were mailed invitation letters to complete a survey on health and well-being. Principal component analysis and multivariable logistic regression were used to identify FHI's key constructs and correlates for 15,166 men and women respondents (9524 men, 5642 women). One-third of veterans reported FHI; it was significantly more likely among women than men (crude odds ratio = 1.31, 95% CI:1.21-1.41) and most prevalent post-service (64.2%). "Mental Health/Stress/Trauma", "Physical Health", and "Substance Use" were FHI's major constructs. In both sexes, significant adjusted associations ( < 0.01) were found between FHI and homelessness, depression, adverse childhood experiences, low social support, being enlisted, being non-deployed, living with seriously ill/disabled person(s), and living in dangerous neighborhoods. In men only, posttraumatic stress disorder (adjusted odds ratio (AOR) = 1.37, 95% CI:1.14-1.64), cholesterol level (elevated versus normal, AOR = 0.79, 95% CI:0.67-0.92), hypertension (AOR = 1.25, 95% CI:1.07-1.47), and illegal/street drug use (AOR = 1.28, 95% CI:1.10-1.49) were significant ( < 0.01). In women only, morbid obesity (AOR = 1.90, 95%CI:1.05-3.42) and diabetes (AOR = 1.53, 95% CI:1.06-2.20) were significant ( < 0.05). Interventions are needed that jointly target adverse food and housing, especially for post-9/11 veteran women and enlisted personnel.
食品和/或住房不稳定(FHI)在 9/11 后美国退伍军人中研究甚少。从 9/11 后美国退伍军人人群中随机选择了一个具有全国代表性的男性和女性退伍军人样本(n=38633),向他们邮寄了邀请信,以完成一项关于健康和幸福感的调查。使用主成分分析和多变量逻辑回归来确定 15166 名男性和女性受访者(9524 名男性,5642 名女性)的 FHI 关键结构和相关性。三分之一的退伍军人报告了 FHI;女性比男性更有可能出现这种情况(粗比值比=1.31,95%可信区间:1.21-1.41),并且退伍后最常见(64.2%)。“心理健康/压力/创伤”、“身体健康”和“物质使用”是 FHI 的主要结构。在两性中,都发现 FHI 与无家可归、抑郁、不良童年经历、低社会支持、入伍、未部署、与重病/残疾人士同住以及居住在危险社区之间存在显著的调整关联(<0.01)。仅在男性中,创伤后应激障碍(调整比值比(AOR)=1.37,95%可信区间:1.14-1.64)、胆固醇水平(升高与正常相比,AOR=0.79,95%可信区间:0.67-0.92)、高血压(AOR=1.25,95%可信区间:1.07-1.47)和非法/街头药物使用(AOR=1.28,95%可信区间:1.10-1.49)具有显著相关性(<0.01)。仅在女性中,病态肥胖(AOR=1.90,95%可信区间:1.05-3.42)和糖尿病(AOR=1.53,95%可信区间:1.06-2.20)具有显著相关性(<0.05)。需要针对不良食物和住房问题采取联合干预措施,特别是针对 9/11 后女性退伍军人和入伍人员。