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      Food insecurity among active duty soldiers and their families during the coronavirus disease 2019 pandemic

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          Abstract

          Objective:

          We examined the determinants of food insecurity among active duty Army households that transitioned into food insecurity during the coronavirus disease 2019 (COVID-19) pandemic.

          Design:

          We compared Army households that recently transitioned into marginal food insecurity with those households that remained highly food secure ( n 2832) to better understand how these households differ in their resilience to food insecurity during economic downturns using data from a military installation in the USA in 2020.

          Setting:

          A US military installation in the USA.

          Participants:

          Active duty US Army soldiers.

          Results:

          Prior to the pandemic, the prevalence of marginal food insecurity among Army households was similar to that reported for households in the general population. Marginal food insecurity among Army households increased over 1·5-fold – from 19 % to 33 % – with the onset of the pandemic. Relative to Army households with consistently high food security, the Army households that transitioned into marginal food insecurity after the onset of the pandemic were more likely to report concerns about financial insecurity and the job security of their family members.

          Conclusions:

          Army households, like their civilian counterparts, are vulnerable to food insecurity because of instability in their income during periods of economic uncertainty. Periods of economic uncertainty are more common for Army households because of the frequent relocations associated with military service which could lead to predictable periodic spikes in their food insecurity.

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          Most cited references28

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          The Multidimensional Scale of Perceived Social Support

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            A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population.

            The 4-item Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report questionnaire that consists of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2). Given that PHQ-4, PHQ-2, and GAD-2 have not been validated in the general population, this study aimed to investigate their reliability and validity in a large general population sample and to generate normative data. A nationally representative face-to-face household survey was conducted in Germany in 2006. The survey questionnaire consisted of the PHQ-4, other self-report instruments, and demographic characteristics. Of the 5030 participants (response rate=72.9%), 53.6% were female and mean (SD) age was 48.4 (18.0) years. The sociodemographic characteristics of the study sample closely match those of the total populations in Germany as well as those in the United States. Confirmatory factor analyses showed very good fit indices for a two-factor solution (RMSEA .027; 90% CI .023-.032). All models tested were structurally invariant between different age and gender groups. Construct validity of the PHQ-4, PHQ-2, and GAD-2 was supported by intercorrelations with other self-report scales and with demographic risk factors for depression and anxiety. PHQ-2 and GAD-2 scores of 3 corresponded to percentile ranks of 93.4% and 95.2%, respectively, whereas PHQ-2 and GAD-2 scores of 5 corresponded to percentile ranks of 99.0% and 99.2%, respectively. A criterion standard diagnostic interview for depression and anxiety was not included. Results from this study support the reliability and validity of the PHQ-4, PHQ-2, and GAD-2 as ultra-brief measures of depression and anxiety in the general population. The normative data provided in this study can be used to compare a subject's scale score with those determined from a general population reference group. Copyright 2009 Elsevier B.V. All rights reserved.
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              Food Insecurity And Health Outcomes.

              Almost fifty million people are food insecure in the United States, which makes food insecurity one of the nation's leading health and nutrition issues. We examine recent research evidence of the health consequences of food insecurity for children, nonsenior adults, and seniors in the United States. For context, we first provide an overview of how food insecurity is measured in the country, followed by a presentation of recent trends in the prevalence of food insecurity. Then we present a survey of selected recent research that examined the association between food insecurity and health outcomes. We show that the literature has consistently found food insecurity to be negatively associated with health. For example, after confounding risk factors were controlled for, studies found that food-insecure children are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children; and food-insecure seniors have limitations in activities of daily living comparable to those of food-secure seniors fourteen years older. The Supplemental Nutrition Assistance Program (SNAP) substantially reduces the prevalence of food insecurity and thus is critical to reducing negative health outcomes.
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                Author and article information

                Journal
                Public Health Nutr
                Public Health Nutr
                PHN
                Public Health Nutrition
                Cambridge University Press (Cambridge, UK )
                1368-9800
                1475-2727
                24 January 2022
                24 January 2022
                : 1-8
                Affiliations
                [1 ]U.S. Department of Agriculture, Economic Research Service , PO Box 419205, MS 9999, Kansas City, MO 64141-6205, USA
                [2 ]U.S. Army Public Health Center, Behavioral and Social Health Outcomes Program , Aberdeen Proving Ground, MD, USA
                [3 ]U.S. Army Public Health Center, Health Promotion and Wellness Directorate , Aberdeen Proving Ground, MD, USA
                Author notes
                [* ] Corresponding author: Email matthew.rabbitt@ 123456usda.gov
                Author information
                https://orcid.org/0000-0003-4620-1425
                Article
                S1368980022000192
                10.1017/S1368980022000192
                8861550
                35067266
                42263812-7ff8-4d64-8626-545498e04bbf
                © The Authors 2022

                This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of The Nutrition Society.

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 July 2021
                : 04 December 2021
                : 05 January 2022
                Page count
                Figures: 1, Tables: 3, References: 29, Pages: 8
                Categories
                Research Paper

                Public health
                coronavirus disease 2019,food insecurity,food security,military,pandemic
                Public health
                coronavirus disease 2019, food insecurity, food security, military, pandemic

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