Neighborhood Resources to Support Healthy Diets and Physical Activity Among US Military Veterans

Abstract

IntroductionAmong the nearly 21 million military veterans living in the United States, 64.0% of women and 76.1% of men are overweight or obese, higher rates than in the civilian population (56.9% of women and 69.9% of men). Attributes of the residential environment are linked to obesity. The objective of this study was to characterize the residential environments of the US veteran population with respect to availability of food and recreational venues.MethodsWe used American Community Survey data to determine the concentration of veterans (the percentage of veterans among the adult population) in all continental US census tracts in 2013, and we used proprietary data to construct measures of availability of food and recreational venues per census tract. Using descriptive statistics and ordinary least-squares regression, we examined associations between the concentration of veterans per census tract and those residential environmental features.ResultsIn census tracts with high concentrations of veterans, residents had, on average, 0.5 (interquartile range, 0–0.8) supermarkets within a 1-mile radius, while residents in census tracts with low concentrations of veterans had 3.2 (interquartile range, 0.6–3.7) supermarkets. Patterns were similar for grocery and convenience stores, fast food restaurants, parks, and commercial fitness facilities. In adjusted analyses controlling for census-tract–level covariates, veteran concentration remained strongly negatively associated with availability of those food and recreational venues. In nonmetropolitan tracts, adjusted associations were greatly attenuated and even positive.ConclusionWhere veterans live is strongly associated with availability of food outlets providing healthy (and unhealthy) foods and with recreational venues, raising questions about the contributions of veterans’ residential environments to their high obesity rates. Additional research is needed to address those questions.

Food Insecurity in US Military Veterans

“…60,66,75 Most had samples containing men and women, 60,69,70,74,75,79 but FI statistics were not reported by gender for all. 60,66,69,74,79…”

“…The remaining 21 articles (Table 1) were published roughly in the past decade and most within the past 5 years. Most of the selected studies relied on surveys—8 analyzed data from nationwide, population-based federal surveys, or surveys supported by the federal government, including the Survey of Income and Program Participation (SIPP; US Census Bureau; n = 2), 61,63 the Current Population Survey (CPS; US Census Bureau; n = 1), 64 the Behavioral Risk Factor Surveillance System survey (BRFSS; US Department of Health and Human Services; n = 2), 60,65 the American Community Survey (ACS; US Census Bureau; n = 2), 62,66 and the Health and Retirement Study (HRS; University of Michigan Institute for Social Research; n = 1). 67 Findings from one study were based on data from a survey of California state residents.…”

“…78 Longitudinal survey data were cited as data sources in some reports—either a single wave of data was evaluated or pooled or multiple years of data were used. 61 -64,66,67 One study assessed changes in body mass index (BMI) and food outlet access over time. 75…”

“…Eight central themes were dominant (Figure 1): (1) FI prevalence in veterans (n = 4), 64,67,70,73 (2) health status (n = 7), 60,66,69,70,74,75,79 (3) dietary practices/service-related dietary experiences (n = 2), 68,78 (4) health care utilization (n = 2), 71,72 (5) economic instability (n = 2), 61,63 (6) homelessness/housing instability (n = 1), 76 (7) federal food program participation (n = 1), 62 and (8) community and emergency preparedness factors (n = 5). 65,75,77,79,80 Health status was the most dominant domain, while food program participation and homelessness/housing instability were the least dominant (Figure 2).…”

“…60,66,69,70,74,75,79 Some of the veteran samples that were studied focused on specific subpopulations of veterans, 69,70,74,79 whereas others relied on broader veteran samples. 60,66,75 Most had samples containing men and women, 60,69,70,74,75,79 but FI statistics were not reported by gender for all. 60,66,69,74,79…”