Senators Gillibrand and Ernst Urge Department of Veterans Affairs to Screen Veterans for Food Insecurity

WASHINGTON, D.C. – U.S. Senators Kirsten Gillibrand (D-NY) and Joni Ernst (R-IA) today sent a bipartisan letter urging the Department of Veterans Affairs (VA) to begin screening veterans for food insecurity as part of routine health care screenings. Veterans are at an increased risk for food insecurity, or a lack of reliable access to affordable and nutritious food. Food insecurity is more prevalent among veterans than the general population due in part to higher rates of disability, medical problems, and mental health conditions that may make it more difficult for veterans to maintain an adequate income.

“We owe it to our veterans to do everything we can to ensure that they do not go hungry,” the Senators said. “We believe that veterans would benefit from the VA including a brief screener on food insecurity when veterans seek health care from the VA. Any veteran who claims food insecurity can be referred to a social worker, who can then assist the veteran in completing paper work for SNAP or other resources. The addition of this screener is simple, requires little of the VA, and has the potential to help prevent millions of veterans and their families from going hungry.”

Food insecurity is particularly high among veterans of the wars in Iraq and Afghanistan. 27 percent of veterans from these wars reported difficulty with food insecurity, while 14.5 percent of the general U.S. population struggle with food insecurity. Despite the higher rates of food insecurity among veterans, Supplemental Nutrition Assistance Program (SNAP) use among veterans is considerably lower than the general population. Potential reasons for underuse among veterans may include stigma associated with SNAP, lack of information about the program, and difficulty navigating the application process. Screening for food insecurity at the VA can help address each of these barriers.

The full text of the letter is below:

The Honorable Robert McDonald
Secretary of Veterans Affairs
810 Vermont Avenue Northwest
Washington, DC 20420

Dear Secretary McDonald,

We write to encourage the Veterans Health Administration (VHA) to incorporate screening for food insecurity among all veterans seeking healthcare. Veterans are at a particular risk for food insecurity, or the lack of reliable access to a sufficient amount of affordable and nutritious food. Higher rates of disability, medical problems, and mental health conditions among veterans may render it difficult if not impossible for them to maintain employment and adequate income. We owe it to our veterans to do everything we can to ensure that they do not go hungry and believe that asking a few simple questions can help in this effort.

Perhaps surprisingly, it appears that younger veterans are more likely to be food insecure than older veterans. Researchers at the University of Minnesota in conjunction with the Minneapolis VA Healthcare System found that, in that system, 27% of veterans of the wars in Iraq and Afghanistan reported difficulties with food security, which is markedly higher than the U.S. population at 14.5%. Food insecure veterans were also found to have more children than those who were food secure, suggesting that screening for food insecurity will help not only veterans, but their families as well.

The Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) is the cornerstone of our nation’s efforts to reduce food insecurity. A November 2014 report by the Center on Budget and Policy Priorities found that 1.7 million veterans lived in households that participated in SNAP at some point within the prior twelve months. Although studies suggest prevalence of food insecurity among veterans is higher than the general population, SNAP use among veterans is considerably lower. Potential reasons for underuse among veterans include stigma associated with SNAP, lack of information about the program, and difficulty navigating the application process. Screening for food insecurity at VHA can help address each of these barriers.

The Computerized Patient Record System (CPRS) contains “Clinical Reminders” that providers can administer to patients when prompted. Providers can screen veterans for homelessness, depressive symptoms, and alcohol and tobacco use, among other issues, and many of these screeners are administered at least annually. Positive screens prompt providers to place an appropriate referral, for example, a positive tobacco screen initiates a referral for tobacco cessation programs, including medications and behavior therapy.

We believe that veterans would benefit from VHA including a brief screener on food insecurity as a CPRS Clinical Reminder. Any veteran who claims food insecurity can be referred to a social worker, who can then assist the veteran in completing paper work for SNAP or establishing other services as appropriate.

Although we certainly understand that administering these screeners may add burden to providers, we believe the desired outcome—helping veterans secure adequate food—can be achieved with only a few questions. VHA may want to adopt the recommendation of the American Academy of Pediatrics, which recently put out a policy statement encouraging pediatricians to screen for food insecurity with a two-item questionnaire comprised of only the following questions:

1. Within the past 12 months, we worried whether our food would run out before we got money to buy more. (Yes or No)

2. Within the past 12 months, the food we bought just didn’t last and we didn’t have money to get more. (Yes or No)

The addition of this screener is simple, requires little of the provider, and has the potential to help millions of veterans and their families. We therefore request that VHA implement this screener into its Clinical Reminders as soon as possible.

Thank you in advance for your attention and cooperation with our request. We look forward to hearing more from you on this matter.

Sincerely,

Kirsten Gillibrand
United States Senator

Joni Ernst
United States Senator

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