An American flag flies in front of the Atlanta VA Medical Center in Georgia. (David Goldman/AP)

When Greg Stegall left the Navy at 30 years old, he found himself utterly adrift: a single dad with no degree, no clear plans for the future and a short résumé in a down job market. Struggling to find work, Stegall put his son in a boarding school for poor children and asked his parents for money and food.

Nearly 30 years later, Stegall — now 58 — oversees a program at a Pennsylvania food bank that delivers meals to hungry veterans. But he still regularly sees other vets in similar situations.

Military advocates have long warned that certain groups of veterans suffer extreme rates of hunger. Those include veterans of the wars in Iraq and Afghanistan — 27 percent of whom have struggled to put food on the table.

Now, in a first-of-its-kind program, the Department of Veterans Affairs will screen all vets who visit its health-care facilities for hunger, asking them whether they've struggled to afford food in the past three months. That’s welcome news to Stegall and other advocates, who say vets are especially hard to reach because they’re often unwilling to seek help.

Any program that tries to engage hungry vets will “make a positive impact in their lives,” Stegall said.

Veterans' hunger has long flown under the policy radar, in part because it varies widely between generations and regions. Overall, multiple studies have found that all veterans’ rates of both poverty and food insecurity are lower than those in the general population.

But there are pockets of vets who experience hunger often. People with disabilities and mental illnesses are far more likely to be food insecure, according to data from the Department of Agriculture. An estimated 39,000 veterans were homeless in 2016, which can make it difficult to access food.

Most strikingly, 2015 paper published in the journal Public Health Nutrition found that veterans of the Iraq and Afghanistan wars suffer from food insecurity at more than double the national rate of 12 percent.

It isn’t entirely clear why more recent veterans suffer higher rates of hunger. Researchers have hypothesized that it may relate to the state of the job market when they left the military, or to the high incidence of post-traumatic stress disorder and substance abuse. It may also have something to do with the demographics of servicemen in an all-volunteer army — which tends to draw from lower socioeconomic groups — as opposed to the demographics of those who served in Vietnam, Korea and World War II.

The apparent epidemic among recent veterans — as well as urging from a bipartisan coalition of politicians and anti-hunger groups — has prompted VA to reevaluate its food security approach. In early October, VA launched a screening initiative that will be implemented at all its facilities by the end of the month.

“This is a huge step forward, to just ask the question,” said Josh Protas, the head of government relations for the anti-hunger organization Mazon, which spearheaded efforts to get VA to launch a screening project. “We’re hoping that VA will continue building on that.”

Under the program, VA health-care providers will ask all patients whether they have run out of food or struggled to pay for it within the past three months. If they say yes, VA staff will connect them to a local food pantry or community program, share information on enrolling in Supplemental Nutrition Assistance Program (food stamps) or refer them to follow-up care with a dietary counselor, if needed.

Advocates say this is a critical step toward addressing hunger in a vulnerable — and often unreachable — population. Veterans frequently suffer from conditions, such as disability or mental illness, that can impede them from seeking help. The stigma against accepting “handouts” is also a common problem, said Stegall, whose program distributes pantry boxes at VFW Halls to help needy veterans feel more comfortable.

He remembers one vet — a man with a recent hip replacement and a single jar of spaghetti sauce in his cupboard — who refused a pantry box because “someone else might need that food more.” The man was referred to Stegall’s program by one of his VA caretakers.

Experts are also hopeful the screenings will help clinicians address other diet-related health issues, such as diabetes and depression. Studies of VA patients have shown that veterans who struggle with food insecurity also tend to have problems in these areas, and VA has identified hunger as a major factor behind hypoglycemic incidents in its diabetic patients.

A 2015 pilot of the VA hunger-screening program, which focused on clinics for homeless and formerly homeless veterans, found the screenings could help identify these issues early.

“When health care providers at pilot clinics were queried on user acceptance and implementation issues related to the screening, all universally endorsed the program,” an academic paper on the pilot concluded.

In the coming months, the agency plans to ramp up a number of other initiatives designed to feed veterans on and off their campuses.

Anne Utech, the acting national director of VA Nutrition and Food Services, said the agency is conducting regular training on food insecurity. In June, VA launched a pilot program with Feeding America that set up mini-food pantries at 10 VA medical facilities. And the agency consulted with Community Foodworks, a D.C.-based nonprofit organization, on a tool to help connect veterans to nearby farmers markets.

But advocates say the government must still do more to address hunger — among veterans and among families with active-duty military members. Protas said he would like to see better follow-up from VA to make sure vets are getting help. His organization has called on the department to come up with ways to reach the millions of veterans who don’t use VA hospitals or health clinics.

Mazon is also pushing for changes in SNAP rules that prevent military families from receiving food benefits. More than half of children in Pentagon-run schools qualify for free or reduced-price lunch — indicating their families are struggling to provide food, according to the Department of Defense.

Protas expects the issue to surface during the upcoming Farm Bill negotiations.

“We’d like to get that issue resolved as soon as possible,” he said. “Needless to say, it’s important.”

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