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Health Services Research & Development

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2006 HSR&D National Meeting Abstract


3004 — Greater Mental Distress Among Younger VA Patients in BRFSS Surveys During and After the Iraq Invasion

Author List:
West AN (White River Jct VAMC)
Weeks WB (White River Jct VAMC)

Objectives:
To determine whether Veterans Health Administration (VA) patients who participated in national health surveys of US civilians reported more mental distress, compared to other respondents, as the Iraq war began or re-intensified.

Methods:
We analyzed data from the annual Behavioral Risk Factor Surveillance System (BRFSS) health surveys conducted nationwide in 2000 and 2003. Unlike most years, these particular surveys asked if respondents were military veterans; like most years, they also asked if respondents used VA medical care. Male respondents were stratified by age (18-44, 45-65, or 65+) and separated into three groups: VA patients, non-VA-using veterans, and non-veterans. Our measures of interest were the proportions of respondents who reported five or more days of poor a) mental or b) physical health during the month prior to being interviewed. Using chi-square tests (with SUDAAN software) we assessed differences between years within each group, age category, and part of the year (January-April, May-August, or September-December) in which respondents were interviewed.

Results:
While past-month days of poor mental health among non-veterans, non-VA-using veterans, and older VA patients were stable from 2000 to 2003 (on average, fewer than 20% reported 5+ poor days), younger VA patients in 2003 reported substantially more problem days in two intervals: During January through April of 2003, when the Iraq war buildup and invasion occurred, the proportion of VA patients ages 18-44 with 5+ poor mental health days was 36.1%, nearly double the rate of 21.1% for the same interval in 2000. During September through December of 2003, when resistance on the ground re-intensified, their rate was 32.1%, nearly double the rate of 16.2% for the same period in 2000 (p < .05). Rates of 5+ poor physical health days, which averaged less than 20%, did not reveal seasonal changes across years.

Implications:
In times of war, the VA may anticipate more mental health problems among its current patients, particularly younger veterans.

Impacts:
VA budget decisions may need to anticipate increased demand for mental health care during wartime. Moreover, analyses of free, public-access datasets from annual national health surveys offer a very cost-effective method to monitor ongoing changes in veterans’ health care needs.


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