JGIM Supplement Highlights Women Veterans' Health

A special supplement of the Journal of General Internal Medicine (JGIM - open access) published in July 2013 focuses on women Veterans' health and healthcare. With the increasing participation of women in the U.S. military, and more than 2.2 million U.S. women Veterans, the health and healthcare of military and Veteran women is an important VA priority. Sponsored by VA's Health Services Research and Development Service (HSR&D) through the VA Women's Health Research Consortium, the goal of this JGIM Supplement¹ is to:

• Disseminate new research findings;
• Highlight research that can lead to improvements in care (both within and outside VA); and
• Raise awareness of, stimulate interest in, and increase research about the healthcare of women Veterans and women in the military.

The Supplement is based on six main topics identified in the 2010 VA agenda-setting conference for women's health research. Topics include: 1) Access to care and rural health, 2) Primary care and prevention, 3) Mental health, 4) Health concerns associated with military deployment, 5) Complex chronic conditions/aging and long-term care, and 6) Reproductive health. Below are a few examples of this research. In addition to the research articles, the Supplement includes five important Editorials by VA and non-VA leaders.

Access to care and rural health. Hamilton and colleagues explored why women Veterans leave VA healthcare, as an opportunity to better understand patients' perceptions of the care they received. Using data from the National Survey of Women Veterans — conducted in 2008-2009 among 3,611 women Veterans — study investigators found that over time, 54% of VA healthcare users reported no longer using VA healthcare. A new study funded through HSR&D's CREATE initiative, "Lost to Care: Attrition of Women Veterans New to VHA," is expected to inform efforts to sustain women Veterans' enrollment in — and continued use of — VA care.

Primary care and prevention. Articles in this Supplement identify the most common risk factors for cardiovascular disease (CVD) among women in middle adulthood (aged 35 to 64 years). For example, Vimalananda and colleagues report that more than one-third of women Veterans using VA healthcare have more than two CVD risk factors by age 55-64. Rose and colleagues report that Black women Veterans are more likely to be obese and to report hypertension and diabetes, but are less likely to report smoking cigarettes compared to non-Hispanic white women.

Mental health. Pavao and colleagues examined a large cohort of homeless Veterans and found that 40% of women and 3% of men had experienced military sexual trauma, and had increased odds of having one or more mental health conditions. Bernardy and colleagues found that women Veterans were more likely to receive drug therapy for PTSD compared to men, but were also more likely to receive benzodiazepines than men, despite guidelines against their use.

Health concerns associated with military deployment. Maguen and colleagues found high rates of overweight and obesity among a relatively young group of OEF/OIF Veterans, and that obesity rates were highest among those with depression.

Complex chronic conditions/aging and long-term care. Washington and colleagues identified population profiles that highlight differences in women Veterans' health and healthcare use by period of military service and found that despite their younger age, OEF/OIF women Veterans had the greatest number of healthcare visits.

Reproductive health. Several papers discuss gaps in the availability of reproductive services and identify potential solutions. Another important topic addressed in this Supplement is whether lesbian and bisexual women Veterans are accessing VA healthcare services.

Implications
Disseminating new research findings about women's health will help to inform the research agenda on the healthcare of women Veterans and women in the military.

Additional Resources

• Visit VA's Office of Research & Development's Women's Health Research Program Page or VA's Center for Women Veterans website.
• Listen to and download archived cyberseminars on Women's Health.
• Search for citations of published research on women Veteran's Health.

References

1. Women Veterans' Health and Health Care Supplement. Journal of General Internal Medicine July 2013;28(2).

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This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.