Journal Issue Highlights Women Veterans' Health Issues
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. The goal of this Supplement 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 was sponsored by HSR&D through the VA Women's Health Research Consortium and includes 16 manuscripts. The supplement is based on six main topics identified in the 2010 VA agenda-setting conference for women's health research led by Yano and colleagues. 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. Following are a few examples of this research.
- 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 for healthcare services. 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 at 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 services.
Bernardy N, Lund B, Alexander B, et al. Gender differences in prescribing among Veterans diagnosed with post-traumatic stress disorder. JGIM May 2013;
Blackstock O, Tate J, AkgÃ¼n K, et al. Are there sex differences in overall burden of disease among HIV-infected individuals in the VA healthcare system? JGIM May 2013;
Cordasco K, Zephyrin L, Kessler C, et al. An inventory of VHA emergency departments' resources and processes for caring for women. JGIM May 2013;
Hamilton A, Frayne S, Cordasco K, Washington D. Factors related to attrition from VA healthcare use: Findings from the National Survey of Women Veterans. JGIM May 2013;
Katon J, Reiber G, Rose D, et al. VA location and structural factors associated with onsite availability of reproductive health services. JGIM May 2013;
Lehavot K and Simpson T. Incorporating lesbian and bisexual women into women Veterans' health priorities. JGIM May 2013;
Maguen S, Madden E, Cohen B, et al. The relationship between body mass index and mental health among Iraq and Afghanistan Veterans. JGIM May 2013;
Mattocks K, Sadler S, Yano E, et al. Sexual victimization, health status, and VA healthcare utilization among lesbian and bisexual OEF/OIF Veterans. JGIM May 2013;
Pavao J, Turchik J, Hyun J, et al. Military sexual trauma among homeless Veterans. JGIM May 2013;
Rose D, Farmer M, Yano E and Washington D. Racial-ethnic differences in cardiovascular risk factors among women Veterans. JGIM May 2013;
Schwarz E, Mattocks K, Brandt C, et al. Counseling of female Veterans about risks of medication-induced birth defects. JGIM May 2013;
Street A, Jaimie L, Gradus J, et al. Gender differences among Veterans deployed in support of the wars in Afghanistan and Iraq. JGIM May 2013;
Vimalananda V, Miller D, Christiansen C, et al. Cardiovascular disease risk factors among women Veterans at VA medical facilities. JGIM May 2013;
Vimalananda V, Miller D, Hofer T, et al. Accounting for clinical action reduces estimates of gender disparities in lipid management for diabetic Veterans. JGIM May 2013;
Washington D, Bean-Mayberry B, Hamilton A, et al. Health profiles of U.S. women Veterans by war cohort: Findings from the National Survey of Women Veterans. JGIM May 2013;
Yan G, McAndrew L, D'Andrea E, et al. Self-reported stressors of National Guard women Veterans before and after deployment: The relevance of interpersonal relationships. JGIM May 2013;
Women Veterans’ Health and Health Care Supplement. Journal of General Internal Medicine July 2013