Highlights from the National Veteran Health Equity Report - FY2013

Below are highlights and selected charts from VHA's inaugural National Veteran HealthEquity Report (NVHER).
The NVHER details patterns and provides comparative rates of health conditions for vulnerable Veteran groups. Specifically, this report is designed to provide basic comparative information on the sociodemographics, utilization patterns and rates of diagnosed health conditions among the groups over which the VHA Office of Health Equity (OHE) has responsibility with respect to monitoring, evaluating and acting on identified disparities in access, use, care, quality and outcomes. The report allows the VA, Veterans, and stakeholders to monitor the care vulnerable Veterans receive and set goals for improving their care.
Data for the National Veteran Health Equity Report are from centralized, national VHA administrative databases of enrollment, outpatient, inpatient, and Non-VA (Fee) medical care, but do not include long-term care services or care received privately by VHA users. All of the report chapters are drafted by VA subject matter experts.
The 2016 version of the National Veteran Health Equity Report details VHA care for vulnerable Veterans in FY2013 by:
  • race/ethnicity (Chapter 3);
  • gender (Chapter 4);
  • age (Chapter 5);
  • geography (Chapter 6);
  • and mental health status (Chapter 7).

Health and healthcare for veterans in VHA by race/ethnicity

  • Racial and ethnic diversity of Veteran VHA User population is increasing, particularly in younger groups and women.
  • Greater VA ambulatory care utilization by racial/ethnic groups that are traditionally underserved in the private sector compared with utilization by White Veterans.
  • Prevalence of diagnosed conditions – higher in racial/ethnic minorities in VA versus in broader U.S., but lower in racial/ethnic minorities in VA compared with White Veterans in VA

Health and Healthcare for Women Veterans in VHA

Women are one of the fastest growing populations in VHA, representing nearly 7% of VHA patients in FY13 (380,000 women). Since continued growth in the women Veteran population is expected, VHA must continue to strategically plan for capacity and services to meet the healthcare needs of women Veterans across the lifespan, and to provide equitable, high quality care for women Veterans at all sites of care.
Despite their younger average age, women have higher or similar rates of most diagnosed condition domains compared to men. Among the most common conditions in women Veterans are cardiovascular risk factors (e.g., hypertension, lipid disorders, obesity), mental health conditions (e.g., depression, anxiety and PTSD), musculoskeletal conditions (e.g., joint disorders, spine disorders), and reproductive health conditions (e.g., menopausal disorders, menstrual disorders).

Health and Healthcare for Older Veterans in the VHA

  • 46% of Veteran VHA users are age 65 and older. This percentage is projected to increase and to become more diverse.
  • The population of older Veterans face an increased burden of chronic disease, polypharmacy, functional decline and geriatric syndromes.
  • Older Veterans are more likely to live in rural locations compared to their younger counterparts

Health and Healthcare for Veterans in Rural Areas

  • Overall, the distribution of diagnosed conditions between rural and urban Veterans are largely similar, with rural Veterans having higher diagnosed rates of some conditions (e.g., diabetes and COPD) while urban Veterans have higher diagnosed rates of other conditions (e.g., HIV and Hepatitis C).
  • Disparities in health outcomes are largely a result of geographic differences in delivery of and access to quality care, which encompasses differences in prevention, diagnosis, screening, outreach, and clinical service delivery.
  • Understanding how rurality impacts health goes beyond exploring rates of health conditions, and should explore differences in health outcomes, in treatment provision, and in health behaviors, to name a few.

Healthcare for Veterans with Serious Mental Illness

  • Similar to the Veteran population on the whole, Veterans with serious mental illness have high rates of hypertension and lipid disorders.  On top of those disorders, the Veteran population with serious mental illness also has a very high rate of tobacco use.  These are each significant risk factors for coronary heart disease.
  • Compared to the Veteran population on the whole, the Veteran population with serious mental illness had considerably more burden from psychosocial factors and housing insufficiency.
  • Compared to the Veteran population on the whole, the Veteran population with serious mental illness had higher rates of dental disorders and dental caries.