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Military personnel and veterans are disadvantaged by inadequate tobacco control policies. We conducted a case study of a Department of Veterans Affairs (VA) effort to disallow smoking and tobacco sales in VA facilities. Despite strong VA support, the tobacco industry created a public relations-focused grassroots veterans' opposition group, eventually pushing the US Congress to pass a law requiring smoking areas in every VA health facility. Arguing that it would be unpatriotic to deny veterans this "freedom" they had ostensibly fought for and that banning smoking could even harm veterans' health, industry consultants exploited veterans' organizations to protect tobacco industry profits. Civilian public health advocates should collaborate with veterans to expose the industry's manipulation, reframe the debate, and repeal the law.

The war in Iraq has been the longest sustained ground combat that the US military has engaged since the Vietnam War. With the ongoing battle against the global war on terrorism, many military personnel will be deployed to hostile areas in support of these operations. The effects of multiple deployment and combat engagement on the mental health of military personnel have been extensively studied. The impacts of mental illnesses, such as PTSD, are tied to longer period in the combat zone. Meeting the psychiatric needs of these veterans will be costly: rehabilitation, retraining, post combat counseling, long-term medical treatment, and even assisted living. This study attempts to predict the cost of mental healthcare for the OIF and OEF veterans. However, we failed to accomplish a forecast for the cost of psychiatric treatment for those veteran populations due to data limitations. This study will not only give a general forecast for mental health care cost in the Veterans Affairs Healthcare System, but as well as explain any correlations between the various independent variables and mental health care costs. The data were compiled from various government documents and medical journals. Information received from VA Office of Policy, Planning and Preparedness was extensively used in this study.

Introduction: Substance use disorder (SUD) is damaging to women's health and quality of life. Appropriate treatment can mitigate the effects and health consequences of SUD, yet many woman face access barriers to such treatment. This research seeks to bridge gaps in the current understanding of access to gender-aware care for women Veterans with SUD and to identify ideal treatment program elements for this population. Methods: We interviewed interdisciplinary providers in Los Angeles Veterans Health Administration facilities ( n = 17; psychiatrists, psychologists, social workers, primary care providers, and nurses) and Veterans ( n = 6), identified using purposive snowball sampling, to characterize key components of a non-residential patient-centred SUD treatment program for women Veterans. A semi-structured interview guide elicited current SUD treatment options for women Veterans, barriers to SUD services, and ideal SUD treatment program components. Mutually agreed-on themes were reached using constant comparison. Results: Analyses revealed five key elements of an ideal SUD treatment program for women Veterans: safety (safe and free from harassment in treatment), flexible scheduling (able to accommodate other work and life responsibilities), resourced (no limit to number of visits, staff able to meet needs of comorbidities, on-site child care, etc.), informed providers (providers with access to a comprehensive resource list and aware of easy referral options), and positive (supportive and not punitive). Discussion: The elements identified as necessary for an optimal outpatient SUD treatment program may guide future implementation efforts. SUD programs may not be viable options for women Veterans if they cannot accommodate multidimensional barriers of health care access.

In recent years, policymakers and members of the media have raised concerns regarding access to behavioral health care for service members and veterans of the U.S. military and their families. Particular concern has been raised regarding the availability and accessibility of care to individuals covered by the U.S. Department of Defense Military Health System and the Veterans Health Administration. In this study, researchers analyzed the National Study of Drug Use and Health to examine utilization of behavioral health care among current or former wives of service members and veterans who are covered by either TRICARE or CHAMP-VA. Three findings of interest emerged from the analysis. First, relative to the comparison group, military wives were more likely to receive behavioral health services, but this pattern was exclusively due to use of prescription psychiatric medications. No difference was found for specialty behavioral health treatment. Second, residing in rural areas was negatively associated with behavioral health care service use for both groups. Third, contrary to expectations, military wives who live more than 30 minutes from a military treatment facility were more likely than military wives who lived closer to receive prescription psychiatric mediations but not other types of behavioral health services.

STUDY OBJECTIVES: Veterans experience high levels of trauma, psychiatric, and medical conditions that may increase their risk for insomnia. To date, however, no known study has examined the prevalence, risk correlates, and comorbidities of insomnia in a nationally representative sample of veterans. METHODS: A nationally representative sample of 4,069 US military veterans completed a survey assessing insomnia severity; military, trauma, medical, and psychiatric histories; and health and psychosocial functioning. Multivariable analyses examined the association between insomnia severity, psychiatric and medical comorbidities, suicidality, and functioning. RESULTS: A total of 11.4% of veterans screened positive for clinical insomnia and 26.0% for subthreshold insomnia. Greater age and retirement were associated with a lower likelihood of insomnia. Adverse childhood experiences, traumatic life events, lower education and income were associated with greater risk for insomnia. A "dose-response" association was observed for health comorbidities, with increasing levels of insomnia associated with elevated odds of psychiatric and medical conditions (clinical vs no insomnia odds ratio = 1.8–13.4) and greater reductions in health and psychosocial functioning (clinical vs no insomnia Cohen's d = 0.2–0.4). The prevalence of current suicidal ideation was 3–5 times higher in veterans with clinical and subthreshold insomnia relative to those without insomnia (23.9% and 13.6% vs 4.5%, respectively). CONCLUSIONS: Nearly 2 in 5 US veterans experience clinical or subthreshold insomnia, which is associated with substantial health burden and independent risk for suicidal ideation. Results underscore the importance of assessment, monitoring, and treatment of insomnia in veterans as they transition from the military. CITATION: Byrne SP, McCarthy E, DeViva JC, Southwick SM, Pietrzak RH. Prevalence, risk correlates, and health comorbidities of insomnia in US military veterans: results from the 2019–2020 National Health and Resilience in ...

The older adult veteran population is at high risk of contracting COVID-19. New York State's veterans are concentrated in geographic areas with rapidly increasing COVID-19 case counts. As the virus continues to spread, the Veterans Health Administration (VHA) must prepare to provide coronavirus treatments to older adult veterans in NYS.

<i>Objective:</i> Communicating genetic research results to participants presents ethical challenges. Our objectives were to examine participants' preferences in receiving future genetic research results and to compare preferences reported by veteran and nonveterans participants. <i>Methods:</i> Secondary analysis was performed on data collected in 2000–2004 from 1,575 consent forms signed by Mexican-American participants enrolled in 2 genetic family studies (GFS) in San Antonio: The Family Investigation of Nephropathy and Diabetes (FIND) and the Extended FIND (EFIND). The consent forms for these studies contained multiple-choice questions to examine participants' preferences about receiving their (1) clinical lab results and (2) future genetic research results. The FIND and EFIND databases had information on subjects' demographic characteristics and some selected clinical variables. We identified veterans using the Veterans Health Administration's (VHA's) centralized data repository. We compared veterans' and nonveterans' preferences using Student's t test for continuous variables and χ² test for discrete variables. A logistic regression analyzed subjects' preference for receiving their research results, controlling for other socio-demographic and clinical variables. <i>Results:</i> The sample included 275 (18%) veterans and 1,247 (82%) nonveterans. Our results indicated a strong desire among the majority of participants 1,445 (95%) in getting their clinical lab research results. Likewise, 93% expressed interest in being informed about their future genetic results. There was no significant difference in veterans' and nonveterans' preference to disclosure of the research results (χ² test; p > 0.05). Regression analysis showed no significant relationship (p = 0.449) between the outcome (receiving research results) and veterans' responses after controlling for demographics and educational levels. <i>Conclusion:</i> Participants believed they would prefer receiving their genetic research results. Veterans are similar to nonveterans in their preferences. Offering genetic research results to participants should be based on well defined and structured plans to enhance interpretation of genetic data.

The following article tests the hypothesis that veterans have better health if they were officers when they were in the U.S. military than if they served in the enlisted ranks. It examines this hypothesis by presenting results from logistic regressions that are based on four surveys: the National Survey of Veterans, the Survey of Retired Military, the Panel Study of Income Dynamics, and the Wisconsin Longitudinal Study. In all four of these surveys, the evidence is consistent with the hypothesis that military rank is associated with health, particularly among veterans who served longer. It also suggests that the health gradient by rank is independent of similar gradients by education and income as well as health differences by race. These findings indicate that health may be influenced not just by differences in civilian society but also by those in the military. [Reprinted by permission; copyright Inter-University Seminar on Armed Forces and Society/Sage Publications Inc.]

LAY SUMMARY For a long time, it has been assumed that to study military members and Veterans means to study men. Further compounding the problem, military and Veteran health research has historically neglected sex and gender issues. This has resulted in systemic biases and gaps in military and Veteran health research that perpetuate existing inequities. However, as this Perspectives piece argues, equity should be a key objective of military and Veteran research. Equity means that the diverse needs of all in the military and Veteran population are considered and addressed. Equity helps ensure fairness and justice in the military and Veteran sector. One of the best ways to advance the goal of equity in research and beyond is to apply an intersectional sex and gender lens. This means, for example, to make visible women's specific experiences and health outcomes, as well as those of sub-groups of women, men, or gender-diverse military members and Veterans. The author provides tools and considerations for the application of an intersectional sex and gender lens in military, Veteran, and family health research.

Studies aiming to identify if war veterans are at higher risk of suicide have often produced inconsistent results; this could be due to the complexity of comparisons and different methodological approaches. It should be noted that this contingent has many risk factors, such as stressful exposures, wounds, brain trauma and pain syndrome. Most recent observations confirm that veterans are really more likely to die of suicide as compared to the general population; they are also more likely to experience suicidal ideation and suffer from mental health problems. Suicides are more frequent in those who develop PTSD, depression and comorbid states due to war exposure. Combat stress and its' frequency may be an important factor leading to suicide within the frame of the stress-vulnerability model. According to this model, the effects of stress may interact with social factors, interpersonal relations and psychological variables producing suicidal tendencies. Modern understanding of stress-vulnerability mechanisms based on genetic predispositions, early life development, level of exposure to stress and stress-reactivity together with interpersonal aspects may help to build more effective suicide prevention programs based on universal/selective/indicated prevention principles.

A link between posttraumatic stress disorder and health behaviors, such as exercise, alcohol, smoking, and caffeine has been suggested. However, it is unknown whether veterans with combat-related PTSD differ from combat veterans without PTSD and whether health behaviors change over the course of exposure therapy for PTSD or differ based on PTSD severity. This study examined the relationship between health behaviors and PTSD. More specifically, combat veterans with and without PTSD were compared across self-reported levels of alcohol use, smoking, exercise, and caffeine. Health behaviors of combat veterans with PTSD were compared before and after a 17-week treatment for PTSD. Results showed a significant number of participants decreased alcohol use at post-treatment by an average of eight drinks over 30 days, regardless of their PTSD severity level or amount of improvement in PTSD symptoms. No significant differences were found for other health behaviors. ; 2017-12-01 ; M.S. ; Sciences, Psychology ; Masters ; This record was generated from author submitted information.