Despite access to care, male veterans in poorer health than civilian men

Even with access to health care, male military veterans are in poorer health than men in active military duty, men in the National Guard and Reserves, and civilian men, finds a new study in the American Journal of Preventive Medicine. The study concluded that organizations that serve veterans should increase efforts at preventing poor health behaviors and linking them to health care services.

The findings are from a 2010 survey of 53,000 , 3,700 Guard and Reserve members, 2,000 active duty servicemen and 110,000 civilians. The survey included questions about their health and health behaviors, and their access to health care. A similar study of women veterans, National Guard/Reserve members, active servicewomen and civilians was published earlier this year by the same research team.  

"We think our research substantiates claims that veterans bear a disproportionate disease burden," said Katherine D. Hoerster, Ph.D., MPH, a research psychologist at the VA Puget Sound in Seattle. Survey results found that veterans were more likely than active duty men to report diabetes. Veterans were more likely to report current smoking and heavy than men in the National Guard and Reserves and civilian men and a lack of exercise compared to active duty and National Guard and Reserve. National Guard and Reserve men had higher obesity, diabetes and cardiovascular disease (versus active duty and veteran men, active duty men, and civilian men, respectively). Active duty were more likely to report current smoking and heavy alcohol consumption than civilians and National Guard and Reserves, and reported more smokeless tobacco use than civilians.

While the Department of Veterans Affairs (VA) addresses these common health concerns, Hoerster noted that only 37 percent of eligible veterans receive care through the VA system of hospitals. In addition, National Guard and Reserve servicemen were found to be the least likely of the groups to have access to health care. The researchers advised that other providers need to be aware of the prevalence of these health issues facing Guard and Reserve servicemen and veterans.

The finding that National Guard and Reserve members have poorer access to care should be addressed, Hoerster added. "This is an important military sub-population to target." One factor may be that members of the National Guard and Reserves are not linked up to services provided by the VA as effectively as active duty service members are when they leave the military, she noted.  The greater prevalence of heart problems and diabetes reported by these servicemen makes poor access to care even more problematic, she said.

Increased rates of tobacco and alcohol use reported by active duty servicemen can lead to greater health problems for this group in the future, Hoerster said. "Addressing tobacco and alcohol use should also be a top priority."

Other research has suggested that veterans have a higher disease burden because of their military service, said Joy Ilem, deputy national legislative director for Disabled American Veterans, an organization that serves veterans and provides assistance in learning about and applying for benefits.  However, it is surprising that this study found that veterans have poorer health outcomes and poorer health behavior than other groups given the emphasis that the VA puts on prevention of disease and promotion of a healthy lifestyle, Ilem observed. 

"Not all vets have a connection to the VA system, but they may need one in the future," she added. Veterans who have issues directly related to their service are more likely to use VA facilities and are more likely to be sicker than the overall population of veterans, Ilem added. 

More information: Hoerster KD, Lehavot K, Simpson T et al. Health and health behavior differences: U.S. military, veteran, and civilian men. American Journal of Preventive Medicine. In Press.

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