Transcript Presentation Title Here

Women Veterans Health Care
Laura Herrera, MD, MPH
Director, Comprehensive Women’s Health
Women Veterans Health Strategic Health Care Group
Veterans Health Administration
U.S. Department of Veterans Affairs
November 11, 2010
Population of Women Veterans
Source data supplied 7/9/10 by the Office of the Actuary, Office of Policy and Planning, Department of Veterans Affairs
2
Women Active Duty Personnel by
Branch of Service (Sept 09)
Branch of Service
Women %
of Total
Personnel
Number of
Women
Army
13.4%
73,771
14,346
59,425
Navy
15.4%
50,090
7,961
42,129
6.3%
12,964
1,207
11,757
Air Force
19.5%
64,063
12,097
51,966
Coast Guard
16.5%
2,497
1,295
1,202
Reserve & Guard
17.9%
151,021
22,388
128,633
Marine Corps
Officers
Enlisted
US Dept of Defense, Defense Manpower Data Center as of September 30, 2009.
3
4
5
Demographics: Ethnicity and Race
OEF/OIF Female Veteran Utilization (n=70,722)
Race /Ethnicity
Frequency
Percent
White
27,198
38.5%
Black
13,261
18.8%
Hispanic
7,393
10.5%
Others
5,300
7.5%
Unknown
17,570
24.8%
VA Health Care Utilization Among 137,942 Female OEF/OIF Veterans through 3rd Qtr. FY 2010 Environmental Epidemiology Service
6
Demographics: Age

Average age of VA users
•
•

Female Veteran = 47
Male Veteran = 61
Among women VA users returning from OEF/OIF
•
•
76.8% are age 40 or below
47.1% are 30 or younger
VA Health Care Utilization Among 137,942 Female OEF/OIF Veterans through 3rd Qtr. FY 2010 Environmental Epidemiology Service
7
Trimodal Age Distribution
Women Veteran VA Patients
Frequency
FY00
FY09
10,000
9,000
8,000
7,000
6,000
5,000
4,000
3,000
2,000
1,000
0
20
30
40
50
Age
60
70
Frayne SM. VA Women’s Health Evaluation Initiative.
Plenary Presentation at the VA HSR&D Women’s Health Services Research Conference in Washington DC July, 2010
80
90
100
8
Women’s Deployment Health
How Does Combat Affect Health?







Physical injuries with residual pain
Diagnosable mental health conditions
Unexplained symptoms with general health decline
Hearing problems
Dental problems
Psychosocial distress: marriage/work/social
disruption
Post-war death/injury from “incidental trauma”
10
Deployment Risk Factors











Combat exposure (mortars, IED, RPG)
Heavy gear
Ceramic vests
Moving heavy equipment
Walking, jumping, running
Driving long distances
Extreme temperature
Hygiene issues
Dietary issues
Interactions with male counterparts
Family and other relationship issues
11
Reintegration and Service Needs of
Women Veteran Mothers: Family

Feeling isolated; difficulty communicating with family
and friends
 Not having enough time to “readjust”
 Family members expecting a quick return to former
roles and “old selves”
 Difficulties bonding with children (differed depending
on age of child, time/distance away)
 Feeling need to “compensate” for being away
 Feeling “out of sync” with children, partners/family
Gudrun Lange, PhD (PI) & Karen Quigley, PhD (Co-PI)
NJ War Related Illness & Injury Study Center - WRIISC
12
Reintegration and Service Needs of
Women Veteran Mothers: Work

Employment concerns (with or without children)
• Making more $ in military than since returning home
• Difficulty finding civilian job that pays as well as military


Going back to school as attractive option (GI bill)
Difficulties in money management
• From having basic needs (housing, food, clothing) taken
care of to learning how to budget/manage $$
• Made more difficult by lower earning power
• Tensions about (mis)management of $$ while away
Gudrun Lange, PhD (PI) & Karen Quigley, PhD (Co-PI)
NJ War Related Illness & Injury Study Center - WRIISC
13
Post-Deployment Medical Conditions
14
Musculoskeletal Disorders




Joint Disorders
Back Disorders
Disorders of Soft Tissues
Disorders of Cervical Spine
15
Genitourinary Disorders




Menstrual disorders
Disorders of cervix, vagina, vulva
Disorders of the urethra
Pain associated with female genital organs
16
Reproductive Health Concerns






Contraception
Pregnancy/Lactation
Infertility/Birth Defects/Miscarriages
Abnormal Uterine Bleeding
Pelvic Pain
Sexually Transmitted Infections
17
Mental Health Disorders




Adjustment reaction
Depressive disorders
Post Traumatic Stress Disorder
Nondependent abuse of drugs
18
Military Trauma among Female
Veterans




OEF/OIF female Veterans may experience both
Military Sexual Trauma (MST) and combat trauma
20% of female OEF/OIF Veterans accessing VA
health care screened positive for MST
Combat trauma rates not yet known
Survivors of childhood abuse are at risk for
re-traumatization, depression, and substance use
19
Women Veterans Comprehensive
Health Care
Mission: Women Veterans Health
Strategic Health Care Group

Ensure that all women Veterans receive equitable,
high-quality, and comprehensive health care
services in a sensitive and safe environment at all VA
facilities
 Be a national leader in the provision of health care for
women Veterans, thereby raising the standard of
care for all women
21
“Since the Revolutionary War, America’s women have
earned America’s gratitude and respect for their
contributions to the military and to the nation.
VA will continue to improve our benefits and services
for women Veterans as we transform into a 21st
century organization.”
– Secretary of Veterans Affairs Eric K. Shinseki
March 10, 2010
22
Full-time Women Veterans Program
Managers (WVPMs)
Roles:
•Improve advocacy
•Increase outreach
•Facilitate improvements in the quality of care
•Help develop best practices
23
Revised VHA Handbook 1330.01:
“VHA Services for Women Veterans”

Outlines specific services that must be provided at
VA facilities and CBOCs
 Defines Comprehensive Primary Care for Women
Veterans
 Requires women to be seen by designated Women’s
Health Primary Care Providers
 Offers three primary care clinic models
 Details safety and security requirements
 Establishes systematic data collection process
24