Are veterans seeking Veterans Affairs' primary care as healthy as those seeking Department of Defense primary care? A look at Gulf War veterans' symptoms and functional status

Administration of an amino Acid-based regimen for the management of autonomic nervous system dysfunction related to combat-induced illness

The etiology and pathophysiology of posttraumatic stress disorder (PTSD) remains poorly understood. The nutritional deficiencies associated with the altered metabolic processes of PTSD have not previously been studied in detail. This pilot study measured the reduction in symptoms in 21 military veterans reporting moderate to severe symptoms associated with PTSD. Two amino acid–based medical foods specifically formulated with biogenic amines and other nutrients were administered to study subjects targeting specific neurotransmitter deficiencies resulting from altered metabolic activity associated with PTSD. This study included the Physician Checklist – Military (PCL-M), Short Form General Health Survey (SF-36), and Epworth Sleepiness Scale to measure the change in each subject’s score after 30 days of administration. An average decrease of 17 points was seen in the PCL-M, indicating a reduction in PTSD symptoms (P < 0.001). The mental health component of the SF-36 showed an average 57% increase in the subjects’ mental health rating (P < 0.001). The results of this initial study demonstrate that addressing the increased dietary requirements of PTSD can improve symptoms of the disease while eliminating significant side effects. A larger, double-blind, randomized, placebo-controlled trial is warranted.

Veterans Administration health care policies as a protective mechanism supporting an expected life trajectory after military service

Changes in the American military since the end of military conscription, as well as the increasing number of service-connected disabilities, suggest the need for increased consideration of the effects of health policies when assessing the impact of military service on young Americans' life course. This study analyzes data from the most recent National Survey of Veterans to investigate the health status, health benefits, and health care utilization of 2,773 Gulf War veterans, in association with resumption of their civilian life trajectory. Findings suggest that this sample of veterans may have poorer health status than previous veteran cohorts and did not fully utilize veterans' health care benefits to which they were entitled. This article examines whether veterans may usefully be considered a group at risk for health disparities, in that they have greater health risks and potentially poorer health status and access than mainstream Americans.

Health indicators for military, veteran, and civilian women

BACKGROUND

Women who have served in the military are a rapidly growing population. No previous studies have compared directly their health status to that of civilians.

PURPOSE

To provide estimates of several leading U.S. health indicators by military service status among women.

METHODS

Data were obtained from the 2010 Behavioral Risk Factor Surveillance Survey, a U.S. population-based study. Health outcomes were compared by military status using multivariable logistic regression among the female participants (274,399 civilians, 4221 veterans, 661 active duty, and 995 National Guard or Reserves [NG/R]). Data were analyzed in August 2011.

RESULTS

Veterans reported poorer general health and greater incidence of health risk behaviors, mental health conditions, and chronic health conditions than civilian women. Active duty women reported better access to health care, better physical health, less engagement in health risk behaviors, and greater likelihood of having had a recent Pap than civilian women. Women from the NG/R were comparable to civilians across most health domains, although they had a greater likelihood of being overweight or obese and reporting a depressive and anxiety disorder.

CONCLUSIONS

Compared with civilian women, NG/R women rated their health and access to health care similarly and active duty women rated theirs better on several domains, but veterans consistently reported poorer health.

Coping with life-threatening events was associated with better self-perceived health in a naval cross-sectional study

OBJECTIVE

We studied the relationship between experiencing and coping with life-threatening events and self-perceived health in navy personnel operating mainly under peaceful circumstances.

METHODS

The data were collected in a cross-sectional study from a questionnaire sent by mail at the end of 2002 to all employees in the Royal Norwegian Navy (N=3878) as part of a general health study. Both military and civilian personnel with different types of work on ships and ashore participated in the study. Logistic regression analyses were performed to study the relationship between the number of life-threatening events, occupational status, sex, age, and the extent of putting these events behind. The possible trends between the degree of putting the events behind and each of the eight SF-36 scales were calculated by bivariate correlations.

RESULTS

Military personnel had experienced life-threatening events more often than civilians, but the military personnel appeared 5.5 times more likely to have put such events behind themselves than the civilians. The extent of having put life-threatening events behind oneself was clearly correlated to self-perceived health as measured by the SF-36 subscales bodily pain, general health, vitality, social functioning, role-emotional, and mental health. These associations had linear appearances.

CONCLUSION

Navy personnel who have experienced a life-threatening event and have not been able to put this event behind them are more likely to report a reduced self-perceived health.

Utilization of medical services by Veterans Health Study (VHS) respondents

The first objective of this study was to profile Veterans Health Study (VHS) respondents' use of medical services-the types of services used, use of a regular source of care, and the propensity to use services for selected symptoms. We focused on differential use of VA and non-VA services and highlighted differences in use by age group. The second objective was to use multivariate analysis to identify factors associated with respondents' use of any medical services and with VA services specifically. We incorporated 2 self-reported variables not used in previous studies of VA utilization-health status and disease burden. Patients receiving ambulatory care services in 4 VA ambulatory outpatient clinics in the greater Boston area were eligible for inclusion in the VHS. A sample of 2425 community-dwelling male veterans was randomly selected from among veterans receiving ambulatory services at Boston-area VA facilities. This analysis focuses on 1909 respondents for whom we had complete data. Interviews and questionnaires were used to collect cross-sectional, observational data on sociodemographic, economic, and clinical characteristics; health status; disease burden; and service-connected disability (SCD) rating. To measure health status, we used 2 summary measures, the Physical Component Summary (PCS) and the Mental Component Summary (MCS), derived from the 8 scales of the Medical Outcomes Study Short Form 36-item Health Survey (MOS SF-36). To measure disease burden, we used the Physical Comorbidity Index (PHYCI) and Mental Comorbidity Index (MENCI), composed of 30 physical and 6 mental health conditions and symptoms, respectively. Information on the availability of non-VA insurance was obtained from administrative VA files. Information on utilization prior to the interview was self-reported. Recall periods of 3 and 12 months were used for ambulatory and inpatient services, respectively. We used descriptive statistics to profile respondents and their utilization patterns. We used multivariate probit models to identify respondent characteristics associated with use of any medical services, medical visits, mental health visits, and hospital stays. Independent variables used in the models were socioeconomic and demographic characteristics, and measures of disease burden, health status, and VA eligibility. The respondents relied heavily on the VA for medical care: 74% of the respondents said the VA was their regular source of care; 72% of all the respondents and 87% of those who had used any medical service in the recall period had used a VA service; 68% of those who were hospitalized used a VA hospital; and 76% of the medical care the respondents received and 60% of their hospital stays were in VA facilities. Younger veterans (aged 22-44) used substantially more mental health services than older respondents, but they were less likely than older veterans to have seen a doctor recently for most of the medical symptoms studied. PHYCI and PCS were significantly related to use of any medical services and to use of inpatient services; MENCI and MCS were significantly related to use of mental health services (P<.05 for each, respectively). Lower income and lack of alternatives to VA care were directly related to use of any VA services and VA inpatient services. Information on the reasons for differential use of VA and non-VA services can be useful to the VA as it serves an aging veteran population, seeks to provide comprehensive care to a wider spectrum of veterans, and moves into a more competitive healthcare marketplace.