Women Veterans Health Strategic Healthcare Group

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Women Veterans Health Strategic Healthcare Group

• Patty Hayes, PhDChief ConsultantSeptember 24,
  2008

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Women Veterans

• The important role of women in our nations
  defense and as part of the veteran population
  over the years cannot be over-stated
• Women now comprise 17 of active duty deployed
  forces- and are becoming veterans at an
  increasing rate

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THEN AND NOW
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Women on the RADAR

• Move from Women Veteran Program to Women Veteran
  Health Strategic Healthcare Group- March 2007
• Move beyond focus on gender specific care such as
  Pap Smears to comprehensive care of women- and
  public health, strategic approach
• Increase focus on quality of care issues and
  comprehensive longitudinal care for women veterans

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Demographic Differences

• Women VA users are younger
• Mean Age 49.5 years
• Men Mean age 61.5 years
• Women users have more education (65 have
  college, 35 of males users do)
• Less likely to be married (25 of women, 48 of
  men)

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All Veteran Utilization Trends
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Women Veterans Using VA
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Women Veterans Using VA
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The women population Bi Modal(Then and Now)

• The NOW is the returning veteran from Global War
  on Terror
• She is young, child bearing age, many with
  children at home.
• She is currently physically fit, with a high
  burden of mental health issues
• Ongoing issues of MST and co-morbid mental
  health conditions
• Combat adjustment /Stress disorder

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More homeless veterans are women

• Increased rate from 2 to 7 in 10 yrs.
• Two reasons why
• More female soldiers
• Prevalence of sexual assault

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The NOW Childbearing age

• There were over 1500 VA babies last year
• Challenge Avoiding teratogenic drugs in sexually
  active women planning families
• With significant mental health burden and most
  psychotropics dangerous to development
• Issues of Lactation and prescription drugs

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The NOW veteran

• She is utilizing VA Services 42.2 enroll
• She is coming to VA frequently
• 45.6 were seen 2-10 visits
• 38.5 seen 11 or more times since 2002
• The total number of women using VA services will
  double in the next 2-5 years

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Gulf War I Veterans Results of Institute of
Medicine Study 2006 All veterans

• No unique syndrome or illness has been identified
  
• Increased risk for PTSD, depression, anxiety and
  substance abuse
• No difference in cognitive and motor measures
• Most common symptoms reported dyspepsia,
  dermatologic conditions and joint pains
• No difference in diabetes or cardiovascular
  prevalence

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Gulf War I Women Veterans
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Gulf War I Women Veterans

• 11 of deployed military personnel serving the
  Persian Gulf were women
• 71 of women reported at least one combat
  exposure
• Women reported similar rates of exposure to
  environmental agents such as diesel fuel, smoke
  from oil-well fires

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Gulf War I Women Veterans Health

• Fibromyalgia, Chronic Fatigue Syndrome and
  Dyspepsia ? found to be more common in GWI
  deployed women than in non-deployed women
• Gulf War I women had significantly more
  outpatient and inpatient visits compared to male
  veterans
• Dept Veterans Affairs Study, 2000
• Iowa Persian Gulf Study Group, 1997

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Gulf War I Registry Exams
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Birth Defects Gulf War I Veterans

• No consistent pattern of birth defects among
  offspring of male and female GW I vets
• Araneta et al 2003 Doyle et al 2004
• Data was inconclusive to support a link between
  Gulf War Service and Goldenhar Syndrome (syndrome
  of craniofacial abnormalities)
• IOM Report 2006

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Pregnancy Outcomes Gulf War I Veterans

• Trend towards an increased risk of spontaneous
  abortions and ectopic pregnancies in deployed GW
  I veterans
• Not statistically significant
• Areneta et al. 2004
• No observed effect of Gulf War service on the
  risk of stillbirths or miscarriages
• Doyle et al 2004

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Air Force Women Study, 1997

• 88,415 women served in the Air Force during the
  Gulf War I Era
• Women deployed to the Gulf Region reported rash,
  cough, depression, unintentional weight loss,
  insomnia and memory problems more frequently than
  women deployed elsewhere
• More likely to report breast cysts and lumps and
  abnormal cervical cytology

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The THEN Women WWII, Korea, Vietnam, Gulf War I

• While seeing an influx of young women, we dont
  lose sight of our aging women
• Significant numbers over age 50 use VA, largest
  group is Vietnam Era
• Cardiac risk the number one risk for morbidity
  and mortality
• High prevalence diabetes and obesity
• Health concerns of peri-menopause and menopause
• Cancer screenings mammograms
• Bone health Osteoporosis risks, fractures

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Aging and Womens Mental Health

• Increased incidence of Depression
• Increased suicide risk
• Losses of spouse, partner and
• Loss of income, home
• Women outlive their male partners-
• Emergence of buried trauma issues
• Challenge Address MH services for Women
• Assess long term care supports

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SUMMARY

• Shrinking total veterans population but a
  doubling of women veterans
• Changing roles of active duty women increased
  types of military health related problems for
  women seeking VA health care
• Follow gender specific post-deployment health
  issues
• Services provided for Military Sexual Trauma and
  co-morbid mental health conditions
• Enhance health services for entire the
  population of women veterans- enhanced delivery
  of primary care
• Increasing recognition of women veterans unique
  and complex health needs- gear up for influx of
  younger women veterans

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You Served - You Deserve the Best Care
Anywhere