AANP 2018 Conference Spotlight: Improving the Health of Women Veterans

On June 27, at this year’s AANP conference, a session titled “Overlooked and Underserved: Improving the Health of Women Veterans” was presented. This talk covered the growing number of women who are joining the ranks of our nation’s veterans. These female veterans tend to be younger, on average, than male veterans. As women, they also have unique health needs in comparison to their male counterparts. So, just how many women veterans are in the U.S. and when in their lives are they seeking health services?

On the Rise: A Snapshot of Women Veterans

Today, women are the fastest growing group within the veteran population. While women have been associated with the military since the very beginning of our nation, it was just recently that they began serving in combat situations.

In 2011, eight percent of all U.S. veterans were women. This is expected to increase to 11 percent by 2020. When looking at the age distribution of female veterans who use health services provided by the VA, in 2009 it was broken out into “three main peaks which were: The mid-twenties, mid-forties, and mid-fifties.”

With a growing number of women becoming veterans, how has the VA tried to address this emerging population?

A Brief History of the VA’s Efforts to Address Women Veterans

The VA created the Women Veterans Health Program in 1988. The program was meant “to streamline services for women veterans [and to] provide more cost-effective medical and psychosocial care.” At the time of its creation, only 4.4 percent of veterans were women. In 2011, the Women’s Health program officially became part of the Office of Patient Care Services before undergoing a name change (Women’s Health) in 2012. The rename was done to afford “greater opportunities for collaboration between Women’s Health and programs including primary care, mental health, and specialty care.

While the VA has reorganized to accommodate female veterans more effectively, studies show that veteran women are less likely to turn to the VA for medical services, seeking services instead at non-VA related facilities. So, how do healthcare organizations and nurse practitioners (NPs) better serve this growing population?

Specific Concerns Regarding Women Veterans that Healthcare Organizations and NPs Should Know

Many Women Veterans Don’t Self-Identify

It is essential that healthcare organizations and NPs identify veteran women. Veteran women rarely self-identify, so many are not accounted for by the non-VA institutions that treat them. Thus, it is critical that NPs ask women about their military service. Also, while many women do not use VA services, healthcare organizations and NPs should advise patients on their rights and the resources available for care at a VA facility.

Possible Delays in Preventive Care

Military service can create many problems for women regarding their reproductive health. For example, in “combat zones, preventive care for women is often interrupted,” which can mean many preventive tests and screenings may be delayed. Thus, it is critical for healthcare organizations and NPs know how long a veteran has been deployed, and if preventive care has been re-established.

Abuse, PTSD Screenings, and Support

Women in the military or who have been in the military are at higher risk for experiencing violence and sexual abuse within their lifetimes. The rate of violence and abuse veteran women experience is far greater than for nonmilitary women. Thus, when healthcare organizations and NPs are caring for a veteran woman, it is vital to ask about their history of abuse or sexual assault. With this information, an NP can anticipate possible mental healthcare needs and come up with a plan to address them.

Additionally, veteran women are more than twice as likely to experience PTSD than nonmilitary women. For NPs who treat veteran women, it is important to establish any possible PTSD symptoms in these women now or in the past. Again, by knowing this information, an NP can better prepare for the current and future needs of these patients.

Improving Care for Veteran Women: A Task for Healthcare Organizations and NPs

Women veterans tend to be younger than male veterans and rarely seek VA services. Thus, it is critical medical providers, such as NPs, anticipate having women veterans as patients now and in the future.

Healthcare organizations and NPs can improve care for veteran women in several ways. First, healthcare organizations and NPs should identify veteran women who usually do not self-identify. Secondly, due to their military service, veteran women can have interrupted preventive care, so ensuring screenings are up-to-date is crucial. Lastly, veteran women are more likely to have experienced abuse or be dealing with PTSD than nonmilitary women. Thus, healthcare organizations and NPs and should ask veteran women about their past experiences to better address their mental health needs.  By using these strategies, healthcare organizations and NPs can improve the health of veteran women.

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