Veterans Medical Care: Literature Review

Research Problem

Recently, there has been great concern about the welfare and health of veterans and their families, as this sub-population has a characteristic vulnerability to health risks. Moreover, numerous veterans are homeless in the US and many more are yet to face this chronic problem. Despite several efforts that the US government has made to care for this sub-population owing to their significant contribution to the nation’s security, there are major flaws in veteran health care. Therefore, there is a need to provide more insight into the veteran medical care policies because the previous programs have not been sufficient.

Literature Review

Before health care services among veterans are discussed, the highest risk this sub-population is facing in America is worth noting. Homelessness is almost a default status for veterans. The challenges associated with homelessness of both veterans and nonveterans include consistent substance abuse leading to mental illness, low socioeconomic status, social isolation, and high level of incarceration. Past research studies that have been conducted concerning veteran health care have pointed out three areas that require policy change and development to improve veterans’ health. According to Tsai and Rosenheck (2015), areas that need policy development to improve this sub-population's health include mental illness, substance abuse, and low socioeconomic status. Veterans are considered at high risk of homelessness and at an increased risk of health and socioeconomic challenges. The US government through the Veteran Affairs Agency is mandated to ensure the health and well-being of veterans, regardless of whether they have other medical care.

Kizer, Demakis, and Feussner (2000) in their research on veteran care noted that the improvement in health care service delivery for this sub-population started with the 1995 initiative to re-engineer health care services in the Veterans Health Administration (VHA). Re-engineering of the VHA has been applauded several years down the line for improved quality care for the target sub-population, who were otherwise at high risk of vulnerability (Kizer et al., 2000). Research done by the VA in 1997 after re-engineering efforts of the VHA were instituted indicated that there was an overall improvement in veteran health care. The rate of vaccination for influenza and pneumococcal infections doubled while diabetes was managed more effectively. The management of acute myocardial infarction for inpatients was also improved significantly. Over the years, there had been an improvement in veteran health care with high rates of screening and vaccination recorded in the year 2000 (Kizer et al., 2000). Chronic diseases were managed effectively and there was an improvement in inpatient care. However, the reforms did not yield results regarding managing other challenges such as hypertension, optical care for diabetic patients, and colorectal cancer screening.

Sayer et al. published their research in 2009, investigating the challenges veteran carers face. The hypothesis for their research was that carers of veterans, most of whom were diagnosed with various forms of mental problems, had experienced numerous challenges. The data they collected from professional and non-professional veteran carers indicated that these two groups faced significant problems when caring for this sub-population because veterans are deemed to have more special needs as compared to the non-veteran needy population. This research revealed a new challenge in the veteran care as seen from the carer’s perspective. Particularly, at a time when all resources are directed towards veteran medical issues and their welfare, carers are likely to be neglected. Therefore, Sayer et al. (2009) revealed valid claims that there is a gap that needs to be addressed alongside important veteran medical issues. To solve persistent veteran’s health care challenges, there is a need to develop integrated strategies. Therefore, problem-solving strategies should care for both veterans as the population in need and primary and secondary carers, involved in caring for this needy population.

Furthermore, veterans encounter countless issues after their return from service. For instance, mental illness as a challenge puts veterans at a risk of destabilizing their families with a consequence of increasing joblessness and homelessness. The rates of mental diseases among veterans are disproportionate with problems such as posttraumatic stress disorder, depression, anxiety, substance abuse disorders, and military sexual trauma (Spelman, Hunt, Seal, & Burgo-Black, 2012). More than 50% of troops returning from Iraq have reported suffering and alcoholic dependency. Another research study conducted indicated that approximately 22 veterans committed suicide in 2010 (Kemp & Bossarte, 2012). In addition, most veterans who were experiencing psychological distress did not receive any psychological help (Kemp & Bossarte, 2012).

Moreover, veterans in the US have a higher chance of becoming homeless due to social isolation emanating from the lack of support networks, poverty, and poor living conditions in substandard and overcrowded housing facilities ("Veteran homelessness", 2009). Social isolation is the largest risk factor in the bid for veterans to access health care after discharge from service, coupled with the lack of support. Data available indicated that rates of marriage among veterans were very low with high levels of divorce being 1 in 5 veterans (Cunningham, Henry, & Lyons, 2007). The importance of social networks arises for veterans in crisis and needs urgent medical attention. Without social support, they are more likely to succumb to their health-related complications. The challenge of social isolation is so huge that the VA has made a tremendous effort in serving over 92,000 veterans in 2009 alone. The VA managed to reach about 20% of veterans with an estimated 500,000 homeless veterans, which translates to over 400,000 veterans without social support ("Programs and services for Native veterans", 2012). Programs by the VA since 1987 have emphasized the need for collaboration with the community in expanding services to more veterans.