Dataset Information

Evidence Review-Social Determinants of Health for Veterans.

ABSTRACT:

Background

Veterans Health Administration (VHA) is committed to providing high-quality care and addressing health disparities for vulnerable Veterans. To meet these goals, VA policymakers need guidance on how to address social determinants in operations planning and day-to-day clinical care for Veterans.

Method

MEDLINE (OVID), CINAHL, PsycINFO, and Sociological Abstracts were searched from inception to January 2017. Additional articles were suggested by peer reviewers and/or found through search of work associated with US and VA cohorts. Eligible articles compared Veterans vs non-Veterans, and/or Veterans engaged with those not engaged in VA healthcare. Our evidence maps summarized study characteristics, social determinant(s) addressed, and whether health behaviors, health services utilization, and/or health outcomes were examined. Qualitative syntheses and quality assessment were performed for articles on rurality, trauma exposure, and sexual orientation.

Results

We screened 7242 citations and found 131 eligible articles-99 compared Veterans vs non-Veterans, and 40 included engaged vs non-engaged Veterans. Most articles were cross-sectional and addressed socioeconomic factors (e.g., education and income). Fewer articles addressed rurality (N?=?20), trauma exposure (N?=?17), or sexual orientation (N?=?2); none examined gender identity. We found no differences in rural residence between Veterans and non-Veterans, nor between engaged and non-engaged Veterans (moderate strength evidence). There was insufficient evidence for role of rurality in health behaviors, health services utilization, or health outcomes. Trauma exposures, including from events preceding military service, were more prevalent for Veterans vs non-Veterans and for engaged vs non-engaged Veterans (low-strength evidence); exposures were associated with smoking (low-strength evidence).

Discussion

Little published literature exists on some emerging social determinants. We found no differences in rural residence between our groups of interest, but trauma exposure was higher in Veterans (vs non-Veterans) and engaged (vs non-engaged). We recommend consistent measures for social determinants, clear conceptual frameworks, and analytic strategies that account for the complex relationships between social determinants and health.

SUBMITTER: Duan-Porter W

PROVIDER: S-EPMC6153229 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Evidence Review-Social Determinants of Health for Veterans.

Duan-Porter Wei W Martinson Brian C BC Greer Nancy N Taylor Brent C BC Ullman Kristen K McKenzie Lauren L Rosebush Christina C MacDonald Roderick R Falde Samuel S Wilt Timothy J TJ

Journal of general internal medicine 20180720 10

<h4>Background</h4>Veterans Health Administration (VHA) is committed to providing high-quality care and addressing health disparities for vulnerable Veterans. To meet these goals, VA policymakers need guidance on how to address social determinants in operations planning and day-to-day clinical care for Veterans.<h4>Method</h4>MEDLINE (OVID), CINAHL, PsycINFO, and Sociological Abstracts were searched from inception to January 2017. Additional articles were suggested by peer reviewers and/or found ...[more]

PMID: 30030735

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Dataset Information

Evidence Review-Social Determinants of Health for Veterans.

Background

Method

Results

Discussion

Publications

Evidence Review-Social Determinants of Health for Veterans.

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