Executive BriefForewordIntroductionDesignKey FindingsOverviewMental HealthPhysical HealthHigh Health StatusAccess to Health Care and Preventive ServicesSubstance UseSeniorsConclusionsAppendixTable 1. MeasuresMethodology2022 Health of Those Who Have Served Advisory Committee
Those who have served have higher rates of access to health care and uptake of preventive clinical services, with some racial/ethnic populations reporting higher rates for each measure.
Even as the Affordable Care Act helped to increase health insurance coverage for the civilian population since 2011-2012 (from 80.4% to 85.8%), those who have served still reported higher rates of health insurance (92.4%) in 2019-2020. In addition, they were also less likely than those who have not served to report having a time in the past 12 months when they needed to visit a doctor but could not because of cost (8.5% vs. 13.0%).
While financial barriers to health care have decreased overall over the past decade, some subpopulations continue to have lower rates of access to health care. However, having served in the military narrows the gaps. For example, Hispanic adults and those with less than a high school education who have served are both 1.3 times more likely than their civilian counterparts to have health insurance (88.5% vs. 70.6%, 80.8% vs. 64.1%, respectively). Black adults who have served are less likely to report having avoided care due to cost (8.1%), compared to 15.6% of those who have not served.
Still, among those who have served, those who graduated from college are 1.2 times more likely to have health coverage than those with less than a high school education (95.5% vs. 80.8%). American Indian/Alaska Native and Hispanic adults who have served are also 1.5 and 1.4 times more likely to report having avoided care due to cost than white adults who have served (11.5% and 11.0% vs. 7.8%). In addition, those who have served living in non-metro areas have rates of avoiding care due to cost 1.5 times higher than those who live in metro areas (11.8% vs. 8.1%).
Financial barriers to care can cause people to forgo preventive care and treatment for minor health issues, which can worsen over time. Those who have a history of military service report higher levels of preventive screenings than those who have not served. For example, 74.2% of adults ages 50-75 who have served reported having received a colorectal cancer screening within the recommended time, compared to 70.2% of those who have not served. Over two-thirds (68.0%) of those who have served have visited a dentist in the past year, compared with 64.3% of those who have not served. Finally, adults who have served are 1.3 times more likely to report receiving a flu vaccine in the last year than those who have not (52.5% vs. 41.8%).
While those who have served are more likely than their non-service counterparts to receive recommended preventive care, those who have not served have experienced larger improvements in rates since 2011-2012. In the case of dental visits, rates for those who have served declined from 70.4% in 2011-2012 to 68.0% in 2019-2020.
Hispanic Adults Who Have Served are More Likely to Report High Health Status and Access to Care
Hispanic adults are more likely than any other racial/ethnic group to report being uninsured, avoiding care due to cost and lacking a dedicated health provider. They, along with Black adults, have higher rates of diabetes, and are more likely than white adults to have poorly controlled diabetes and experience lower quality of care.18,19
While having served increases access to care and the likelihood of reporting high health status overall, military service has a notable positive effect for Hispanic adults. Service increases the likelihood of reporting health insurance coverage by almost 18.0 percentage points; having a dedicated health care provider by 11.2 percentage points; and reporting excellent or very good health by 13.2 percentage points. It also reduces care avoided due to cost by 7.6 percentage points. All of these differences between serving and non-serving Hispanic adults are greater than those of other racial/ethnic groups.
18. Canedo, J.R., Miller, S.T., Schlundt, D. et al. “Racial/Ethnic Disparities in Diabetes Quality of Care: the Role of Healthcare Access and Socioeconomic Status.” Journal of Racial and Ethnic Health Disparities 5 (2018): 7–14. https://doi.org/10.1007/s40615-016-0335-8.
19. Walker R.J., Strom Williams J., Egede, L.E. “Influence of Race, Ethnicity and Social Determinants of Health on Diabetes Outcomes.” The American Journal of Medical Sciences 351, no. 4 (2016): 366-73.4: https://doi.org/10.1016/j.amjms.2016.01.008.