Executive SummaryIntroductionCompare the Health of Those Who Have Served ReportDesignFindingsCore MeasuresBehaviorsPolicyClinical CareHealth OutcomesAppendixData Sources and MeasuresMethodologyLimitationsCrude RatesThe TeamAdvisory Group
Colorectal Cancer Screening
Colorectal cancer is the second leading cause of cancer death among cancers that affect both men and women. The United States Preventive Services Task Force recommends regular colorectal cancer screening for all adults aged 50 to 75. Screening can increase the chance of detecting precancerous lesions or early stage cancers that can be treated with less extensive methods, and is known to help reduce mortality from colorectal cancer. Previous research has shown that veterans and non-veterans generally have similar colorectal cancer screening rates, with a sizeable proportion of both populations not up-to-date with screening recommendations.
- Overall, individuals who have served report a significantly higher rate of colorectal cancer screening than those who have not served.
- Many minorities who have served have significantly higher rates of screening than those who have not served.
- Colorectal cancer screening rates are generally higher at higher incomes.
Oral health is closely linked to physical health, chronic disease, and a person’s psychological and social well-being. Regular dental visits enable prompt identification of dental problems, promote good oral hygiene, and can help prevent disease. People who visit the dentist regularly throughout their life report better oral health status, and have fewer missing teeth and cavities. Research has shown that roughly two-fifths of veterans perceive their oral health status as fair or poor, compared with around one-third of non-veterans. Older veterans in particular report difficulties in some oral care activities including bleeding gums, difficulty or pain during brushing and flossing, and forgetting to brush or floss.
- Those who have served are more likely to have visited the dentist in the past 12 months than those who have not served.
- Blacks, Hispanics, and Asians who have served are more likely to have had a recent dental visit than blacks, Hispanics, and Asians who have not served.
- Adults aged 18 to 39 years who have served are most likely to have visited a dentist recently.
- For those earning less than $50,000 annually, those who have served are more likely to have had a dental visit than those who have not served.
Seasonal influenza, or flu, is a potentially serious viral illness. Thousands of Americans die from flu or related complications every year. Up to 90% of flu-related deaths occur in adults aged 65 and older. To minimize the likelihood of flu infection, the CDC recommends nearly all people receive an annual flu vaccine. In 2015 to 2016, fewer than half of working-age adults obtained a flu vaccine, while six in ten people aged 65 and older were vaccinated. Flu vaccine rates below 50% have been observed in the VA patient population, but some VA clinics have piloted initiatives that have nearly doubled their proportion of immunized patients.
- Overall flu vaccine rates are significantly higher for those who have served than those who have not served.
- Minorities who have served receive flu vaccines more often than those who have not served. Asians who have served have the highest flu vaccine rate of any minority group.
- Older adults are most likely to be vaccinated for the flu. Among adults aged 18 to 39 years, those who have served were vaccinated at twice the rate of those who have not served.
- At all income levels, those who have served have higher vaccine rates than those who have not served.
Personal Health Care Provider
People with a personal health care provider experience better health outcomes. They are more likely to access care when they need it, communicate well with their provider, and follow medical advice. As in the general population, uninsured veterans are least likely to have a personal health care provider. While an estimated 883,000 veterans use VA health care primarily or exclusively, many veterans do not use VA services and doctors. Research documents that some seek care outside the VA system of care.
- A slightly smaller percentage of those who have served than those who have not served say they have a personal health care provider, and these rates have only slightly changed since 2011 to 2012.
- Females generally report having a personal health care provider more often than males.
- Some minorities (e.g., Hispanics) who have served are more likely to have a personal health care provider than those who have not served.
- Adults aged 18 to 39 years and those with annual incomes below $25,000 are much less likely to have a personal health care provider.
Unmet Medical Need
High out-of-pocket health care costs, such as premiums, copays, deductibles, and prescription drugs, can prevent people from seeking needed health care. Cost concerns may lead people to forego screenings and treatment for minor problems that can worsen into serious disease. Usually, eligible veterans can obtain free or low-cost health services through the VA. In veterans, as in the general population, insurance status is a key predictor of medical cost barriers. According to national data, uninsured veterans delay seeking medical care due to cost at four times the rate of insured veterans, and 41% of uninsured veterans say they have unmet medical needs.
- Individuals who have served are less likely to have unmet medical need due to cost than those who have not served.
- Unmet medical need declined significantly since 2011 to 2012 for both those who have and have not served.
- For blacks and Hispanics who have served, unmet medical need is less than half that of blacks and Hispanics who have not served.
- Unmet medical need is more common among adults aged 18 to 39 years and those with incomes less than $25,000. Still, within these groups those who have served have lower rates of unmet need than those who have not served.