Category Archives: Military/veterans
The focus on military concerns in the last few weeks has understandably been on events in the Middle East, Ukraine and Afghanistan. But a new study from the Mailman School of Public Health at Columbia University is shining a light on the continuing problems faced by returning U.S. military personnel—in particular their increased risk of abusing alcohol.
The study found that regardless of whether they experienced traumatic events during deployment, returning National Guard soldiers were more likely to develop a drinking problem when faced with civilian life setbacks, including job loss, legal problems, divorce, and serious financial or legal problems. The study authors say these are all very common for military families. The study was published in the American Journal of Preventive Medicine.
Previous studies have shown that alcohol abuse is a major concern for reservists returning home. While almost 7 percent of Americans abuse or are dependent on alcohol, the rate of alcohol abuse among reserve soldiers returning from deployment is 14 percent, or almost double that of the civilian population, according to the Mailman researchers.
The study looked at 1,095 Ohio National Guard soldiers who had primarily served in either Iraq or Afghanistan in 2008 and 2009. The soldiers were interviewed three times over three years via telephone about their alcohol use, exposure to deployment-related traumatic events and stressors such as land mines, vehicle crashes, taking enemy fire and witnessing casualties. They were also questioned about any stress related to everyday life since returning from duty.
More than half (60 percent) of the soldiers who responded experienced combat-related trauma, 36 percent of soldiers experienced civilian stressors and 17 percent reported being sexually harassed during their most recent deployment. The researchers found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders; combat-related traumatic events were only marginally associated with alcohol problems.
Evidence-based practices and model homelessness reduction programs that have been effective in other cities are the key tools behind a new initiative, the Mayors Challenge to End Veteran Homelessness, launched earlier this month by the U.S. Department of Housing and Urban Development (HUD) and the U.S. Department of Veterans Affairs (VA).
The goal of the Mayors Challenge is to end veteran homelessness by the end of 2015.Close to 60,000 veterans are homeless on any given night. Housing experts say the model practices and speed of their deployment can also serve as examples to greatly reduce homelessness in the general population—which can be as high as 3.5 million in any given year, according to HUD surveys.
Ending veteran homelessness has received increased attention in recent years. According to Eric Grumdahl, policy director of the U.S. Interagency Council on Homelessness, there has already been a 24 percent reduction in veteran homelessness in the last three years that is directly tied to evidenced-based practices, including:
- Housing First, a concept that eliminates prerequisites such as sobriety and minimum income before a veteran can be given housing.
- Permanent supportive housing, which adds mental health services.
- Rapid re-housing aimed at people who are homeless from time-to-time rather than chronically homeless.
San Diego and Phoenix were both recently cited by both HUD and the VA for effectively ending chronic homelessness among veterans.
In Phoenix, where one in five homeless adults was a veteran—about twice the national average—the city leveraged partnerships and local, state and federal funding to find housing solutions for veterans. Partnerships included state and federal government; the business and faith community; and non-profit groups. The city’s mayor, Greg Stanton, credits “a united front” and Housing First’s work to speed up placing veterans in safe housing.
IOM Report: More Evidence-Based Practices Needed to Help Treat and Prevent Psychological Disorders among Service Members and Families
Between 2000 and 2011, almost 1 million service members or former service members were diagnosed with at least one psychological disorder either during or after deployment, according to recent research by the Institute of Medicine (IOM). As a follow up, the U.S. Department of Defense (DOD) asked the IOM to evaluate the department’s efforts to prevent psychological disorders among active-duty service members and their families. That report was recently released.
The report includes recommendations on how the DOD can improve care.
Finding 1: DOD has implemented numerous resilience and prevention programs for service members and their families, but it faces a number of challenges, including an insufficient evidence base to support its interventions and a lack of systematic evaluation and performance measures.
Recommendation 1: By targeting resources to develop the evidence base and disseminate that evidence, DOD’s prevention efforts can be both more effective and cost effective.
Finding 2: There is a need for DOD to improve approaches for identifying and intervening with service members and their members who may already have or may be at risk for developing a psychological disorder.
Recommendation 2: DOD should dedicate funding, staffing and logistical support for data analysis and evaluation to support performance monitoring of programs for accountability and continuous improvement.
Finding 3: Screening, assessment and treatment approaches for psychological health problems are not always implemented between and within the DOD and the U.S. Department of Veterans Affairs (VA) in a consistent manner or aligned with the evidence base, which threatens the delivery of high-quality care and hampers evaluation efforts.
- There are opportunities to improve processes of training and evaluating clinicians, including the incorporation of continuing education and supervision; standardized periodic evaluation; and a greater emphasis on coordination and interdisciplinarity.
- The DOD and VA should invest in research to determine the efficacy of treatments that do not have a strong evidence base.
- Both departments should conduct systematic assessments to determine whether screening and treatment interventions are being implemented according to clinical guidelines and departmental policy.
- Accessible inter-department data systems should be developed to assess treatment outcomes, variations among treatment facilities and barriers to the use of evidence-based treatment.
- Read the complete report.
- Read a NewPublicHealth interview with Jonathan Woodson, MD, Assistant Secretary of Defense for Health Affairs about the National Prevention Strategy.
- Learn more about the state of mental health in the military from this infographic from the American Psychiatric Association embedded below.
A new American Public Health Association (APHA) Press book, “Veteran Suicide: A Public Health Imperative,” addresses the critical and growing issue of suicide among military veterans. The book is a collaboration between the APHA and the Department of Veterans Affairs. Both organizations previously partnered on a supplement to the American Journal of Public Health on suicide risks among veterans.
Topics addressed by the book include
- suicide prevention,
- substance abuse, and
- suicide surveillance.
The new book includes very recent research on suicide among veterans. "The research represented by the collection of manuscripts included in this volume is an important step towards addressing the national problem of suicide and a reminder that even one death by suicide is too many," said Janet Kemp, RN, PhD, Department of Veterans Affairs National Mental Health Program Director for Suicide Prevention.
“Veteran Suicide: A Public Health Imperative” is available for purchase online.
>>Bonus Link: This week the Huffington Post published an article by Kimberly Williams, Director of the Center for Policy, Advocacy, and Education of the Mental Health Association of New York City, pointing out that the connectedness members of the military feel with each other often disappears when they return to their communities, which may be a factor in the rising suicide rates among veterans.
The tornado that ripped through Moore, Okla., on May 20 left at least 24 people dead and nearly 400 injured. More than a mile wide in places, the tornado left billions of dollars in damage in its wake. The people of Moore and the surrounding area are now burying the friends and family members lost that day and the slow process of rebuilding has begun.
Among the first to respond to the natural disaster was Team Rubicon, a collection of hundreds of U.S. military veterans who have been provided disaster relief around the world since the organization was founded in 2010. The name for the Moore effort is “Operation: Starting Gun”—both for their quick response to the tornado’s devastation and for the Sooners of the Oklahoma Land Rush. They expect as many as 250 volunteers, of which 90 percent are veterans.
A recent article in the Washington Post looks at ongoing clinical trials that have researchers studying the potential effects of transcendental meditation as a treatment for post-traumatic stress disorder (PTSD). As many as 10 percent of returning veterans suffer from PTSD and both internal military reports and outside reviews show an insufficient and too-slow response for veterans seeking mental health help. Military spokespeople say they know many returning veteran with mental health concerns who aren’t accessing the help at all. The results of the trials won’t be available for at least a year, but two small pilot studies show a reduction of symptoms by 50 percent in participants just two months after beginning the meditation.
- Read an interview with Jonathan Woodson, MD, assistant secretary for health at the Department of Defense (DOD) on the DOD's emphasis on wellness and suicide prevention.
- Read the full Washington Post article.
- Read a blog post from the Department of Veterans Affairs on maintaining military benefits for veterans displaced by Hurricane Sandy.
World Suicide Prevention Day, co-sponsored by the World Health Organization, promotes commitment and action to prevent suicides. Almost 3,000 people commit suicide every day, and for every person who completes a suicide, 20 or more may attempt to end their lives. In the first five months of 2012, at least 155 military service members committed suicide—more than the number of service personnel killed in Afghanistan during the same time period.
As part of our National Prevention Strategy series, NewPublicHealth spoke with Jonathan Woodson, MD, Assistant Secretary of Defense for Health Affairs in the Department of Defense, about suicide prevention as well as the department’s overall approach to wellness and prevention for military, veterans and their families.
Listen to the podcast and read the full interview with Dr. Woodson below.
Pre-teens living in states that require vaccinations for incoming middle school students are more likely to be immunized than those in states that simply require parents to receive information about the vaccines, according to a study in Pediatrics.
Researchers at the Centers for Disease Control and Prevention reviewed school entry requirements in all 50 states and the District of Columbia for the 2008-2009 school years and compared them to adolescent vaccination rates for three vaccines: TdaP, meningitis and HPV. Compared to states with no requirements, vaccination coverage was significantly higher for the meningitis (71 percent versus 53 percent) and TdaP (80 percent versus 70 percent) vaccines.
The Department of Transportation has announced a month-long web-based dialogue May 7 to June 8, to help facilitate discussion about local transportation needs, challenges and opportunities facing military veterans, wounded service people and military service members and their families. Military families, veterans and organizations that support them are invited to participate in the discussion to create options to improve access to transportation. Registered participants will be able to offer an idea, a comment or vote on ideas they see on the site. A public report will be issued after the dialogue period ends.
The Centers for Disease Control and Prevention is reporting that at least sixteen people have been sickened by dry dog food made by Diamond Pet Foods that may be tainted by salmonella. Humans may have become infected by touching the food or a pet that ate the food. The company has recalled the products. CDC is advising that:
- Consumers should check their homes for recalled dog food products and discard them promptly. Contact Diamond Pet Foods for more information at (800) 442-0402 or www.diamondpetrecall.com.
- Follow tips listed on Salmonella from Dry Pet Food and Treats to help prevent an infection with Salmonella from handling dry pet food and treats.
- People who think they might have become ill after contact with dry pet food or with an animal that has eaten dry pet food should consult their health care providers. For sick animals, contact your veterinary-care providers.
Teen drivers and passengers are more likely to use seat belts in states with "click it or ticket" laws, according to a new study in the American Journal of Public Health. These laws, also known as primary enforcement laws, allow police to stop and ticket drivers for not wearing a seat belt. Under a secondary law, police can only ticket drivers not buckled up if they are stopped for some other reason, such as speeding.
The study found that in states with secondary laws teens were 12 percent less likely to wear a seat belt when driving and 15 percent less likely to do so as a passenger than teens in states with primary laws. Read more on public health law.
A new study by researchers at the University of British Columbia found that a survey of 17,000 Canadian students in grades 8 to 12 showed that 25 to 30 percent admitted to cyberbullying, while only twelve percent said they had participated in schoolyard bullying. The researchers say that indicates that current prevention programs may not be sufficient to protect kids from online bullying. Read more on violence prevention.
Researchers analyzing data from a survey of Vietnam War veterans have found that those with more killing experiences were twice as likely to have suicidal thoughts as those with fewer or no experiences of killing.
The researchers, who published their findings in the journal Depression and Anxiety, say the association between killing and suicidal thoughts remained even after adjusting for variables such as post-traumatic stress disorder, depression, substance use disorders and combat exposure.
"We want clinicians and suicide prevention coordinators to be aware that in analyzing a veteran's risk of suicide, killing in combat is an additional factor that they may or may not be aware of,” says Shira Maguen, PhD, the study’s lead researcher. Read more on military health.