A Population-Based Perspective on Health Care for U.S. Veterans

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Veterans and Department of Veterans Affairs Service Use

The National Center for Veterans Analysis and Statistics (2017a) estimates that there were 20.4 million living veterans in the United States during fiscal year 2016. Of those, most were older men, as women’s access to military roles was legally limited until relatively recently (Wilmoth & London, forthcoming) and military service among men was more common in early–twentieth century birth cohorts than in later–twentieth century and early–twenty-first century birth cohorts (Wilmoth, Landes, & London, 2019). The 2017 Profile of Veterans (National Center for Veterans Analysis and Statistics, 2017b) indicates that the average age of male veterans was 65, while the average age of female veterans was 51.

Public policies aimed at addressing the needs of veterans in general, and older veterans in particular, are focused on the services provided by the U.S. Department of Veterans Affairs (VA). The VA provides health and welfare services designed to compensate veterans and their family members for harms associated with service to the county, with priority for health care given to those with service-connected disabilities, veterans from specific wars, and other veterans with unique, service-related experiences/exposures (U.S. Department of Veteran Affairs, 2019). Given that VA health care is targeted, many veterans, including those with unmet medical needs that are not service-connected, do not receive VA health-care services (Borowsky & Cowper, 1999; Kaplan, Huguet, McFarland, & Newsom, 2007; Nelson, Starkebaum, & Reiber, 2007). Additionally, some veterans who have high priority for receipt of services do not obtain health care from the VA because they have access to other, preferred providers. As a result, a relatively small minority of veterans use VA health-care services. Using data from the 2001 National Survey of Veterans, the VA (U.S. Department of Veterans Affairs, 2001) estimates that 76.6% of veterans received all of their health care from non-VA providers, 16% received health care from both non-VA and VA providers, and 7.4% received all of their health care from the VA. More-recent data from the 2010 National Survey of Veterans (National Center for Veterans Analysis and Statistics, 2011) indicates that relatively few veterans planned to use the VA as their primary source of care in the future or to use VA health care in conjunction with non-VA health care (16.2% and 11.6%, respectively); however, a higher percentage planned to use VA health care as a safety net when needed (34.8%).