Women Veterans’ Health Research: A New Frontier

“Women are the fastest growing segment of the Veteran population.”  You may have heard or seen this statistic many times, but it’s a powerful one. It conveys both the important achievement of more and more women choosing to join our armed forces, as well as the challenges we face in addressing their specific health care needs. In VA research, this has meant not only expanding our knowledge of health conditions and diseases but making sure VA itself is prepared for the “surge” of female Veterans expected into its health care system.

As health services researchers focused on the needs of women Veterans, that is exactly what we do each day! Like our colleagues whose research studies are conducted in the lab, our goal is to improve health care delivery and health outcomes for Veterans over their entire life span. Often, finding the right treatment or course of action requires examining the health care delivery system itself.

Our strong interest in women Veterans’ health stems from our combined clinical and research experience caring for women within the VA Health Care System. Here, women have been a historical and numerical minority with specific challenges in obtaining comprehensive care (general primary care, gynecologic or reproductive care, and mental health care).  We believe challenges to women Veterans’ health and health care can be addressed through creative, thoughtful solutions that in are in turn based on several factors.

First, whether women Veterans are seeking general primary care or mental health services, their health care preferences must be taken into consideration. Even issues that don’t seem important—such as whether a woman can see a female provider or, if needed, go to a separate women’s clinic—can have a tremendous impact on health outcomes. In some cases, such matters may make the difference between whether or not a female Veteran receives the care she needs.

Second, improving women’s care requires we first understand how VA care for women Veterans is currently organized. Over two-thirds of VA medical centers have women’s clinics, and most of the rest have designated a women’s health provider to see women Veteran patients. As researchers, it is our job to identify and study anything that stands in the way of a woman Veteran getting the best care possible!

Third, we are concerned about issues related to helping women Veterans continue a care program and sustain good health. For example, has the patient been assigned a primary care provider and/or nurse case manager? Does the patient live near a comprehensive women’s health center? Will there be follow up via telephone, Internet, or group visits? Can the patient receive timely appointments for preventive health care, such as mammography, or cholesterol screening and management?

These are a just a few of the issues we think about everyday as we work to improve access and delivery of care for women Veterans. You can imagine, then, our excitement when a national health care journal—Women’s Health Issues—recently chose to showcase VA-sponsored research in a special supplement of articles and commentaries! Titled “Health and Health Care of Women Veterans and Women in the Military:  Research Informing Evidence-based Practice and Policy,” the supplement not only shows the tremendous growth and diversity of VA women’s health research in recent years, it also exemplifies the many ways the VA is working to integrate research findings into patient care, and, of course, affirms the priority status given women across the Department. Together, the articles cover a broad spectrum of topics, such as:

• Gender differences and disparities in care – in other words, how does care received by women Veterans compare to care received by male Veterans?
• The critically important area of mental health, including military sexual trauma and substance abuse;
• Post-deployment health, including posttraumatic stress disorder; and
• Special populations, including homeless women Veterans and those with traumatic brain injuries.

In short, the journal supplement presents a selection of VA health services research articles that have shaped VA clinical practice and policy regarding the provision of care to women Veterans. Going forward, these articles will inform future VA health services research on how to strengthen the care delivered to women who served our nation.

In closing, we’d like to provide you with the following toolkit of Web resources on women’s health research:

• VA women’s health research (including biomedical, clinical, and rehabilitation studies)
• VA health services research
• July Spotlight on Women’s Health

Bevanne Bean-Mayberry, MD, MHS is a Staff Physician and Investigator and Katherine J. Hoggatt, PhD is an Epidemiologist and Post-Doctoral Fellow at the VA Greater Los Angeles Health Services Research and Development (HSR&D) Center of Excellence, Sepulveda, CA, USA; Evidence Based Synthesis Program, West Los Angeles VA Medical Center, Los Angeles, CA; and VA Women’s Health Research Network, Sepulveda, CA.