Gender differences in a psycho-social survey of National Guard veterans

Objective: Combat veterans, including activated members of the National Guard (NG), discharged or released from active military service on or after January 28, 2003, are eligible to enroll in Veterans Affairs (VA) healthcare for five years from the date of discharge. Veterans are encouraged to apply for enrollment within their enhanced eligibility (EE) period. It is unknown how willing NG are to utilize VA services or if gender might influence this decision. Methods: Members of the NG attending a 60-day Post Deployment Yellow Ribbon Reintegration Program event were invited to complete a brief anonymous survey. Survey items included self-rated functional, interpersonal, and health problems, intention/willingness to use VA health care, rationale for use/non-use of VA services, and demographic information. Results: A total of 904 surveys were returned. Of those surveyed, 60% were using, or were planning to use, VA services. However, 17% were ambivalent about obtaining care from VA and 23% had no intention to receive VA care. Nine percent of the sample was female. There were no significant gender differences regarding use of VA. However, there were significant gender differences regarding the reasons for not using VA. Male NG were more likely to cite being “healthy – I don't need medical care” (p=0.02); female NG were more likely to “prefer to continue receiving care from my community doctor.” (p=0.02) Female NG were more likely to have a community healthcare provider (p=0.04). Female NG were also more likely (p<0.05) to endorse several difficulties in the past 30 days including maintaining friendships, taking care of chores, taking part in community activities, belonging in “civilian” society, and enjoying use of free time. Conclusions: These results suggest that there are significant differences between male and female NG regarding post-deployment difficulties. Female NG were more likely then male NG to endorse difficulties with interpersonal connectedness. It appears that many female NG would prefer to receive healthcare services from their established local community doctor despite the availability of enrolling for VA services during EE. Impact Statement: Many female NG Veterans had indicated interpersonal difficulties following deployment. VA is in a position to offer care under EE. However, many female NG are reluctant to take advantage of VA healthcare, preferring local, non-VA doctors in the community. This highlights the need for VA to continue outreach efforts to female Veterans and the need to integrate community providers into the model of care provided by VA.