Health And Illness:

For A New Generation Of

Veterans Women
Heidi Geha
Cultural Aspects of Health
Professor McMullen
Cultural Practices Presentation
September 28, 2016
 Learning Objectives

Viewers will gain an understanding of the barriers female veterans face

when receiving quality health care at the Veterans Administration Hospital
(VA hospital).
Viewers will be able to identify the types of care available to female
veterans.
Viewers will gain a knowledge about the diverse ethnic and cultural
backgrounds of the female veterans receiving health care from the VA
hospital.
Viewers will learn how female veterans define health and illness.
 Hypothetical Character

Lauren Hall is a 40 year old female veteran

Lauren is married and has one child; a son 8 years old
Lauren is a disabled veteran:
service connected 90%
Receiving benefits for 100% because she has been determined Permanently &
Totally disabled and Unemployable
She receives full medical and dental benefits through the VA
Vocational rehabilitation education benefits from Veterans Benefits
Administration
Her family is entitled to Champ VA (medical program) and education Benefits
 Lauren and Jackson
Her return home from serving her country.
Department of Veterans Affairs: White
River Junction, Vermont
VHA Mission Statement:
Honor Americas Veterans by
providing exceptional health care
that improves their health and well-
being (va.gov)
Lauren receives her health care
at this VA facility.
Lauren is one of 3,274 women
that this facility provides health
care for (1).
 Statistics And Demographics

Total of 48,602 Veterans treated at this facility

Male 45,327
Female 3,274
White alone: 47,325
Black or African American alone: 167
American Indian and Alaska Native alone: 266
Native Hawaiian and other pacific Islander alone: 1
Some other race alone: 25
Two or more races: 635
Hispanic or Latino (of any race): 451
White alone not Hispanic or Latino: 46,913
www.va.gov.vetdata/veteran_population.asp
 Women Veteran Needs

Living in a small state and having a small VA facility requires that much of
the womens health care is feed out to hospitals in the community.
Lauren was sent to Dartmouth-Hitchcock Medical Center for: a rare form of
cancer (GTN), child birth, mammograms
Other services that were not provided by the VA until recently:
acupuncture, chiropractic, hydro-therapy (pool), some physical therapy
 Female Veterans
From Active duty to Veteran, she serves her country with pride.
 History of Womens health care in the
VA
A 1980 census determined that 1.2 million women were veterans; very few
used the VA services, because 57% did not know they were entitled to
benefits
Congress and the VA joined forces to get information out to female
veterans, informing them of their benefits
Findings of various studies show that VA care is sub-par at best when it
comes to womens health care: women didnt have adequate or fair
access to benefits, inadequate exams, gynecological and female specific
care was not previously available
A study shows that women veterans have a higher incidence of
gynecological cancer compared to non-veteran women (2)
 Important Historical Dates For Women
Veterans
April 1983 A National Advisory Committee on Women Veterans was
established
November 1983 Public law 98-160 authorized a committee to assess the
needs of women veterans in the VA system
1984 Identified lack of adequate privacy and care specific to female
patients
1985 The first womans veteran coordinator was appointed
1986 Focus on womens health care needs in the VA: osteoporosis,
gynecological, hormonal, research, mammography, agent orange
exposure, and smoking cessation. (2)
 Historical Events Continued

1991 GAO report titled, VA Health Care For Women Despite Progress,
Improvement Needed
1994 Center For Women Veterans was established
By Nov 2011 1.9 (8%) of veterans using the VA are women
2014 VA and the American Heart Association joined together to raise
awareness about heart disease in female veterans. (2)
 Language

Lauren does not see that language with providers is a problem. It can
sometimes be challenging with male doctors because the majority of the
patients they see are male. She said, I think sometimes they forget I am a
woman, and they just treat me as another Veteran.
Lauren stated she has a female primary care physician who is also her
gynecologist. She has a male podiatrist and psychiatrist. The nurses and
receptionist are a mixture of male and female.
All her doctors are Caucasian, except for her podiatrist, he is from Africa
and very very hard to understand. The language barrier can be difficult
when he is trying to explain a procedure. He draws pictures sometimes to
show what he means.
Most doctors speak in layperson terminology making it easy to understand
what they are trying to tell you in terms of your medical care/treatment.
 Language

A campaign is under way across the VA system to enhance the language,

practice and culture of VA to be more inclusive of women. VA has taken
this culture change message public with a PSA and materials like this,
encouraging everyone to rethink the term Veteran, recognize the vital role
of women in the military, and appreciate what it means to be a female
Veteran. (3)
 Religion

Religion can be difficult; Lauren believes in a more holistic approach based

on her religion. She is Wicca and believes in using home remedies,
meditation, and yoga instead of feeding the problem with another pill that
will only mask the problem.
Because Wicca is still the underdog religion it is hard for people to
understand without bias or discrimination. They hear Wicca and think evil
it is actually about being one with everything around you, the air, earth,
water, universe, sun and moon. Its about mind, body, and spirit. And yes it
is about believing in a higher power; a Goddesses and Gods, equality.
 Education

The education level of female veterans seen at the VA hospital ranges from
GED to doctors.
Some veterans have little education, while others are very well educated.
A 2014 study collected data pertaining to the education level of male and
female veterans, the statistics show the following:
Male Female
37.4% High school or equivalent 20.6%
36.4% Some college 45.3%
15.7% Bachelors Degree 20.1%
10.6% Advanced Degree 14.0%
(www.va.gov/vetdata/docs/SpecialReports/Profile_of_Veterans_2014.pdf)
 Definition of Health and Illness

Laurens view of health and illness is based on her religion, health is when
her mind, body, and spirit are balanced with everything around her, her
chakras are in alignment. If a chakra should be out of alignment then she
has an illness of the mind, body, or spirit, or a combination.
Lauren will first seek to bring her self back into balance through meditation,
yoga, essential oils, herbs, and other home remedies appropriate to the
illness.
Last resort she will go to the VA hospital to be seen.
Emergency, hospital first.
VA Medical Care
 Lingering Health Concerns for Female
Veterans
More biomedical research is needed, Access to gender appropriate
care and an advanced understanding of the unique health needs of the
female veteran are essential. (Resnick, E.M., Mallampalli, M., Carter, C.)
Depression:
Causes increased risk for osteoporosis, cardiovascular disease, metabolic
syndrome, dementia, and 50% cardiovascular mortality
PTSD:
Stress x gender and the neurobiology of PTSD in Women. Is it different than in
men?
Other mental conditions
 Continued Health Concerns

Urogenital health disorders

Urinary tract infections, pelvic organ prolapse, urinary incontinence, bladder
pain syndrome
According to Christine Sears, M.D., women in a military environment are at higher
risk for these conditions
Musculoskeletal Health
Traumatic Brain Injury
Studies related to the differences between male and female veterans will
lead to better quality health care for female veterans at the VA hospitals.
(Resnick, E.M., Mallampalli, M., Carter, C.).
 Socio-Cultural Factors

Average age of female veteran is 49

Current systems to provide housing for female veterans are almost non-existent
Active duty traumas and incidents are the majority cause of homeless female veterans
Unemployment rates are high among young veterans
Many of the veteran families are dealing with high debt
More veterans are likely to be poor despite higher income levels than most people
Women veterans generally earn less than male veterans even though they may have a
higher education level
8% of female veterans are unemployed
Between 2006 and 2010 the increase in homeless female veterans was 140% compared to
45% male veterans.
Homeless Female Veteran
 Conclusion

The VA Medical Centers have come a long way in providing adequate

health care for female veterans.
It is obvious that there is still a long ways to go until womens health care is
looked at and treated in a gender perspective
Care that the VA is unable to provide is still provided to the veteran by
feeing the veteran out to a local hospital; at no charge to the veteran
The future of health care for female veterans is very promising
 References

1. Department of Veterans Affairs. National Center for Veterans Analysis and

Statistics. (2016). Retrieved from
http://www.va.gov.vetdata/veteran_population.asp
2. Women Veterans Issues: A Historical Perspective. Retrieved from
http://www.va.gov/womenvet/docs/20yearshistoricalperspective.pdf
3. Department of Veterans Affairs. Women Veterans Health Strategic Health
Group. (2012). A Profile of Women Veterans Today. Rethink Veterans: Who
is the woman veteran? Retrieved from
http://www.womenshealth.va.gov/WOMENSHEALTH/docs/WV_Profile_FINA
L.pdf
 References Continued

1. Resnick, E.M., Ph.D., Mallampalli, M., Ph.D., & Carter, C.L., Ph.D.,
M.P.H..(2012). Journal of Womens Health, 21 (9), 895-900. doi:
10.1089/jwh.2012.3644
2. Department of Veterans Affairs. The National Center for Veterans Analysis
and Statistics. (2016). Profile of Veterans: 2014. Data From the American
Community Survey. Retrieved from
http://www.va.gov/vetdata/docs/SpecialReports/Profile_of_Veterans_2014
.pdf
3. Fairweather, A. & Lara, S. (2013). Women Veterans: Risk Factor for
Homelessness Fact Sheet. Swords to Plowshares. Institute for Veteran Policy.
Retrieved from http://www.swords-to-plowshares.org/wp-
content/uploads/Risk-Factors-for-Women-Veteran-Homelessness-Fact-
Sheet-2014.pdf