DAV Study Details Significant Gaps in Services for Women in Health Care, Transition Services, Disability Compensation, Employment, Community Reintegration, Housing, and Eradication of Military Sexual Assault
WASHINGTON, D.C. (September 24, 2014)—While the federal government has raced to establish programs to serve combat veterans, the current system that awaits women transitioning from military service is a disjointed patchwork of programs marked by serious gaps in health care, housing, other community support services, employment and efforts to eradicate sexual assault, according to a landmark report released today by DAV (Disabled American Veterans).
Women Veterans: The Long Journey Home presents the most comprehensive assessment conducted to date of the policies and programs at the Departments of Veterans Affairs (VA), Defense (DoD), Labor (DoL), and Housing and Urban Development (HUD) for women veterans returning home. The report reveals that the number of women who volunteer to defend our nation is increasing dramatically, while they are being put at risk by a services and support system designed for and dominated by men.
Women Veterans: The Long Journey Home paints a compelling picture of federal agencies and community service providers that consistently fail to understand that women are impacted by military service and deployment differently than men. The report identifies 27 key policy and programmatic changes needed to overhaul the culture and services provided by the federal government and their local communities.
“At a time when the number of women veterans is growing to unprecedented levels, our country is simply not doing enough to meet their health, social and economic needs,” said Joy J. Ilem, DAV’s deputy national legislative director. “Women veterans deserve equal respect, consideration and care as the men who served, yet the support systems are ill-equipped to meet the unique needs of the brave women who have defended our country.”
Since the Civil War, women have served with distinction in the armed forces. However, in 1973, a two percent legislative cap on women’s participation in the military was lifted and women began entering military service at unprecedented rates. Today, women make up 20 percent of new recruits, 14.5 percent of the 1.4 million service members on active duty and 18 percent of 850,000 reservists. Approximately 280,000 women served in the post 9/11 Global War on Terrorism: Operations Enduring Freedom (OEF), Iraqi Freedom (OIF) and New Dawn (OND). Most of these women were directly exposed to combat and the daily threat of wartime violence.
Since the U.S. military is in the midst of a significant downsizing, many more women can be expected to transition out of service and back to lives as mothers, spouses, daughters, employees and neighbors. These women will depend on services provided by the federal government and local communities to help with the journey back to civilian life, a journey, the report reveals, that is often difficult, prolonged and presents different challenges than for men.
Women service members and veterans are less likely to be married than men, but more likely to be divorced, single parents, in a dual military relationship or part of non-traditional families. Studies also show that women are much more likely to identify interpersonal issues as a significant source of stress during reintegration and, at the same time, report less social support. Because of societal norms, women are consistently challenged to balance family, work and community roles in a way not experienced by men. The perceived demand to address all competing priorities simultaneously creates an enormous challenge for military women and transitioning women veterans. Most handle it without significant impacts, but many struggle in their journey home.
Highlights from the report’s findings include—
- Unemployment: Post-9/11 women veterans have higher rates of unemployment than male veterans and non-veteran women. Their challenges in the labor market are exacerbated by higher rates of medical and mental health concerns than their male counterparts, and they are less likely than the general female population to have earned a bachelor’s degree. Despite these challenges, the effectiveness of the primary program designed to help veterans transition to the civilian labor force, the Transition Assistance Program (TAP), cannot be determined—DoD and VA do not collect data on participation, satisfaction, and outcomes by gender and race.
- Homelessness: Women veterans are at least twice as likely to be homeless than non-veteran women. This is compounded by the fact that women veterans are more likely to be single parents with one or more dependent children. VA’s efforts to eliminate homelessness among veterans have been impressive, but safe housing for women veterans has lagged.
- Military Sexual Assault: Rape, sexual assault and harassment are crimes. In fiscal year 2013, DoD reports of sexual assault increased by 50 percent. The Defense Department needs to eliminate sexual assault by ensuring that its efforts on military culture change and assault prevention are successful.
One in five women enrolled in VA health care screen positive for military sexual trauma (MST). Many of these survivors of sexual assault will suffer a lifetime of serious illness including PTSD, depression and a broad array of co-morbid medical conditions. Yet nearly one-third (31 percent) of VA medical centers and community-based outpatient clinics were unable, as recently as 2013, to provide adequate staffing for MST and struggled to provide any MST services.
- Disabled Veterans: The burden of illness and injury in Post-9/11 veterans is high. Nearly half of this group has applied for VA disability compensation. VA needs to do more to assure that women are receiving fair and equal adjudication of their disability claims. Women, who have lost one or more limbs, while a small number, may not receive peer support, rehabilitation or prosthetic limbs that are tailored to their needs. Overall, women are less likely to have a prosthetic that fits properly and they face unique issues when pregnant, including increased wear on the prosthetic and need for recurrent modifications.
- Health Care: VA and DoD are the largest direct providers of federal health care through their integrated systems; however, they still are not fully prepared to provide equitable access to the gender-specific care and services that women need. Women remain a small minority of VA patients, making up only 6.8 percent of those who come for care each year. One-third of VA medical centers do not employ a staff gynecologist, even as VA is facing increasing demand for gender-specific preventative screening, breast care, prenatal and obstetrical care, neonatal care and infertility services. Many facilities don’t provide the leadership needed in women’s health and routinely refer women to community providers who may be uninformed about the unique health issues facing women veterans, or to other VA facilities a long distance away.
- Research shows that women who served in Afghanistan and Iraq have higher rates of PTSD symptoms than men. And PTSD can be different for women—they are more likely to manifest depression as a co-occurring condition. Despite these new demands, VA and DoD have difficulty providing gender-specific peer support, group therapy, residential rehabilitation and specialized inpatient mental health care that is designed to meet the needs and preferences of women.
VA’s health care system is unique in that it offers a full continuum of health care services, including health promotion and disease prevention, primary and specialty ambulatory medical, surgical, mental health, substance-use disorder and rehabilitation treatment services, hospital care, home care and nursing home, and respite and palliative care programs. In addition to health care programs, VA provides adjunct services that help veterans with disability compensation, supported employment, caregiver support, and housing and homeless assistance. This integrated approach to health and support services is fundamentally different than private-sector offerings and, if properly managed, could deliver substantial benefits to women in terms of better access, continuity, coordination, effectiveness, safety and satisfaction. If the identified gaps are filled, VA could truly deliver the “Best Care Anywhere” to women veterans.
DAV recommends that Congress pass legislation to provide every individual who serves in a combat theater of operations with eligibility for lifetime VA health care. The organization also asks that Congress authorize and appropriate the resources needed to fill the current gaps in federal programs.
“DAV commissioned this report to shed light on the unique challenges facing women as they transition out of military service,” explained DAV Washington Headquarters Executive Director Garry J. Augustine. “While the study shows there are still large gaps to fill, it also establishes a clear path forward for elected leaders, policymakers, and public and private entities to ensure women veterans receive the benefits and services they earned and deserve.”
The 27 key policy and programmatic recommendations put forth by DAV range from requiring that every VA medical center hire a gynecologist, to creating gender-sensitive mental health programs, to developing education and career guidance programs just for women veterans, to establishing a pilot program of structured women transition support groups.
Visit www.DAV.org/womenveterans to read the entire report and recommendations.
DAV empowers veterans to lead high-quality lives with respect and dignity. It is dedicated to a single purpose: fulfilling our promises to the men and women who served. DAV does this by ensuring that veterans and their families can access the full range of benefits available to them; fighting for the interests of America’s injured heroes on Capitol Hill; and educating the public about the great sacrifices and needs of veterans transitioning back to civilian life. DAV, a non-profit organization with 1.2 million members, was founded in 1920 and chartered by the U.S. Congress in 1932.