Table 2.
Differences in Psychiatric, Medical, and Functioning by Primary Use of VA Healthcare Service Status
| Bivariate Test of Difference | Multivariable Tests | |||||||
|---|---|---|---|---|---|---|---|---|
| Measure | Total (N = 3,152) |
Non-VA user (n = 2,547)a |
VA-user (n = 608)a |
t/p^ or χ2 | P | Wald x2 or F | P | Adjusted OR (95% CI) or Cohen db |
| Psychiatric measures, n (%) | ||||||||
| Lifetime | ||||||||
| Mental health treatment | 676 (21.4) | 444 (17.5) | 242 (40.2) | 147.05 | < 0.01 | 77.41 | < 0.01 | 2.56 (2.09–3.20) |
| Psychopathology | 716 (22.7) | 497 (19.7) | 230 (38.3) | 93.21 | < 0.01 | 35.36 | < 0.01 | 1.93 (1.56–2.40) |
| Psychopathology + SUD | 454 (14.4) | 319 (12.7) | 150 (24.9) | 57.13 | < 0.01 | 17.97 | < 0.01 | 1.69 (1.32–2.15) |
| Posttraumatic stress disorder | 306 (9.7) | 217 (8.6) | 131 (21.8) | 84.76 | < 0.01 | 18.92 | < 0.01 | 1.81 (1.39–2.37) |
| Depression | 517 (16.4) | 352 (13.8) | 183 (30.1) | 92.37 | < 0.01 | 40.29 | < 0.01 | 2.12 (1.68–2.67) |
| Social phobia | 271 (8.6) | 196 (7.7) | 105 (17.3) | 52.14 | < 0.01 | 16.44 | < 0.01 | 1.80 (1.35–2.38) |
| Alcohol use disorder | 1282 (40.7) | 1064 (41.8) | 266 (43.8) | 0.79 | .385 | 0.00 | 0.97 | 1.00 (0.82–1.21) |
| Drug use disorder | 386 (12.2) | 297 (11.7) | 126 (20.7) | 34.73 | < 0.01 | 19.20 | < 0.01 | 1.78 (1.37–2.30) |
| Substance use disorder | 1342 (42.6) | 1108 (43.5) | 284 (46.8) | 2.15 | 0.15 | 0.18 | 0.67 | 1.04 (0.86–1.26) |
| Suicide attempt | 165 (5.2) | 129 (5.1) | 88 (14.5) | 67.41 | < 0.01 | 20.26 | < 0.01 | 2.08 (1.51–2.85) |
| Current | ||||||||
| Depression | 212 (6.7) | 153 (6.1) | 93 (15.3) | 57.59 | < 0.01 | 10.91 | < 0.01 | 1.66 (1.23–2.24) |
| Anxiety | 202 (6.4) | 157 (6.2) | 92 (15.2) | 53.10 | < 0.01 | 11.77 | < 0.01 | 1.69 (1.25–2.27) |
| Suicidal ideation | 222 (7.0) | 178 (7.1) | 107 (17.7) | 65.98 | < 0.01 | 19.02 | < 0.01 | 1.87 (1.41–2.48) |
| Alcohol use disorder | 264 (8.4) | 219 (12.3) | 75 (19.3) | 13.36 | < 0.01 | 3.08 | 0.08 | 1.33 (0.97–1.83) |
| Traumatic event | 2730 (86.6) | 2184 (86.1) | 552 (91.5) | 12.94 | < 0.01 | 9.06 | < 0.01 | 1.64 (1.19–2.27) |
| Total traumas, mean (SD) | 3.30 (2.7) | 3.07 (2.5) | 4.70 (3.4) | 0.20^ | < 0.01 | 40.70 | < 0.01 | 0.15 |
| Medical conditions, n % | ||||||||
| Any medical diagnosis | 2746 (87.1) | 2161 (84.8) | 548 (90.3) | 11.95 | < 0.01 | 15.31 | < 0.01 | 1.90 (1.38–2.63) |
| Arthritis | 983 (31.2) | 723 (28.4) | 209 (34.4) | 8.42 | < 0.01 | 11.73 | < 0.01 | 1.44 (1.17–1.78) |
| Lung conditions | 341 (10.8) | 259 (10.2) | 89 (14.6) | 9.99 | < 0.01 | 4.69 | < 0.05 | 1.36 (1.03–1.79) |
| Cancer | 492 (15.6) | 408 (16.0) | 70 (11.5) | 7.75 | < 0.01 | 0.01 | 0.91 | 0.98 (0.73–1.33) |
| Chronic pain | 595 (18.9) | 438 (17.2) | 188 (31.0) | 58.47 | < 0.01 | 34.94 | < 0.01 | 1.91 (1.54–2.37) |
| Liver disease | 54 (1.7) | 35 (1.4) | 24 (3.9) | 17.71 | < 0.01 | 7.98 | < 0.01 | 2.28 (1.29–4.05) |
| Diabetes | 597 (18.9) | 427 (16.8) | 120 (19.7) | 3.03 | 0.08 | 3.58 | 0.06 | 1.27 (0.99–1.61) |
| Heart disease | 443 (14.1) | 347 (13.6) | 95 (15.6) | 1.63 | 0.22 | 5.63 | < 0.05 | 1.40 (1.06–1.85) |
| Heart attack | 254 (8.1) | 209 (8.2) | 56 (9.2) | 0.64 | 0.42 | 2.57 | 0.11 | 1.32 (0.94–1.86) |
| High cholesterol | 1563 (49.6) | 1166 (45.8) | 292 (48.0) | 0.10 | 0.32 | 9.45 | < 0.01 | 1.36 (1.12–1.66) |
| High blood pressure | 1600 (50.8) | 1195 (46.9) | 330 (54.3) | 10.64 | < 0.01 | 17.62 | < 0.01 | 1.55 (1.26–1.90) |
| Kidney disease | 84 (2.7) | 71 (2.8) | 15 (2.5) | 0.19 | 0.78 | 0.19 | 0.66 | 0.87 (0.47–1.61) |
| Sleep disorders | 600 (19.0) | 434 (17.0) | 183 (30.1) | 53.21 | < 0.01 | 23.40 | < 0.01 | 1.70 (1.37–2.11) |
| Migraine | 198 (6.3) | 137 (5.4) | 58 (9.5) | 14.65 | < 0.01 | 4.90 | < 0.05 | 1.49 (1.05–2.11) |
| Multiple sclerosis | 5 (0.2) | 3 (0.1) | 2 (0.3) | 1.38 | 0.25 | 0.55 | 0.46 | 2.34 (0.25–21.83) |
| Osteoporosis | 100 (3.2) | 59 (2.3) | 25 (4.1) | 6.11 | < 0.05 | 5.92 | < 0.05 | 1.93 (1.14–3.29) |
| Rheumatoid arthritis | 110 (3.5) | 78 (3.1) | 40 (6.6) | 13.84 | < 0.01 | 9.12 | < 0.01 | 1.92 (1.26–2.93) |
| Stroke | 67 (2.1) | 51 (2.0) | 8 (1.3) | 1.26 | 0.32 | 1.21 | 0.27 | 0.64 (0.29–1.42) |
| Traumatic brain injury | 16 (0.5) | 14 (0.5) | 4 (0.7) | 0.10 | 0.76 | 1.50 | 0.22 | 2.08 (0.39–10.98) |
| HIV/AIDS | 11 (0.3) | 4 (0.2) | 3 (0.5) | 2.51 | 0.14 | 42.81 | 0.39 | 2.24 (1.76–2.85) |
| Sum medical conditions, mean (SD) | 2.7 (2.0) | 2.5 (1.9) | 3.1 (2.2) | 4.96 | < 0.01 | 61.21 | < 0.01 | 0.14 |
| Functioning | ||||||||
| Any disability | 385 (12.2) | 255 (10.0) | 153 (25.2) | 100.00 | < 0.01 | 42.81 | < 0.01 | 2.24 (1.76–2.85) |
| Cognitive functioning, mean (SD) | 90.1 (14.1) | 91.1 (12.9) | 81.2 (22.1) | −0.21^ | < 0.01 | 35.58 | < 0.01 | −0.18 |
| SF-8 mental summary, mean (SD) | 63.7 (8.0) | 64.1 (7.6) | 59.0 (12.1) | −0.19^ | < 0.01 | 46.22 | < 0.01 | −0.16 |
| Vitality | 50.8 (7.4) | 50.9 (7.2) | 47.9 (8.8) | 7.58 | < 0.01 | 17.96 | < 0.01 | −0.11 |
| Social functioning | 50.7 (7.5) | 51.5 (7.0) | 46.3 (10.2) | −0.23^ | < 0.01 | 30.12 | < 0.01 | −0.19 |
| Mental health | 52.4 (7.2) | 52.9 (6.9) | 48.3 (10.5) | −0.22^ | < 0.01 | 41.57 | < 0.01 | −0.16 |
| Role-emotional | 49.8 (5.8) | 50.1 (5.5) | 46.9 (8.6) | −0.20^ | < 0.01 | 26.28 | < 0.01 | −0.14 |
| SF-8 physical summary, mean (SD) | 57.0 (9.7) | 57.5 (9.2) | 53.1 (11.4) | −0.15^ | < 0.01 | 27.36 | < 0.01 | −0.16 |
| General health | 49.0 (7.7) | 49.2 (7.4) | 45.1 (8.7) | 10.60 | < 0.01 | 28.04 | < 0.01 | −0.16 |
| Physical functioning | 47.5 (8.3) | 48.0 (8.1) | 44.5 (10.0) | −0.14^ | < 0.01 | 20.77 | < 0.01 | −0.14 |
| Role-physical | 48.2 (8.6) | 48.6 (7.8) | 44.4 (10.2) | −0.18^ | < 0.01 | 27.90 | < 0.01 | −0.16 |
| Bodily Pain | 48.8 (8.4) | 49.4 (8.2) | 45.5 (9.8) | 8.94 | < 0.01 | 16.49 | < 0.01 | −0.16 |
a
values are weighted
b
ORs (95% CIs) and Cohen d estimates are adjusted for age, gender, race/ethnicity, income, education, marital status, branch of service, combat status, and years in the military.
Lifetime psychopathology = major depression disorder, social phobia, posttraumatic stress disorder, or suicide attempt.
Lifetime substance use disorder = was categorized as lifetime alcohol use disorder or drug use disorder.
^
Spearman rho correlation (p) is provided because of non-normal [skewed, kurtotic] distribution.
Abbreviations: VA = Department of Veterans Affairs; HIV = human immunodeficiency virus; AIDS = acquired immunodeficiency syndrome; SF-8 = Short form-8 Health Survey.