Military-civilian residential segregation and military member psychological distress in Kentucky counties
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Military-civilian residential segregation and military member psychological distress in Kentucky counties Justin T. McDaniel . David L. Albright . Robert Rados . Robert McDermott . Heather Goelz . Katharine Juul
Ó Springer Nature B.V. 2019
Abstract The objective of this study was to estimate and map the distribution of veteran psychological distress (PD) in Kentucky counties and examine the relationship between veteran PD prevalence rates and military-civilian residential segregation (MCRS) in Kentucky counties. We used data from the 2016 National Survey of Drug Use and Health to conduct small area estimation of the prevalence of PD among military veterans in Kentucky’s 120 counties. MCRS was calculated in each county using Wong’s (J Urban Geography 20(7):635–647, 1999) deviational ellipse. J. T. McDaniel (&) Department of Public Health and Recreation Professions, College of Education and Human Services, 475 Clocktower Drive, Mailcode 4632, Southern Illinois University, Carbondale, IL, USA e-mail: [email protected] D. L. Albright School of Social Work, The University of Alabama, Tuscaloosa, AL, USA R. Rados School of Allied Health, College of Applied Sciences and Arts, Southern Illinois University, Carbondale, IL, USA R. McDermott H. Goelz Department of Public Health and Recreation Professions, Southern Illinois University, Carbondale, IL, USA K. Juul Center for Rural Health and Social Service Development, School of Medicine, Southern Illinois University, Carbondale, IL, USA
We examined the relationship between veteran PD prevalence and MCRS in Kentucky counties using multiple linear regression. Results showed that the average indirect synthetic estimate of PD in Kentucky was 5.027%, however, we observed substantial geographic variation in these rates. After controlling for county-level covariates, counties with greater MCRS had an increase in veteran PD prevalence, b = 0.547 (95% CI 0.051, 0.983). Rural health care and public health practitioners may need to become more cognizant of patients’ veteran status and sensitized to risk factors that alert them to responsive treatment options and referrals to applicable evidence-based interventions. Keywords Veterans Mental health Segregation Psychological distress Nonveterans
Introduction An estimated 13.8% of military veterans—compared to 12.0% of nonveterans—have serious psychological distress, according to analyses of the Substance Abuse and Mental Health Services Administration’s 2004–2010 National Survey on Drug Use and Health (Golub et al. 2013). Golub et al. (2013) reported that this comparison was statistically significant at an alpha level of 0.05. One report indicates that the United States (U.S.) Department of Veterans Affairs (VA)
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spent approximately $8 billion for mental health care in 2017 (VA 2018a). Unique approaches, both within the VA and among public health practitioners, are needed to minimize the burden of psychological distress and the associated costs of treatment. The VA h
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