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2023 HSR&D/QUERI National Conference Abstract

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1076 — Employment trajectories of Post-9/11 Veterans in the three years following military discharge: The impacts of gender, race/ethnicity, and health

Lead/Presenter: Mary Jo Pugh,  COIN - Salt Lake City
All Authors: Pugh M (IDEAS COIN VA Salt Lake City), Bouldin E (IDEAS COIN, VA Salt Lake City) Hansen JL (IDEAS COIN, VA Salt Lake City) Kroll-Desrosiers AR (VA Central Western Massachusetts Health Care System) Vogt DS (National Center for PTSD; VA Boston Healthcare System)

Objectives:
Employment after military transition is a functional outcome of high importance reflected by the 2021 National Defense Authorization Act (NDAA) requirement for the Center for Women Veterans to identify health factors associated with unemployment in Post-9/11 Veteran women. Research suggests that the time immediately after military separation is a period of vulnerability for unemployment but has not examined trajectories of employment immediately following military transition or characteristics associated with employment/unemployment. We used longitudinal data from The Veterans Metrics Initiative (TVMI) to examine employment/unemployment in the first three years after military discharge among Post-9/11 era Veterans.

Methods:
In the fall of 2016, TVMI recruited a cohort of 9,566 newly separated U.S. Veterans, including those who had separated from active-duty service or from activated status with the Reserve component within the last 90 days. Veterans received a web-based survey every six months over the three years following separation. Outcome measures were based on self-reported employment status at each time point. Consistent with Department of Labor definitions, those who were working for pay or looking for work were considered in the labor force and are the denominator for unemployment estimates. We examined trajectories of employment probabilities for men and women, and characteristics (race/ethnicity, self-reported mental and physical health conditions) associated with employment/unemployment among those in the labor force adjusting for demographics, education, service-connected disability, and deployment history. All findings reflect significant differences (p < .05).

Results:
Employment was lowest six months after military separation (baseline; 56.5% and 67.8% for women/men respectively), increased in the first year, and plateaued thereafter (83.4% and 89.4% for women/men at year 3). Employment probabilities were lowest for Hispanic women, (38.6% baseline to 70.4% after 3 years) followed by Non-Hispanic Black and non-Hispanic other/mixed race (probabilities 10% higher than Hispanic women at each time point) and non-Hispanic White women (67.6% baseline to 88.8% after 3 years). Women with mental and physical health comorbidities were less likely to be employed at all time points, with observed difference of 30% (baseline) and 13% (year 3) for those with mental health conditions and 8.6% (baseline) and 4.1% (year 3) for those with physical health conditions. Results were similar for unadjusted models.

Implications:
In this national sample of recently separated Post-9/11 era Veterans employment was consistently lower for women than men with significantly higher unemployment for women of under-represented populations compared to non-Hispanic White women. Women with Hispanic ethnicity had significantly higher unemployment than all other groups. Rates of unemployment were also markedly higher for women with mental health conditions/symptoms, and for those with physical health conditions.

Impacts:
Employment is a key social determinant of health, and these findings suggest that some subgroups of the population may need better/different support to enhance their employment prospects when they leave service. Additional efforts to better understand barriers to employment for minoritized women and those with mental/physical health conditions is needed to identify and implement approaches that mitigate barriers to employment.