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Military and mental health predictors of unemployment in a national sample of women Veterans

Hamilton A, Washington DL. Military and mental health predictors of unemployment in a national sample of women Veterans. Paper presented at: VA HSR&D Enhancing Partnerships for Research and Care of Women Veterans Conference; 2014 Jul 31; Arlington, VA.


Objective: Recent reports indicate that the unemployment rate is higher among women Veterans (WVs) than among civilian women and male Veterans. Our prior works suggests that unemployment is a primary pathway to homelessness among WVs. Using data from the National Survey of Women Veterans, the objective of this study was to determine whether characteristics unique to women's experiences as Veterans predicted unemployment. Methods: In 2008-09, we conducted a telephone survey among a national, population-based sample of WVs (n = 3,611; 86% response rate). Survey items included demographics, mental health conditions, healthcare utilization, and military experiences and effects. Unemployment was defined as being in the labor force (i.e., able to work) but being "unemployed and looking for work." We conducted chi square analyses to identify characteristics of unemployed WVs, then conducted logistic regression with characteristics significant in bivariate analyses as covariates, to identify independent factors associated with unemployment. Results: Overall, 10.3% of WVs in the labor force were unemployed. Controlling for demographics, perceptions of military experiences, having a regular source of healthcare, and intensity of VA use, independent predictors of unemployment were service during wartime (OR = 2.0; 95% CI 1.02-3.8), service in the regular military (vs. in National Guards/Reserves only) (OR 3.5; 95% CI 1.3-9.8), and screening positive for PTSD (OR = 2.3; 95% CI 1.1-4.7). Being unmarried (OR = 3.7; 95% CI 1.8-7.7) and not being a college graduate (OR = 2.3; 95% CI 1.2-4.6) were also risk factors. Though recent depression, using the VA 4-plus times in the past year, and certain military perceptions were associated with unemployment in bivariate analyses (all p < 0.01), they were not independently associated. Combat exposure and military sexual trauma were not significantly associated. Conclusions: Unemployment was prevalent in this national sample of WVs, and was predicted by regular military service during wartime, mental health (PTSD), marital status, and education. Impacts: Given the prevalence of unemployment and the role of PTSD in WV's unemployment, WVs may benefit from gender-specific, trauma-sensitive employment services. The finding that unemployed WVs are using the VA frequently suggests that screening for unemployment in the VA may be an important step toward identifying vulnerability to homelessness and other potential sequelae of unemployment.

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