Prevalence of Alcohol Misuse among Women Veterans High Regardless of Care Setting
Although most research on alcohol misuse (drinking above recommended limits) in U.S. Veterans has focused on men, a number of recent studies highlighted it as a health issue for women Veterans. However, the majority of women Veterans still seek healthcare outside VA, where routine alcohol screening may not be the norm. To better deliver care to women Veterans with alcohol misuse, providers and planners need information on the prevalence of alcohol misuse, the mental health correlates of alcohol misuse among women Veterans, and possible gaps in mental healthcare. Thus, this study sought to estimate the prevalence and correlates of alcohol misuse in women Veterans – and to assess the associations between alcohol misuse and mental health use in a group comprising both VA healthcare system users and non-users. Using data from the National Survey of Women Veterans (NSWV was conducted between 2008 and 2009), investigators identified 3,585 women Veterans with total scores for the Alcohol Use Disorders Identification Test Consumption (AUDIT-C). The AUDIT-C assesses the quantity and frequency of average alcohol consumption, as well as the frequency of binge drinking (the AUDIT-C used in this study included a gender-specific binge drinking question). Also using NSWV self-reported data, investigators examined demographics, era of military service, combat exposure, overall health status, mental health conditions (i.e., PTSD) and possible military stressors (i.e., sexual assault in the military, or SAIM).
- Women Veterans who did not use VA healthcare had a higher prevalence of alcohol misuse (32%) compared to women Veterans who did use VA healthcare (27%). The prevalence of binge drinking was similar for VA non-users (26%) and VA users (24%).
- The prevalence of past-year mental healthcare among women Veterans with alcohol misuse was higher for VA users than for VA non-users: 26% versus 5% for mild alcohol misuse, and 43% versus 17% for moderate-to-severe alcohol misuse.
- Among VA non-users, 46% of women Veterans with PTSD and 66% of those with SAIM screened positive for alcohol misuse. Among VA healthcare users, the prevalence of alcohol misuse was notably high among younger women (ages 18-44, 43%), those who served in OEF/OIF (51%), and those with combat exposure (41%).
- This study lacked data on the clinical presentation of VA users and non-users with alcohol misuse.
- Investigators lacked a measure of specialty substance abuse treatment related to alcohol misuse, and it is not clear whether mental healthcare received by women with alcohol misuse includes treatment for alcohol misuse per se.
This study was partly funded by HSR&D (SDR 08-270). Drs. Hoggatt and Williams were supported by HSR&D Career Development Awards, and Dr. Yano was supported by an HSR&D Senior Research Career Scientist Award. Drs. Hoggatt, Yano, and Washington are part of HSR&D's Center for the Study of Healthcare Innovation, Implementation and Policy in Los Angeles, CA. Dr. Williams is part of HSR&D's Center for Innovation for Veteran-Centered and Value-Driven Care in Seattle, WA.
Hoggatt K, Williams E, Der-Martirosian C, Yano E, and Washington DL. National Prevalence and Correlates of Alcohol Misuse in Women Veterans. Journal of Substance Abuse Treatment. May 2015;52:10-16.