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2011 National Hispanic Medical Association Conference

2011 National Hispanic Medical Association Conference Becoming Familiar with Hispanic Veterans Healthcare: Hispanic Veterans and the VA Gabriel Pérez , CEO, Phoenix VA Health Care System

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2011 National Hispanic Medical Association Conference

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  1. 2011 National Hispanic Medical Association Conference Becoming Familiar with Hispanic Veterans Healthcare: Hispanic Veterans and the VA Gabriel Pérez, CEO, Phoenix VA Health Care System and President, Board of Directors, National Forum for Latino Healthcare Executives

  2. La Familia • Hispanic Veterans increasing • Stress on military families • Clinician awareness • Special considerations

  3. Phoenix Experience • Governor’s Commission 2010 • Shift in emphasis to family members • National Task Force Recommendations

  4. Hispanic Veterans • Exhibit higher risk of PTSD • Might other postwar adjustment problems and life stressors be more prevalent among Hispanics? • Did factors in the War Zone contribute to Hispanic Veterans’ higher rates of PTSD? • Puerto Rican Vietnam Veterans

  5. PTSD • Elevated prevalence rates • Other possible explanations • War Zone stressors • Differences in prewar vulnerability factors • Ethno-cultural factors (experiencing distress) • Powerful stressful events • Experiences with racial/ethnic prejudices and distress • La familia relationships

  6. Severity of Combat Related PTSD vs Non-Combat Related PTSD • Combat exposure • Psychiatric disorders • Social impairment • Rates of PTSD Comparison

  7. Demographics and Diagnosis of OEF/OIF Veterans Demographics: • OEF/OIF Patients • 12,480 triaged In Germany • 10.1% to Psychiatry • More likely to be: • Female under 31 years • Black or Hispanic • Enlisted or National Guard/Reserves • 80% evacuated during first 6 months • 17% evacuated during second 6 months

  8. Demographics and Diagnosis of OEF/OIF Veterans Diagnosis: • Adjustment Disorders 37.6% • Mood Disorders 22.1% • Personality Disorders 15.7% • Anxiety Disorders 15.4% • No Psychiatric Diagnosis 9.2% • Only 5% returned to OEF/OIF duty

  9. Veteran Suicides • Military Service – Traumatic Experience • Devastation • Killing • Torture • Life-threatening situations • Unexpected • US Army suicide rates doubled since 1943.

  10. Suicide Rates Keep Rising • Increased risk • Lack of social support • Traumatizing life events • Deprived sense of control • PTSD (Iraq – US Marines experience highest DX) • General anxiety disorders • Depression • Failed relationships • Hispanics higher risk • Marginalization conditions • Lack of bilingual language management • Discrimination

  11. Partial Solution for Prevention • Screening at earliest interface • Culturally sensitive • Planned interaction

  12. How to Serve Veterans • Understand • Past military service • Utilization of available services • Examples • 1954 Segregation • Utilization of VA Services • Black Veterans – 3.7 times more likely to use VA • Hispanic Veterans – 5.3 times more likely • Korean Veterans – More than WWII • OEF/OIF – Phoenix: 44% market penetration

  13. Department of Veterans Affairs • Mission • Provide Primary care, Secondary Care, and Related Medical and Social Support Services to eligible Veterans. • Mitigation of disparities • Minority Veterans go to VA for treatment • Why??

  14. The VA – “The Best Health Care System in the World” One Part: Mental Health • Prevention • PTSD and Suicide screening • Coordinated care • Housing • Mental Health expansion • MICHM • Homelessness Hotline: 1-877-4AID-VET (877-424-3838) • Tele-health • Veterans Court • National Suicide Hotline: 1-800-273-TALK (8255) • Your help is needed. How??

  15. Conclusion • Future Veterans • Disparity attention • Access • Target Groups • Constant Needs Assessment

  16. A Few References J. Clin Psychiatry, 2010 Jul; 71(7): e16. J. Clin Psychiatry, 2010 Apr; 71(4): e08. J. Trauma Stress, 2002 Apr; 21(2): 133-41. J. Nerv Ment Dis, 2007 Aug; 195(8): 655-61 Cultur Divers Ethnic Minor Psychol, 2000 Aug; 6(3): 235-51 Am J of Psychiatry, 2000 Apr; 157(4): 615-9 Gen Hosp Psychiatry, 2006 Jul-Aug; 28(4): 352-6 Bol Assoc Med PR, 2009 Jul-Sep; 101(3): 33-41 Mil Med, 2002 Jul; 167(7): 525-31 Mil Med, 2002 Mar; 167(3): 235-41 Med.Care, 2002 Jan; 40(1 Suppl): 117-28

  17. Hispanic Veterans Health Care and the VA Thank you! Gabriel Pérez, CEO, Phoenix VA Health Care System and President, Board of Directors, National Forum for Latino Healthcare Executives

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