Study highlights growth of women veterans’ health literature

Study highlights growth of women veterans’ health literature | Image Credit: © bongkarn - © bongkarn - stock.adobe.com.

The volume of literature about the health of women veterans has significantly expanded, but several gaps remain, according to a recent study published in JAMA Network Open.¹

There are over 2 million US women veterans, making up 10% of the current veteran population and expected to rise to 18% by 2040. This has led to a significant increase in Veteran Affairs (VA) health care use, from approximately 160,000 women veterans in 2010 to over 800,000 in 2020.²

“Thus, women’s health clinicians in VA and non-VA settings must understand the health needs of this unique population to provide patient-centered care,” wrote investigators.¹

Updated systematic review of literature since 2015

While women veteran-focused literature was described in a 2017 evidence map, significant advancements in women veteran’s health research has occurred since this time. Therefore, investigators conducted a systematic review to create an updated map of women veterans’ health literature published since 2015.

Peer-reviewed articles reporting health outcomes among women veterans in the United States, as well as articles discussing the experience of providing care to this population, were included in the analysis. Articles with patient level outcomes were required to only list women veteran’s outcomes or list these outcomes separately for inclusion.

Articles published between January 1, 2016, and October 17, 2023, were obtained through searches of the MEDLINE, Embase, and CINAHL databases. Title and abstract screening were performed by 2 independent reviewers, with full-text screening performed in articles accepted by either of the reviewers.

Data extraction and categorization

Data extraction was performed by a single reviewer, with a primary focus area assigned to each article based on categories from a previous map. New focus areas, such as toxic exposures, were also added, allowing each article to have 1 primary focus area and up to 2 secondary focus areas.

Key study characteristics included study population, study design, focus areas, and funding source. Articles were grouped based on focus area.

Overview of analyzed studies

There were 932 articles published between 2016 and 2023 included in the analysis, 38% of which were in the mental health category, 36% medical conditions, 9% structures of care, 15% trauma, violence, and stressful experiences, and 4% other focus areas. These 5 categories comprise 16 key focus areas.

General mental health was the largest primary focus area, followed by chronic medical conditions and interpersonal violence. Reproductive mental health, chronic pain or opioid use, and suicide or nonsuicidal self-injury had the greatest proportional increases since the prior map, at 5.3-fold, 4.3-fold, and 4.2-fold, respectively.

Common secondary focus areas included access to care and use, general mental health, and health care organization or delivery of care. Forty-four percent of articles only included women veterans, the most common patient populations being veterans with service in the Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn conflicts.

Mental Health as the dominant focus

Mental health was addressed in 51% of articles, with primary focus areas including general mental health, reproductive mental health, substance use, and suicide or nonsuicidal self-injury. The primary focus area with the most content was general mental health in 43% of articles.

General mental health covered posttraumatic stress disorder in 95 articles, multiple mental health symptoms in 28, disordered eating in 18, sleep-related conditions in 17, mental health care in 17, depression in 8, well-being in 5, moral injury in 5, and additional mental health topics in 2. Substance use was highlighted in 71 articles.

Medical conditions and trauma as significant concerns

Medical conditions were addressed by 36% of articles, with primary focus areas including chronic mental conditions, reproductive health, preventative health, chronic pain or opioids, long-term care or aging, and cancer. Chronic medical conditions were the most common focus area, including cardiovascular, endocrine, and nervous system conditions.

Trauma, violence, and stressful experiences were addressed in 15% of articles. Key primary focus areas included interpersonal violence, other violence, and harassment, with interpersonal violence being the most common at 89%.

Other key areas and conclusion

Nine percent of articles addressed structures of care for women veterans, with primary focus areas of health care organization or delivery of care, and access or use of care. Finally, social determinants of health were reported as other focus areas. Overall, a more than 2-fold increase in women veterans' health research has been observed.

“A robust evidence base is critical to promote the overall health of women veterans and improve their quality of life and well-being,” wrote investigators.

References:

1. Goldstein KM, Pace R, Dancu C, et al. An evidence map of the women veterans’ health literature, 2016 to 2023: A systematic review. JAMA Netw Open. 2025;8(4):e256372. doi:10.1001/jamanetworkopen.2025.6372
2. Breland JYFS, Saechao F, Gujral K, et al.Sourcebook Volume 5: Women veterans in the Veterans Health Administration: Longitudinal trends in sociodemographics and utilization, including type, modality, and source of care. Department of Veterans Affairs. 2024.