veteran health

Veterans Fared Better Than General Population During COVID

Although military veterans are at an increased risk of pandemic-related health complications and death, vets who used VA services had a higher survival rate than the general population during COVID.

More U.S. veterans died in 2020 than in prior years, but the increase was less than the increase in the general population, according to a new study of Veterans Health Administration (VA) data by researchers at the School of Public Health and Vanderbilt University Medical Center (VUMC).

Published in The Lancet Regional Health – Americas, the study found that deaths among US veterans using the VA increased 16 percent in 2020, while the increase among the general population increased 23 percent. This finding suggests that despite a higher number of comorbidities among veterans known to increase risk of negative outcomes due to COVID-19—such as age, hypertension, diabetes and obesity—the VA system performed better at preventing deaths related to the pandemic.

“This suggests the Veterans Health Administration performed better than expected,” said Kevin Griffith (SPH’20), assistant professor in the Department of Health Policy at VUMC and an SPH alum.

“Despite VHA-enrolled veterans having a higher prevalence of risk factors for severe COVID-19 illness, their rate of excess deaths was markedly lower than what was observed in the general population,” he says.

The study looked at the demographics and health of 11.4 million veterans at the county level between 2016 and 2019 and then developed several analytical models to predict rates of mortality from March to December 2020, when the COVID-19 pandemic swept over the country and globe, inundating hospitals and critical care units with patients.

“We know that when hospitals and ICUs are full both sicker and healthier patients die at higher rates for many diseases, not just COVID,” Griffith said, noting that veterans tend to have more comorbidities that make them high risk for severe COVID-19 illness.

Geographically, Griffith and researchers at BU found that veterans living in states across the Great Plains faced higher risk of mortality in 2020, where cases of COVID-19 were also higher per 1,000 population. In total, the study estimates that 426,069 veterans died in 2020, which was 51,436 more than what the models predicted absent a global pandemic.

Study co-author Yevgeniy Feyman, a doctoral student at SPH, noted that while there’s no precise explanation for why the VA had a smaller increase in deaths compared to the general population, the VA deployed useful tools early on as the pandemic impacted the nation’s health care system.

“For instance, many in the U.S. lost or were forced to switch health insurance plans due to layoffs—while in the VA access isn’t conditional on employment,” Feyman says. “The VA mounted a large, national response to COVID-19 early on, even in areas where the pandemic wasn’t bad yet and had existing telehealth infrastructure they could rapidly scale that many community-based providers did not already have in place.”