Tuesday, December 27, 2011

Bittersweet homecoming for rural troops

December 17, 2011 marked the last troops to leave Iraq. These soldiers are happy to return home, many to the open arms of their loved ones who have missed them while they were deployed. But after the joy of homecoming dissipates, these men and women will have to face the bleak economy the rest of America has been battling for the past few years.

1% of the people in the nation serve in the military, and within that percent rural communities are overwhelmingly overrepresented. The Jobs and Economic Security for Rural America White House report states: “Although rural residents account for 17% of the population, they make up 44% of the men and women who serve in uniform.” The Daily Yonder has been outspoken about rural over-representation in the army since their inception, but their post earlier this year questioned the veracity of the 44% statistic quoted by the report. Their findings were actually lower, finding that “rural residents were joining the Army at rates 21.5% above the national average.” However, they insist this number is nothing to scoff at and admit that it’s “significant”.

The VHA Office of Rural Health released some astonishing disparity in veteran health in rural areas.
Prior cross-sectional and longitudinal analyses indicate that veterans who live in rural settings have greater healthcare needs than their urban counterparts. Specifically, rural Veterans have lower health-related quality-of-life scores and experience a higher prevalence of physical illness compared to urban Veterans.
Yet despite the greater need, veterans in rural areas are less likely to get the services they need. It is not surprising that spatial isolation plays a large role. Indeed the report mentions, “travel barriers including greater distance to care and lack of public transportation contribute to limited access to care for rural as compared to urban Veterans.” Further, a post in the Huffington Post this summer reported that “five million rural residents live in "shortage areas" defined by the federal government as counties with less than 33 primary care physicians per 100,000 residents. The number is continuing to decrease.” Further, “per capita in rural areas there is less than half the number of surgeons and other specialists.”

The war may be over but the horrors and ghosts of the war will follow these soldiers home. A December 20, 2011 Chicago Tribune article states that “[m]ore than 2,200 Iraq-era cases of PTSD are being treated in Illinois, in addition to more than 400 cases of traumatic brain injury, a medical condition caused by head trauma.” The VHA Office indicates that “[w]hile prevalence of most psychiatric disorders is lower for rural compared to urban Veterans, rural Veterans with psychiatric disorders are sicker as measured by lower health-related quality-of-life compared with urban Veterans.” Rural folks will feel the mental health ramifications hardest due the lack of mental health services and the transportation challenges. One article found that “more than 85 percent of the 1,669 federally designated mental health professional shortage areas are rural. And only in rural America did the National Advisory Committee on Rural Health (1993) find entire counties with no practicing psychiatrists, psychologists, or social workers.”

This year’s Holiday video from President Obama and his family featured the White House 2011 holiday season theme of "’Shine, Give, Share’ which offers an opportunity to pay tribute to our troops, veterans, and their families.” This is on the heels of the White House new “Joining Forces” campaign, whose ads could be seen on every television channel this past month. Our returning forces will struggle to find a job, and President Obama has “issued a challenge to the private sector to hire or train 100,000 unemployed veterans and their spouses.” But it’s clear that rural Veterans will struggle not only with finding employment, but also accessing much needed physical and mental health services. I hope the White House and Congress will openly discuss this rural-urban disparity and attempt to provide social services to better serve our returning rural soldiers.

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