Population Density and VA Health Care Facility Patterns for Veterans in Alabama

Background and Purpose: In Alabama, one in ten individuals is a military veteran (380,00+), and the veteran population is becoming more diverse in its growth. The Department of Veterans Affairs (VA) provides health services through VHA facilities that include hospital services, primary care services, mental health services, and other care offerings. Additional specialty services for unique populations are offered as secondary services within specific facilities, such as women’s health clinics only being located in large VA medical centers (VAMCs). This also includes services for minority veterans, LGBT veterans, and polytrauma veterans. Approximately 95.64% of the state is designated as rural, which may present some challenges in veterans accessing services (Watters, 2012). This study sought to explore to see if patterns in population density in a rural state were evident when looking at VHA facilities.

Methods: This study utilized a geographic information system (GIS) program to help gain an recognizing and interpreting patterns between population density and VHA facilities in the state of Alabama. GIS data was obtained from the Alabama Geographic Office (population density) and the Department of Veterans Affairs (VHA facilities, type of facility). Using ArcGIS, the study merged an overlay of maps to obtain an understanding of the geographic relationship between population density and VHA facilities. The state of Alabama boundaries were created by data obtained from the U.S. Census Bureau on the county lines.

Results: The created map shows that there is a pattern between population density and VHA facilities, with the largest amount of facilities being in the most populated area, and with the larger facilities (VAMCs) being located in the more populated areas. Multiple counties across the state that have lower population densities have no VHA facility representation.

Conclusion & Implications: Several counties within the state of Alabama do not have VHA facilities, indicating that veterans in those counties would need to travel, adding to cost and time. Additionally, because the more dense counties include where Tuscaloosa, Birmingham, and Montgomery, there is a higher amount of services in the central region of the state because the geographic distribution. This also suggests that specialty services for unique populations are limited. This could potentially be problematic for veterans who need cultured care for health care services and would have to travel extensively for VHA services. Additional services for rural counties and regions would not be recommended by population density, but potentially mobile units could provide services to those areas.