VA Healthcare Use Vs Non-Use in Hispanic and Latino Veterans

Background and Purpose:

Access to quality healthcare is imperative to improved health outcomes and maintaining overall well-being. Over the last decade, the Veterans Healthcare Administration (VHA) has made significant strides in expanding and improving care provided to veterans, yet research on VHA use and perceptions (while limited) has shown that disparities remain. With the diversity of the US veteran population continually increasing, and the anticipated growth in the Hispanic/Latino veteran population in the next decade (NBC, 2022), it is incredibly important that VHA healthcare providers can meet the needs of veterans from different backgrounds. The purpose of this study was to examine differences in VHA use, non-use and reasons for non-use in Hispanic and Latino Veterans.

Methods:

In a cross-sectional study design, data were collected between July 2022 and June 2023 from three large Southern California counties as part of a regional needs assessment (Kintzle, Alday & Castro, 2023). To attain maximum representativeness of veterans in Southern California, a targeted recruitment strategy was employed. An online survey approach was utilized for data collection. The survey gathered information on race, Hispanic, Latino or Spanish ethnicity, use or non-use of VHA for healthcare in the past year, and reasons for non-use. Chi-square analyses were calculated to measure differences based on Hispanic/Latino and Non-Hispanic/Latino characteristics.

Results:

In total, 3,188 veterans completed the survey. The sample was predominantly white (61%, n=1928) and male (81%, n=2569), with 28% identifying as being of Hispanic, Latino or Spanish origin (n=898). Hispanic and Latino veterans were significantly less likely to have used the VHA in the past year compared to veterans who identified as non-Hispanic or Latino. Two-thirds (66%) of non-Hispanic veterans reported using the VHA within the past year compared to 62% of Hispanic/Latino veterans. When examining reasons for non-use of VHA, Hispanic/Latino veterans were more likely to report difficulties with access (such as parking and appointment availability), negative perceptions of care, distrust, feeling unwelcome and having bad prior VHA experiences.

Conclusion:

Findings have important implications for how the VHA can continue to improve upon the care provided to veterans and Hispanic/Latino veterans, as well as perceptions of and barriers to VHA care. Results demonstrate Hispanic/Latino veterans are more likely to report logistical, historical and trust experience that reduce willingness to receive VHA care. Results align with research in the general population that has found that Hispanic and Latino populations have historically reported lower levels of healthcare access, utilization and satisfaction. Further research is needed to expand upon reasons for non-use of VHA, and to gain a deeper understanding of the factors that contribute to the negative VHA perceptions reported by Hispanic/Latino veterans. VHA efforts should focus on understanding the unique experiences of Hispanic/Latino veterans, decreasing access barriers and improving VHA healthcare trust and perceptions.