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Murthy Offers Hope as Tenure Ends
In his parting words as US Surgeon General, Vivek Murthy, MD, MBA, urges togetherness as it works through current and future issues, as opposed to continuing down the path of divisiveness.
“Today, we are faced with a profound choice: do we continue with the status quo, marked by pain, disconnection, and division? Or do we choose a different path—one of joy, health, and fulfillment where we turn toward each other instead of away from each other, where we choose love over fear; where we recognize community as the irreplaceable foundation for our well-being?” Murthy writes in his Jan. 7 valedictory essay. “As I finish my tenure as Surgeon General, this is my parting prescription, my final wish for all of us: choose community.”
Murthy based his essay on personal and professional experiences from his tenures as the 19th and 21st US Surgeon General. He outlines his individual perspective on the root causes of widespread pain and unhappiness he has seen across America and offers a prescription for how we can “cultivate health and fulfillment.”
The core pillars of community—relationships, service, and purpose—are powerful drivers of fulfillment, Murthy writes, because “community is a powerful source of life satisfaction and life expectancy.” In his essay, he describes how these elements affect our health.
Relationships can be a powerful source of joy and support. They can act as buffers to stress and break down the barriers of loneliness and improve your overall health. According to Murthy, one-third of adults and one-half of young people experience loneliness; and social disconnectedness increases the risk of heart disease, dementia, depression, anxiety, and premature death.
Service comprises the actions we take that benefit others. Research shows that sustained service efforts can reduce the risk of hypertension, stroke, early death, depression, and cognitive decline.
And purpose is the feeling of having an overarching life aim to guide our decisions and actions. Simply, it is the “why” we do something, and according to Murthy, a high sense of individual purpose may reduce the risk of early death as well as stroke, lung disease, and dementia.
Building community isn’t always easy, Murthy wrote. It requires “rethinking and, in some cases, rejecting the conventional wisdom that tells us what defines success and a good life.” At the conclusion of his essay, Murthy notes how choices we make now must be made with an eye toward the future.
“The choice we make to build community has the power to change lives and transform society,” he writes. “Let us never forget that good people with hearts full of love can change the world.”
In his parting words as US Surgeon General, Vivek Murthy, MD, MBA, urges togetherness as it works through current and future issues, as opposed to continuing down the path of divisiveness.
“Today, we are faced with a profound choice: do we continue with the status quo, marked by pain, disconnection, and division? Or do we choose a different path—one of joy, health, and fulfillment where we turn toward each other instead of away from each other, where we choose love over fear; where we recognize community as the irreplaceable foundation for our well-being?” Murthy writes in his Jan. 7 valedictory essay. “As I finish my tenure as Surgeon General, this is my parting prescription, my final wish for all of us: choose community.”
Murthy based his essay on personal and professional experiences from his tenures as the 19th and 21st US Surgeon General. He outlines his individual perspective on the root causes of widespread pain and unhappiness he has seen across America and offers a prescription for how we can “cultivate health and fulfillment.”
The core pillars of community—relationships, service, and purpose—are powerful drivers of fulfillment, Murthy writes, because “community is a powerful source of life satisfaction and life expectancy.” In his essay, he describes how these elements affect our health.
Relationships can be a powerful source of joy and support. They can act as buffers to stress and break down the barriers of loneliness and improve your overall health. According to Murthy, one-third of adults and one-half of young people experience loneliness; and social disconnectedness increases the risk of heart disease, dementia, depression, anxiety, and premature death.
Service comprises the actions we take that benefit others. Research shows that sustained service efforts can reduce the risk of hypertension, stroke, early death, depression, and cognitive decline.
And purpose is the feeling of having an overarching life aim to guide our decisions and actions. Simply, it is the “why” we do something, and according to Murthy, a high sense of individual purpose may reduce the risk of early death as well as stroke, lung disease, and dementia.
Building community isn’t always easy, Murthy wrote. It requires “rethinking and, in some cases, rejecting the conventional wisdom that tells us what defines success and a good life.” At the conclusion of his essay, Murthy notes how choices we make now must be made with an eye toward the future.
“The choice we make to build community has the power to change lives and transform society,” he writes. “Let us never forget that good people with hearts full of love can change the world.”
In his parting words as US Surgeon General, Vivek Murthy, MD, MBA, urges togetherness as it works through current and future issues, as opposed to continuing down the path of divisiveness.
“Today, we are faced with a profound choice: do we continue with the status quo, marked by pain, disconnection, and division? Or do we choose a different path—one of joy, health, and fulfillment where we turn toward each other instead of away from each other, where we choose love over fear; where we recognize community as the irreplaceable foundation for our well-being?” Murthy writes in his Jan. 7 valedictory essay. “As I finish my tenure as Surgeon General, this is my parting prescription, my final wish for all of us: choose community.”
Murthy based his essay on personal and professional experiences from his tenures as the 19th and 21st US Surgeon General. He outlines his individual perspective on the root causes of widespread pain and unhappiness he has seen across America and offers a prescription for how we can “cultivate health and fulfillment.”
The core pillars of community—relationships, service, and purpose—are powerful drivers of fulfillment, Murthy writes, because “community is a powerful source of life satisfaction and life expectancy.” In his essay, he describes how these elements affect our health.
Relationships can be a powerful source of joy and support. They can act as buffers to stress and break down the barriers of loneliness and improve your overall health. According to Murthy, one-third of adults and one-half of young people experience loneliness; and social disconnectedness increases the risk of heart disease, dementia, depression, anxiety, and premature death.
Service comprises the actions we take that benefit others. Research shows that sustained service efforts can reduce the risk of hypertension, stroke, early death, depression, and cognitive decline.
And purpose is the feeling of having an overarching life aim to guide our decisions and actions. Simply, it is the “why” we do something, and according to Murthy, a high sense of individual purpose may reduce the risk of early death as well as stroke, lung disease, and dementia.
Building community isn’t always easy, Murthy wrote. It requires “rethinking and, in some cases, rejecting the conventional wisdom that tells us what defines success and a good life.” At the conclusion of his essay, Murthy notes how choices we make now must be made with an eye toward the future.
“The choice we make to build community has the power to change lives and transform society,” he writes. “Let us never forget that good people with hearts full of love can change the world.”
Sexual Assaults in Military Down, Benefits Claims Up
The number of sexual assaults in the US military dropped for the first time in a decade, according an annual report from the Pentagon, while benefits claims for assault survivors are on the rise.
Records show that 29,000 active-duty members reported being sexually assaulted in 2023, or 7000 fewer than in 2021. A confidential survey also found the number of service members who experienced some type of unwanted sexual contact dropped nearly 20%, leaving the Pentagon “cautiously optimistic“ its investments in preventing sexual assault and building a healthy climate are having an impact.
Despite these investments, issues persist. An Army anesthesiologist recently pleaded guilty to 41 charges of sexual misconduct involving 21 victims at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington. The alleged incidents occurred between 2019 and 2022 and involved the doctor unnecessarily focusing on the genital area of patients during what he described as routine examinations. Maj. Michael Stockin faces nearly 14 years in prison, should the judge accept the plea agreement Stockin and his attorneys made with government prosecutors.
Additionally, a report from the Watson Institute of International and Public Affairs at Brown University indicated that 24% of active-duty women and 1.9% of active-duty men experienced sexual assault from 2001 to 2021.During post-9/11 wars, “the prioritization of force readiness above all else allowed the problem of sexual assault to fester, papering over internal violence and gender inequalities within military institutions,” the report said. There was also a slight uptick in reports of military sexual assaults in 2020, when troops were largely on lockdown as a result of the COVID-19 pandemic.
Efforts to address sexual assault in the military have increased in the past 10 years to the tune of 10 Department of Defense Inspector General engagements, 60 Government Accountability Office recommendations, > 200 government panel and task force recommendations, > 150 Congressional provisions, and > 50 Secretary of Defense initiatives. Additionally, the 2022 National Defense Authorization gave authority in sexual assault cases to independent prosecutors rather than commanders. Other reforms have included incorporating trauma-informed practices in the claims process.
Meanwhile, the US Department of Veterans Affairs (VA) has also been attempting to convince more sexual assault survivors to file claims for benefits. Assistant Deputy Under Secretary for Field Operations Kenesha Britton said in December that the VA has held 3500 events in the past 14 months focused on benefits for victims of military sexual assault and harassment. It appears to be working, as the VA received 57,400 claims for military sexual trauma in fiscal year 2024 (an 18% increase from 2023), and approved > 63% of them, compared to 40% more than a decade ago. Prior to Oct. 1, VA staffers processed > 11,000 cases in a single day twice. Since that date, they have processed that amount on 9 separate occasions.
“We recognize the remarkable courage it takes for survivors of military sexual trauma to seek the benefits and support they’ve earned,” Britton said. “Our mission is driven by a commitment to ensure survivors are met with care, dignity and sensitivity throughout the claims process.”
The increase in trust is a byproduct of the outreach campaigns, VA Under Secretary for Benefits Josh Jacobs said: “[M]ore veterans are coming in to apply for benefits and I think that has to do with building trust because we are actively trying to reach veterans telling them we want to connect them with their earned benefits.”
The number of sexual assaults in the US military dropped for the first time in a decade, according an annual report from the Pentagon, while benefits claims for assault survivors are on the rise.
Records show that 29,000 active-duty members reported being sexually assaulted in 2023, or 7000 fewer than in 2021. A confidential survey also found the number of service members who experienced some type of unwanted sexual contact dropped nearly 20%, leaving the Pentagon “cautiously optimistic“ its investments in preventing sexual assault and building a healthy climate are having an impact.
Despite these investments, issues persist. An Army anesthesiologist recently pleaded guilty to 41 charges of sexual misconduct involving 21 victims at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington. The alleged incidents occurred between 2019 and 2022 and involved the doctor unnecessarily focusing on the genital area of patients during what he described as routine examinations. Maj. Michael Stockin faces nearly 14 years in prison, should the judge accept the plea agreement Stockin and his attorneys made with government prosecutors.
Additionally, a report from the Watson Institute of International and Public Affairs at Brown University indicated that 24% of active-duty women and 1.9% of active-duty men experienced sexual assault from 2001 to 2021.During post-9/11 wars, “the prioritization of force readiness above all else allowed the problem of sexual assault to fester, papering over internal violence and gender inequalities within military institutions,” the report said. There was also a slight uptick in reports of military sexual assaults in 2020, when troops were largely on lockdown as a result of the COVID-19 pandemic.
Efforts to address sexual assault in the military have increased in the past 10 years to the tune of 10 Department of Defense Inspector General engagements, 60 Government Accountability Office recommendations, > 200 government panel and task force recommendations, > 150 Congressional provisions, and > 50 Secretary of Defense initiatives. Additionally, the 2022 National Defense Authorization gave authority in sexual assault cases to independent prosecutors rather than commanders. Other reforms have included incorporating trauma-informed practices in the claims process.
Meanwhile, the US Department of Veterans Affairs (VA) has also been attempting to convince more sexual assault survivors to file claims for benefits. Assistant Deputy Under Secretary for Field Operations Kenesha Britton said in December that the VA has held 3500 events in the past 14 months focused on benefits for victims of military sexual assault and harassment. It appears to be working, as the VA received 57,400 claims for military sexual trauma in fiscal year 2024 (an 18% increase from 2023), and approved > 63% of them, compared to 40% more than a decade ago. Prior to Oct. 1, VA staffers processed > 11,000 cases in a single day twice. Since that date, they have processed that amount on 9 separate occasions.
“We recognize the remarkable courage it takes for survivors of military sexual trauma to seek the benefits and support they’ve earned,” Britton said. “Our mission is driven by a commitment to ensure survivors are met with care, dignity and sensitivity throughout the claims process.”
The increase in trust is a byproduct of the outreach campaigns, VA Under Secretary for Benefits Josh Jacobs said: “[M]ore veterans are coming in to apply for benefits and I think that has to do with building trust because we are actively trying to reach veterans telling them we want to connect them with their earned benefits.”
The number of sexual assaults in the US military dropped for the first time in a decade, according an annual report from the Pentagon, while benefits claims for assault survivors are on the rise.
Records show that 29,000 active-duty members reported being sexually assaulted in 2023, or 7000 fewer than in 2021. A confidential survey also found the number of service members who experienced some type of unwanted sexual contact dropped nearly 20%, leaving the Pentagon “cautiously optimistic“ its investments in preventing sexual assault and building a healthy climate are having an impact.
Despite these investments, issues persist. An Army anesthesiologist recently pleaded guilty to 41 charges of sexual misconduct involving 21 victims at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington. The alleged incidents occurred between 2019 and 2022 and involved the doctor unnecessarily focusing on the genital area of patients during what he described as routine examinations. Maj. Michael Stockin faces nearly 14 years in prison, should the judge accept the plea agreement Stockin and his attorneys made with government prosecutors.
Additionally, a report from the Watson Institute of International and Public Affairs at Brown University indicated that 24% of active-duty women and 1.9% of active-duty men experienced sexual assault from 2001 to 2021.During post-9/11 wars, “the prioritization of force readiness above all else allowed the problem of sexual assault to fester, papering over internal violence and gender inequalities within military institutions,” the report said. There was also a slight uptick in reports of military sexual assaults in 2020, when troops were largely on lockdown as a result of the COVID-19 pandemic.
Efforts to address sexual assault in the military have increased in the past 10 years to the tune of 10 Department of Defense Inspector General engagements, 60 Government Accountability Office recommendations, > 200 government panel and task force recommendations, > 150 Congressional provisions, and > 50 Secretary of Defense initiatives. Additionally, the 2022 National Defense Authorization gave authority in sexual assault cases to independent prosecutors rather than commanders. Other reforms have included incorporating trauma-informed practices in the claims process.
Meanwhile, the US Department of Veterans Affairs (VA) has also been attempting to convince more sexual assault survivors to file claims for benefits. Assistant Deputy Under Secretary for Field Operations Kenesha Britton said in December that the VA has held 3500 events in the past 14 months focused on benefits for victims of military sexual assault and harassment. It appears to be working, as the VA received 57,400 claims for military sexual trauma in fiscal year 2024 (an 18% increase from 2023), and approved > 63% of them, compared to 40% more than a decade ago. Prior to Oct. 1, VA staffers processed > 11,000 cases in a single day twice. Since that date, they have processed that amount on 9 separate occasions.
“We recognize the remarkable courage it takes for survivors of military sexual trauma to seek the benefits and support they’ve earned,” Britton said. “Our mission is driven by a commitment to ensure survivors are met with care, dignity and sensitivity throughout the claims process.”
The increase in trust is a byproduct of the outreach campaigns, VA Under Secretary for Benefits Josh Jacobs said: “[M]ore veterans are coming in to apply for benefits and I think that has to do with building trust because we are actively trying to reach veterans telling them we want to connect them with their earned benefits.”
Areas of Hope Offered in 2024 VA Suicide Report
Suicide was the 12th-leading cause of death for veterans in 2022. However, fewer veterans died by suicide in 2022 than in 12 of the previous 14 years, according to the 2024 National Veteran Suicide Prevention Annual Report released by the US Department of Veterans Affairs (VA).
The review is the most comprehensive national report on veteran suicide and is based on verified data from the Centers for Disease Control and US Department of Defense from 2001-2022, or the most recent years the VA has data.
The report states that 6407 veterans died by suicide in 2022, 3 more than the year before. For comparison, 41,484 nonveteran US adults died by suicide in 2022, 1476 more than 2021. It is important to assess suicide mortality rates in the context of population changes, the report cautions. From 2001-2022, the veteran population dropped from 25.8 million to 18.5 million, a 28.4% decrease. During that same period, the nonveteran US adult population increased from 186.5 million to 242.4 million, a 30.0% jump.
On average, 131 US adults died by suicide each day in 2022: 18 veterans and 114 nonveterans. Among all US adults, including veterans, the average number of suicides per day rose from 81 per day in 2001 to 131 per day in 2022. The average number of veteran suicides per day rose from 16.5 in 2001 to 17.6 in 2022.
“Hope serves an important role within suicide prevention efforts,” the VA said. “Within the challenges faced in 2022, key areas of hope emerged.”
Among those key findings are a 24.1% decrease in age-adjusted suicide rates, a 37% suicide rate reduction among individuals who received VA homeless program services, 3.8% suicide rate decrease in veterans aged 18 to 34 years, and considerable drops in suicide rates for veterans with Veterans Health Administration mental health diagnoses of anxiety (36.1%), depression (34.5%), posttraumatic stress disorder (31.6%), and alcohol use disorder (13.7%).
Eliminating veteran suicide is VA’s top clinical priority and a critical aspect of the strategy for reducing military and veteran suicide. Since 2022, VA has worked aggressively to expand support, including offering no-cost health care to veterans in suicidal crisis; launching the 988 (then press 1) hotline, qualified responders through the Veterans Crisis Line; expanding firearm suicide prevention efforts; and encouraging veterans to reach out for help through a national veteran suicide prevention awareness campaign.
“There is nothing more important to VA than ending veteran suicide,“ said Secretary of Veterans Affairs Denis McDonough. “We will learn from this report to better serve veterans and save lives.”
Suicide was the 12th-leading cause of death for veterans in 2022. However, fewer veterans died by suicide in 2022 than in 12 of the previous 14 years, according to the 2024 National Veteran Suicide Prevention Annual Report released by the US Department of Veterans Affairs (VA).
The review is the most comprehensive national report on veteran suicide and is based on verified data from the Centers for Disease Control and US Department of Defense from 2001-2022, or the most recent years the VA has data.
The report states that 6407 veterans died by suicide in 2022, 3 more than the year before. For comparison, 41,484 nonveteran US adults died by suicide in 2022, 1476 more than 2021. It is important to assess suicide mortality rates in the context of population changes, the report cautions. From 2001-2022, the veteran population dropped from 25.8 million to 18.5 million, a 28.4% decrease. During that same period, the nonveteran US adult population increased from 186.5 million to 242.4 million, a 30.0% jump.
On average, 131 US adults died by suicide each day in 2022: 18 veterans and 114 nonveterans. Among all US adults, including veterans, the average number of suicides per day rose from 81 per day in 2001 to 131 per day in 2022. The average number of veteran suicides per day rose from 16.5 in 2001 to 17.6 in 2022.
“Hope serves an important role within suicide prevention efforts,” the VA said. “Within the challenges faced in 2022, key areas of hope emerged.”
Among those key findings are a 24.1% decrease in age-adjusted suicide rates, a 37% suicide rate reduction among individuals who received VA homeless program services, 3.8% suicide rate decrease in veterans aged 18 to 34 years, and considerable drops in suicide rates for veterans with Veterans Health Administration mental health diagnoses of anxiety (36.1%), depression (34.5%), posttraumatic stress disorder (31.6%), and alcohol use disorder (13.7%).
Eliminating veteran suicide is VA’s top clinical priority and a critical aspect of the strategy for reducing military and veteran suicide. Since 2022, VA has worked aggressively to expand support, including offering no-cost health care to veterans in suicidal crisis; launching the 988 (then press 1) hotline, qualified responders through the Veterans Crisis Line; expanding firearm suicide prevention efforts; and encouraging veterans to reach out for help through a national veteran suicide prevention awareness campaign.
“There is nothing more important to VA than ending veteran suicide,“ said Secretary of Veterans Affairs Denis McDonough. “We will learn from this report to better serve veterans and save lives.”
Suicide was the 12th-leading cause of death for veterans in 2022. However, fewer veterans died by suicide in 2022 than in 12 of the previous 14 years, according to the 2024 National Veteran Suicide Prevention Annual Report released by the US Department of Veterans Affairs (VA).
The review is the most comprehensive national report on veteran suicide and is based on verified data from the Centers for Disease Control and US Department of Defense from 2001-2022, or the most recent years the VA has data.
The report states that 6407 veterans died by suicide in 2022, 3 more than the year before. For comparison, 41,484 nonveteran US adults died by suicide in 2022, 1476 more than 2021. It is important to assess suicide mortality rates in the context of population changes, the report cautions. From 2001-2022, the veteran population dropped from 25.8 million to 18.5 million, a 28.4% decrease. During that same period, the nonveteran US adult population increased from 186.5 million to 242.4 million, a 30.0% jump.
On average, 131 US adults died by suicide each day in 2022: 18 veterans and 114 nonveterans. Among all US adults, including veterans, the average number of suicides per day rose from 81 per day in 2001 to 131 per day in 2022. The average number of veteran suicides per day rose from 16.5 in 2001 to 17.6 in 2022.
“Hope serves an important role within suicide prevention efforts,” the VA said. “Within the challenges faced in 2022, key areas of hope emerged.”
Among those key findings are a 24.1% decrease in age-adjusted suicide rates, a 37% suicide rate reduction among individuals who received VA homeless program services, 3.8% suicide rate decrease in veterans aged 18 to 34 years, and considerable drops in suicide rates for veterans with Veterans Health Administration mental health diagnoses of anxiety (36.1%), depression (34.5%), posttraumatic stress disorder (31.6%), and alcohol use disorder (13.7%).
Eliminating veteran suicide is VA’s top clinical priority and a critical aspect of the strategy for reducing military and veteran suicide. Since 2022, VA has worked aggressively to expand support, including offering no-cost health care to veterans in suicidal crisis; launching the 988 (then press 1) hotline, qualified responders through the Veterans Crisis Line; expanding firearm suicide prevention efforts; and encouraging veterans to reach out for help through a national veteran suicide prevention awareness campaign.
“There is nothing more important to VA than ending veteran suicide,“ said Secretary of Veterans Affairs Denis McDonough. “We will learn from this report to better serve veterans and save lives.”
VA Launches New Campaign to Attract More Veterans to Health Care
A new US Department of Veterans Affairs (VA) outreach campaign is encouraging all eligible veterans to enroll in VA health care, aiming to connect the roughly 1 million unenrolled veterans to care.
The campaign was prompted following reports of concerns from veterans about health issues—including mental health hurdles and thoughts of suicide—potentially related to repeated low-level artillery blasts, improvised explosive devices, missile launches, heavy fire, and other blast exposures.
Veterans enrolled in VA health care have access to specialty screenings and services to address issues related to blast exposure. Those who served in Vietnam, the Gulf War, Iraq, Afghanistan, and other specific locations are eligible for these benefits based on their deployments. They do not need to have any health conditions specifically associated with their service to be eligible.
“We take veteran concerns about repeated blast exposure very seriously, and we are studying this matter urgently to learn more about potential health impacts,” VA Secretary Denis McDonough said. “While we do that, we don’t want veterans to wait—they should enroll in VA health care today to get full access to primary care, mental health care, regular screenings, specialty care, and more. That’s what this outreach effort is all about: getting veterans in our care, because veterans who come to VA are proven to do better.”
The campaign will consist of text messages and emails sent directly to veterans, in addition to thousands of nationwide events, advertising, and social media campaigns. It is the latest effort to appeal to more veterans and is part of the largest outreach campaign in VA history, which began when President Joseph R. Biden signed the PACT Act into law in 2022. As a result > 835,000 veterans have enrolled in VA health care (a 37% increase), > 900,000 veterans have upgraded their priority groups, making them eligible for health care with fewer copays (a record), and > 4.4 million veterans and survivors have applied for disability compensation benefits (another record).
Increased enrollment benefits not only the individuals enrolled in VA health care, but those who come after.
"[W]e are constantly looking for ways to improve that care as science and research tells us about new concerns," said VA Under Secretary for Health Shereef Elnahal, MD. "The more veterans who enroll, the more we can learn about the impact of blast exposure—and the better care we can ultimately provide those who served."
A new US Department of Veterans Affairs (VA) outreach campaign is encouraging all eligible veterans to enroll in VA health care, aiming to connect the roughly 1 million unenrolled veterans to care.
The campaign was prompted following reports of concerns from veterans about health issues—including mental health hurdles and thoughts of suicide—potentially related to repeated low-level artillery blasts, improvised explosive devices, missile launches, heavy fire, and other blast exposures.
Veterans enrolled in VA health care have access to specialty screenings and services to address issues related to blast exposure. Those who served in Vietnam, the Gulf War, Iraq, Afghanistan, and other specific locations are eligible for these benefits based on their deployments. They do not need to have any health conditions specifically associated with their service to be eligible.
“We take veteran concerns about repeated blast exposure very seriously, and we are studying this matter urgently to learn more about potential health impacts,” VA Secretary Denis McDonough said. “While we do that, we don’t want veterans to wait—they should enroll in VA health care today to get full access to primary care, mental health care, regular screenings, specialty care, and more. That’s what this outreach effort is all about: getting veterans in our care, because veterans who come to VA are proven to do better.”
The campaign will consist of text messages and emails sent directly to veterans, in addition to thousands of nationwide events, advertising, and social media campaigns. It is the latest effort to appeal to more veterans and is part of the largest outreach campaign in VA history, which began when President Joseph R. Biden signed the PACT Act into law in 2022. As a result > 835,000 veterans have enrolled in VA health care (a 37% increase), > 900,000 veterans have upgraded their priority groups, making them eligible for health care with fewer copays (a record), and > 4.4 million veterans and survivors have applied for disability compensation benefits (another record).
Increased enrollment benefits not only the individuals enrolled in VA health care, but those who come after.
"[W]e are constantly looking for ways to improve that care as science and research tells us about new concerns," said VA Under Secretary for Health Shereef Elnahal, MD. "The more veterans who enroll, the more we can learn about the impact of blast exposure—and the better care we can ultimately provide those who served."
A new US Department of Veterans Affairs (VA) outreach campaign is encouraging all eligible veterans to enroll in VA health care, aiming to connect the roughly 1 million unenrolled veterans to care.
The campaign was prompted following reports of concerns from veterans about health issues—including mental health hurdles and thoughts of suicide—potentially related to repeated low-level artillery blasts, improvised explosive devices, missile launches, heavy fire, and other blast exposures.
Veterans enrolled in VA health care have access to specialty screenings and services to address issues related to blast exposure. Those who served in Vietnam, the Gulf War, Iraq, Afghanistan, and other specific locations are eligible for these benefits based on their deployments. They do not need to have any health conditions specifically associated with their service to be eligible.
“We take veteran concerns about repeated blast exposure very seriously, and we are studying this matter urgently to learn more about potential health impacts,” VA Secretary Denis McDonough said. “While we do that, we don’t want veterans to wait—they should enroll in VA health care today to get full access to primary care, mental health care, regular screenings, specialty care, and more. That’s what this outreach effort is all about: getting veterans in our care, because veterans who come to VA are proven to do better.”
The campaign will consist of text messages and emails sent directly to veterans, in addition to thousands of nationwide events, advertising, and social media campaigns. It is the latest effort to appeal to more veterans and is part of the largest outreach campaign in VA history, which began when President Joseph R. Biden signed the PACT Act into law in 2022. As a result > 835,000 veterans have enrolled in VA health care (a 37% increase), > 900,000 veterans have upgraded their priority groups, making them eligible for health care with fewer copays (a record), and > 4.4 million veterans and survivors have applied for disability compensation benefits (another record).
Increased enrollment benefits not only the individuals enrolled in VA health care, but those who come after.
"[W]e are constantly looking for ways to improve that care as science and research tells us about new concerns," said VA Under Secretary for Health Shereef Elnahal, MD. "The more veterans who enroll, the more we can learn about the impact of blast exposure—and the better care we can ultimately provide those who served."
Veterans Enroll in VA MDMA and PTSD Phase 2 Trial
The first study funded by the US Department of Veterans Affairs (VA) for psychedelic-assisted therapy since the 1960s is currently enrolling veterans. Researchers are set to evaluate the potential of methylenedioxymethamphetamine (MDMA) for veterans with posttraumatic stress disorder (PTSD) and alcohol use disorder.
The grant—about $1.5 million over 5 years—will fund a randomized, placebo-controlled trial at the Providence VA Medical Center in Rhode Island and the West Haven VA Medical Center in Connecticut by VA researchers affiliated with Brown University and Yale University. Pharmaceutical-grade MDMA will be used, and some participants will be randomly selected to receive an active placebo (lower dose of MDMA). MDMA is a psychedelic compound believed to increase emotional openness, reduce fear, and promote introspection during therapy.
The study is part of the VA’s broader effort to gather definitive scientific evidence on the potential efficacy and safety of psychedelic compounds used in conjunction with psychotherapy to treat PTSD, depression, and related mental health conditions. Veterans service organizations like the American Legion and Disabled American Veterans in addition to mental health clinician groups have also called for expanded research into psychedelic compounds. The National Defense Authorization Act for fiscal year 2024 also authorized the US Department of Defense to perform research on psychedelics within military populations.
In September 2023, VA and other federal clinicians, scientists, and policy makers assessed the state of scientific evidence regarding psychedelic-assisted therapies. The working groups provided advice to VA leadership, including the recommendation for the VA to begin funding its own research into these areas of care.
The guidance was based on previously published studies that have found encouraging results but included few or no veteran participants. For example, a confirmatory phase 3 study by the MAPP2 Study Collaborator Group involved 104 patients, of whom only 16 were veterans.
However, the findings of that study underscored the potential of the treatment: MDMA significantly improved PTSD symptoms and functional impairment, compared with placebo with therapy over 18 weeks. Notably, 45 of 52 (86%) participants treated with MDMA achieved a clinically meaningful benefit, and 37 of 52 (71%) participants no longer met criteria for PTSD by the end of the study. Consistent with an earlier study, no new major safety issues were reported. Common treatment-emergent adverse effects were like those of previous research and consistent with expected effects of MDMA. MDMA did not appear to increase the risk of suicidal ideation, and no suicidal behavior was observed.
The VA researchers has conducted a limited number of small studies on psychedelics in VA facilities using non-VA funding. “VA is on the cutting edge of clinical research for veteran health, including in the investigation of psychedelics for mental health,” said Under Secretary for Health Shereef Elnahal, MD.
The FDA granted breakthrough therapy status for MDMA in the treatment of PTSD and psilocybin for the treatment of depression in 2017 and 2018, respectively, based on promising preliminary research evidence. However, in June 2024 an FDA panel voted against approving a MDMA therapy for PTSD, citing concerns about research practices, a lack of diversity in the trials, and a failure to provide data on adverse effects such as potential for abuse.
In August, the FDA formally rejected the treatment and called for another phase 3 study. “The FDA’s decision is disgraceful,” said Heroic Hearts Project, a veterans organization that had lobbied for FDA approval citing the many veteran suicides in a statement. “This is the epitome of bureaucratic red tape—and the result is people will keep dying.”
Meanwhile, VA Press Secretary Terrence Hayes said in a statement: “VA is committed to high-quality research that safely promotes the health of our nation’s Veterans … VA anticipates that additional insights on the efficacy and safety of these therapies will add to the broader body of knowledge on MDMA-assisted psychotherapy.”
The first study funded by the US Department of Veterans Affairs (VA) for psychedelic-assisted therapy since the 1960s is currently enrolling veterans. Researchers are set to evaluate the potential of methylenedioxymethamphetamine (MDMA) for veterans with posttraumatic stress disorder (PTSD) and alcohol use disorder.
The grant—about $1.5 million over 5 years—will fund a randomized, placebo-controlled trial at the Providence VA Medical Center in Rhode Island and the West Haven VA Medical Center in Connecticut by VA researchers affiliated with Brown University and Yale University. Pharmaceutical-grade MDMA will be used, and some participants will be randomly selected to receive an active placebo (lower dose of MDMA). MDMA is a psychedelic compound believed to increase emotional openness, reduce fear, and promote introspection during therapy.
The study is part of the VA’s broader effort to gather definitive scientific evidence on the potential efficacy and safety of psychedelic compounds used in conjunction with psychotherapy to treat PTSD, depression, and related mental health conditions. Veterans service organizations like the American Legion and Disabled American Veterans in addition to mental health clinician groups have also called for expanded research into psychedelic compounds. The National Defense Authorization Act for fiscal year 2024 also authorized the US Department of Defense to perform research on psychedelics within military populations.
In September 2023, VA and other federal clinicians, scientists, and policy makers assessed the state of scientific evidence regarding psychedelic-assisted therapies. The working groups provided advice to VA leadership, including the recommendation for the VA to begin funding its own research into these areas of care.
The guidance was based on previously published studies that have found encouraging results but included few or no veteran participants. For example, a confirmatory phase 3 study by the MAPP2 Study Collaborator Group involved 104 patients, of whom only 16 were veterans.
However, the findings of that study underscored the potential of the treatment: MDMA significantly improved PTSD symptoms and functional impairment, compared with placebo with therapy over 18 weeks. Notably, 45 of 52 (86%) participants treated with MDMA achieved a clinically meaningful benefit, and 37 of 52 (71%) participants no longer met criteria for PTSD by the end of the study. Consistent with an earlier study, no new major safety issues were reported. Common treatment-emergent adverse effects were like those of previous research and consistent with expected effects of MDMA. MDMA did not appear to increase the risk of suicidal ideation, and no suicidal behavior was observed.
The VA researchers has conducted a limited number of small studies on psychedelics in VA facilities using non-VA funding. “VA is on the cutting edge of clinical research for veteran health, including in the investigation of psychedelics for mental health,” said Under Secretary for Health Shereef Elnahal, MD.
The FDA granted breakthrough therapy status for MDMA in the treatment of PTSD and psilocybin for the treatment of depression in 2017 and 2018, respectively, based on promising preliminary research evidence. However, in June 2024 an FDA panel voted against approving a MDMA therapy for PTSD, citing concerns about research practices, a lack of diversity in the trials, and a failure to provide data on adverse effects such as potential for abuse.
In August, the FDA formally rejected the treatment and called for another phase 3 study. “The FDA’s decision is disgraceful,” said Heroic Hearts Project, a veterans organization that had lobbied for FDA approval citing the many veteran suicides in a statement. “This is the epitome of bureaucratic red tape—and the result is people will keep dying.”
Meanwhile, VA Press Secretary Terrence Hayes said in a statement: “VA is committed to high-quality research that safely promotes the health of our nation’s Veterans … VA anticipates that additional insights on the efficacy and safety of these therapies will add to the broader body of knowledge on MDMA-assisted psychotherapy.”
The first study funded by the US Department of Veterans Affairs (VA) for psychedelic-assisted therapy since the 1960s is currently enrolling veterans. Researchers are set to evaluate the potential of methylenedioxymethamphetamine (MDMA) for veterans with posttraumatic stress disorder (PTSD) and alcohol use disorder.
The grant—about $1.5 million over 5 years—will fund a randomized, placebo-controlled trial at the Providence VA Medical Center in Rhode Island and the West Haven VA Medical Center in Connecticut by VA researchers affiliated with Brown University and Yale University. Pharmaceutical-grade MDMA will be used, and some participants will be randomly selected to receive an active placebo (lower dose of MDMA). MDMA is a psychedelic compound believed to increase emotional openness, reduce fear, and promote introspection during therapy.
The study is part of the VA’s broader effort to gather definitive scientific evidence on the potential efficacy and safety of psychedelic compounds used in conjunction with psychotherapy to treat PTSD, depression, and related mental health conditions. Veterans service organizations like the American Legion and Disabled American Veterans in addition to mental health clinician groups have also called for expanded research into psychedelic compounds. The National Defense Authorization Act for fiscal year 2024 also authorized the US Department of Defense to perform research on psychedelics within military populations.
In September 2023, VA and other federal clinicians, scientists, and policy makers assessed the state of scientific evidence regarding psychedelic-assisted therapies. The working groups provided advice to VA leadership, including the recommendation for the VA to begin funding its own research into these areas of care.
The guidance was based on previously published studies that have found encouraging results but included few or no veteran participants. For example, a confirmatory phase 3 study by the MAPP2 Study Collaborator Group involved 104 patients, of whom only 16 were veterans.
However, the findings of that study underscored the potential of the treatment: MDMA significantly improved PTSD symptoms and functional impairment, compared with placebo with therapy over 18 weeks. Notably, 45 of 52 (86%) participants treated with MDMA achieved a clinically meaningful benefit, and 37 of 52 (71%) participants no longer met criteria for PTSD by the end of the study. Consistent with an earlier study, no new major safety issues were reported. Common treatment-emergent adverse effects were like those of previous research and consistent with expected effects of MDMA. MDMA did not appear to increase the risk of suicidal ideation, and no suicidal behavior was observed.
The VA researchers has conducted a limited number of small studies on psychedelics in VA facilities using non-VA funding. “VA is on the cutting edge of clinical research for veteran health, including in the investigation of psychedelics for mental health,” said Under Secretary for Health Shereef Elnahal, MD.
The FDA granted breakthrough therapy status for MDMA in the treatment of PTSD and psilocybin for the treatment of depression in 2017 and 2018, respectively, based on promising preliminary research evidence. However, in June 2024 an FDA panel voted against approving a MDMA therapy for PTSD, citing concerns about research practices, a lack of diversity in the trials, and a failure to provide data on adverse effects such as potential for abuse.
In August, the FDA formally rejected the treatment and called for another phase 3 study. “The FDA’s decision is disgraceful,” said Heroic Hearts Project, a veterans organization that had lobbied for FDA approval citing the many veteran suicides in a statement. “This is the epitome of bureaucratic red tape—and the result is people will keep dying.”
Meanwhile, VA Press Secretary Terrence Hayes said in a statement: “VA is committed to high-quality research that safely promotes the health of our nation’s Veterans … VA anticipates that additional insights on the efficacy and safety of these therapies will add to the broader body of knowledge on MDMA-assisted psychotherapy.”
Congress and VA Aim to Improve Health Care Access for Rural Veterans
Veterans living in rural areas are often too far away from health care institutions to easily travel to their appointments. Even if they can drive, the cost of gas and other related travel expenses may be too much for some. Telehealth was meant to help relieve that problem, but poor internet access can mitigate its convenience and accessibility for those patients. Two proposals offer solutions.
In February, Sens. Jon Ossoff (D-GA), Susan Collins (R-ME), and John Thune (R-SD) introduced the Rural Veterans Transportation to Care Act, a bill that would expand eligibility to the US Department of Veterans Affairs (VA) Highly Rural Transportation Grants, a program currently only available to counties with < 7 people per square mile.
“As I’ve sat down with veterans in rural areas across Georgia, one of their key concerns is lack of transportation,” Sen. Ossoff said. “That’s why I’m introducing this bipartisan bill to ensure veterans have more access to transportation services that can bring them to VA clinics and medical centers to get the care they need.”
Amanda Flener and her husband, John, a veteran wounded while serving in Iraq, were driving as long as 3 hours from Fitzgerald, Georgia (population 8900) to attend his medical appointments. In the last 2 years, Flener told the Daily Yonder she had put nearly 72,000 miles on her vehicle. Following hurricane Helene, she said, "We had been driving 30 miles just to get gas to power our generator … and we were fortunate to be able to do that.”
Telehealth appointments can help fill coverage gaps, Flener said. But even while paying for the most expensive internet plan available in her county, the signal isn't always strong enough. Telehealth care is "progress, for sure," Flener said. "So, we pay for the best Wi-Fi we can get in our area, but it isn't always reliable enough to take the video calls from the VA."
As a result, veterans and their caregivers could benefit not only from the bipartisan transportation proposal, but also from a decision announced in November. The VA is proposing to eliminate copayments for all VA telehealth services and establish a grant program to fund designated VA telehealth access points in non-VA facilities, with a focus on rural and medically underserved communities.
The program, called Accessing Telehealth through Local Area Stations (ATLAS), would provide funding to organizations — including nonprofits and private businesses — to offer veterans comfortable, private spaces equipped with high-speed internet access and the technology to remotely meet with VA clinicians. Grants would also provide designated funding to train on-site personnel to support the program.
These proposed changes would advance the VA’s and the Biden-Harris Administration’s ongoing efforts to lower costs and expand access to care for veterans. They also could make a life-changing difference for the 2.7 million rural veterans enrolled in VA health care.
According to a 2024 RAND study, just under half of military and veteran caregivers live in a county without a VA facility, and nearly half live in a primary care physician shortage area. For military/veteran caregivers in particular, the survey found, reduced access to support related to the more complicated care some patients require, greater distances to reach opportunities (eg, retail, economic, or social), and even differences in Wi-Fi/broadband internet access may create “unique needs.” The survey found that 24% of rural military/veteran caregivers did not have reliable broadband internet.
“Waiving copays for telehealth services and launching this grant program are both major steps forward in ensuring veterans can access health care where and when they need it,” said VA Secretary Denis McDonough. “VA is the best and most affordable care in America for veterans — with these steps, we can make it easier for veterans to access their earned VA health care.”
The rulemaking can be viewed in the Federal Register under public inspection, and is open for comment. The VA anticipates a notice of funding opportunity for this grant program following publication of the final rule.
Veterans living in rural areas are often too far away from health care institutions to easily travel to their appointments. Even if they can drive, the cost of gas and other related travel expenses may be too much for some. Telehealth was meant to help relieve that problem, but poor internet access can mitigate its convenience and accessibility for those patients. Two proposals offer solutions.
In February, Sens. Jon Ossoff (D-GA), Susan Collins (R-ME), and John Thune (R-SD) introduced the Rural Veterans Transportation to Care Act, a bill that would expand eligibility to the US Department of Veterans Affairs (VA) Highly Rural Transportation Grants, a program currently only available to counties with < 7 people per square mile.
“As I’ve sat down with veterans in rural areas across Georgia, one of their key concerns is lack of transportation,” Sen. Ossoff said. “That’s why I’m introducing this bipartisan bill to ensure veterans have more access to transportation services that can bring them to VA clinics and medical centers to get the care they need.”
Amanda Flener and her husband, John, a veteran wounded while serving in Iraq, were driving as long as 3 hours from Fitzgerald, Georgia (population 8900) to attend his medical appointments. In the last 2 years, Flener told the Daily Yonder she had put nearly 72,000 miles on her vehicle. Following hurricane Helene, she said, "We had been driving 30 miles just to get gas to power our generator … and we were fortunate to be able to do that.”
Telehealth appointments can help fill coverage gaps, Flener said. But even while paying for the most expensive internet plan available in her county, the signal isn't always strong enough. Telehealth care is "progress, for sure," Flener said. "So, we pay for the best Wi-Fi we can get in our area, but it isn't always reliable enough to take the video calls from the VA."
As a result, veterans and their caregivers could benefit not only from the bipartisan transportation proposal, but also from a decision announced in November. The VA is proposing to eliminate copayments for all VA telehealth services and establish a grant program to fund designated VA telehealth access points in non-VA facilities, with a focus on rural and medically underserved communities.
The program, called Accessing Telehealth through Local Area Stations (ATLAS), would provide funding to organizations — including nonprofits and private businesses — to offer veterans comfortable, private spaces equipped with high-speed internet access and the technology to remotely meet with VA clinicians. Grants would also provide designated funding to train on-site personnel to support the program.
These proposed changes would advance the VA’s and the Biden-Harris Administration’s ongoing efforts to lower costs and expand access to care for veterans. They also could make a life-changing difference for the 2.7 million rural veterans enrolled in VA health care.
According to a 2024 RAND study, just under half of military and veteran caregivers live in a county without a VA facility, and nearly half live in a primary care physician shortage area. For military/veteran caregivers in particular, the survey found, reduced access to support related to the more complicated care some patients require, greater distances to reach opportunities (eg, retail, economic, or social), and even differences in Wi-Fi/broadband internet access may create “unique needs.” The survey found that 24% of rural military/veteran caregivers did not have reliable broadband internet.
“Waiving copays for telehealth services and launching this grant program are both major steps forward in ensuring veterans can access health care where and when they need it,” said VA Secretary Denis McDonough. “VA is the best and most affordable care in America for veterans — with these steps, we can make it easier for veterans to access their earned VA health care.”
The rulemaking can be viewed in the Federal Register under public inspection, and is open for comment. The VA anticipates a notice of funding opportunity for this grant program following publication of the final rule.
Veterans living in rural areas are often too far away from health care institutions to easily travel to their appointments. Even if they can drive, the cost of gas and other related travel expenses may be too much for some. Telehealth was meant to help relieve that problem, but poor internet access can mitigate its convenience and accessibility for those patients. Two proposals offer solutions.
In February, Sens. Jon Ossoff (D-GA), Susan Collins (R-ME), and John Thune (R-SD) introduced the Rural Veterans Transportation to Care Act, a bill that would expand eligibility to the US Department of Veterans Affairs (VA) Highly Rural Transportation Grants, a program currently only available to counties with < 7 people per square mile.
“As I’ve sat down with veterans in rural areas across Georgia, one of their key concerns is lack of transportation,” Sen. Ossoff said. “That’s why I’m introducing this bipartisan bill to ensure veterans have more access to transportation services that can bring them to VA clinics and medical centers to get the care they need.”
Amanda Flener and her husband, John, a veteran wounded while serving in Iraq, were driving as long as 3 hours from Fitzgerald, Georgia (population 8900) to attend his medical appointments. In the last 2 years, Flener told the Daily Yonder she had put nearly 72,000 miles on her vehicle. Following hurricane Helene, she said, "We had been driving 30 miles just to get gas to power our generator … and we were fortunate to be able to do that.”
Telehealth appointments can help fill coverage gaps, Flener said. But even while paying for the most expensive internet plan available in her county, the signal isn't always strong enough. Telehealth care is "progress, for sure," Flener said. "So, we pay for the best Wi-Fi we can get in our area, but it isn't always reliable enough to take the video calls from the VA."
As a result, veterans and their caregivers could benefit not only from the bipartisan transportation proposal, but also from a decision announced in November. The VA is proposing to eliminate copayments for all VA telehealth services and establish a grant program to fund designated VA telehealth access points in non-VA facilities, with a focus on rural and medically underserved communities.
The program, called Accessing Telehealth through Local Area Stations (ATLAS), would provide funding to organizations — including nonprofits and private businesses — to offer veterans comfortable, private spaces equipped with high-speed internet access and the technology to remotely meet with VA clinicians. Grants would also provide designated funding to train on-site personnel to support the program.
These proposed changes would advance the VA’s and the Biden-Harris Administration’s ongoing efforts to lower costs and expand access to care for veterans. They also could make a life-changing difference for the 2.7 million rural veterans enrolled in VA health care.
According to a 2024 RAND study, just under half of military and veteran caregivers live in a county without a VA facility, and nearly half live in a primary care physician shortage area. For military/veteran caregivers in particular, the survey found, reduced access to support related to the more complicated care some patients require, greater distances to reach opportunities (eg, retail, economic, or social), and even differences in Wi-Fi/broadband internet access may create “unique needs.” The survey found that 24% of rural military/veteran caregivers did not have reliable broadband internet.
“Waiving copays for telehealth services and launching this grant program are both major steps forward in ensuring veterans can access health care where and when they need it,” said VA Secretary Denis McDonough. “VA is the best and most affordable care in America for veterans — with these steps, we can make it easier for veterans to access their earned VA health care.”
The rulemaking can be viewed in the Federal Register under public inspection, and is open for comment. The VA anticipates a notice of funding opportunity for this grant program following publication of the final rule.
VA Surpasses Housing Goal for Homeless Veterans in 2024
The US Department of Veterans Affairs (VA) exceeded its 2024 goal to house 41,000 veterans, housing 47,935 veterans—an increase of 16.9% and the highest number housed in a single year since 2019. What’s more, it passed that housing goal a month early.
Ending veteran homelessness has been a priority for VA and the Biden-Harris administration. Since 2022, the VA has permanently housed nearly 134,000 homeless veterans. The number of veterans experiencing homelessness in the US has decreased by over 4% since 2020 and by more than 52% since 2010.
The marked decline in homelessness is largely due to the VA’s change in approach. Transitional housing often has followed a linear stepwise model, designed to foster housing readiness by encouraging sobriety and treatment compliance before moving the veteran to the next stage, from emergency shelter to transitional, and finally, permanent housing. While this method worked for some, it posed challenges for those with serious mental illness, substance addiction, or chronic medical conditions.
The VA began shifting its approach in 2012, adopting what it calls its north star—the evidence-based housing first approach. This strategy prioritizes getting veterans into housing as quickly as possible, skipping the intermediate transitional interventions, and then providing wraparound services such as job training and legal and education assistance. “Permanent housing is a critical tool, rather than a reward, for recovery,” says Shawn Liu, director of communications for the VA Homeless Programs Office, in a 2023 article.
A systematic review of studies from 1992 to 2017, shows that the housing first model leads to quicker exits from homelessness and greater long-term housing stability compared with traditional methods. The VA has also found that doing away with enrollment preconditions helps shorten stays among transitional housing providers, improves rates of permanent housing, and increases access to supportive services when needed.
Evidence suggests that the housing first model may reduce the use of emergency department services, hospitalizations, and hospitalized time compared with traditional treatment methods (although the meta-analysis found “considerable variability” between its examined studies). However, evidence that the Housing First model improves health outcomes associated with mental health, substance abuse, or physical health, remains inconclusive.
In 2010, a demonstration project in the VA setting compared the housing first model with a treatment‐first program for 177 homeless veterans. The study found that the housing first model reduced time to housing placement from 223 to 35 days, significantly increased housing retention rates (98% vs 86%), and significantly reduced emergency room visits.
Over the past decade, the VA has focused on building on the strengths of the program and identifying areas for improvement, such as increasing the prevalence of recovery-oriented philosophies among service providers. “Nearly 48,000 formerly homeless veterans now have a safe, stable place to call home—and there’s nothing more important than that,” said VA Secretary Denis McDonough. “No veteran should experience homelessness in this nation they swore to defend. We are making real progress in this fight, and we will not rest until veteran homelessness is a thing of the past.”
The US Department of Veterans Affairs (VA) exceeded its 2024 goal to house 41,000 veterans, housing 47,935 veterans—an increase of 16.9% and the highest number housed in a single year since 2019. What’s more, it passed that housing goal a month early.
Ending veteran homelessness has been a priority for VA and the Biden-Harris administration. Since 2022, the VA has permanently housed nearly 134,000 homeless veterans. The number of veterans experiencing homelessness in the US has decreased by over 4% since 2020 and by more than 52% since 2010.
The marked decline in homelessness is largely due to the VA’s change in approach. Transitional housing often has followed a linear stepwise model, designed to foster housing readiness by encouraging sobriety and treatment compliance before moving the veteran to the next stage, from emergency shelter to transitional, and finally, permanent housing. While this method worked for some, it posed challenges for those with serious mental illness, substance addiction, or chronic medical conditions.
The VA began shifting its approach in 2012, adopting what it calls its north star—the evidence-based housing first approach. This strategy prioritizes getting veterans into housing as quickly as possible, skipping the intermediate transitional interventions, and then providing wraparound services such as job training and legal and education assistance. “Permanent housing is a critical tool, rather than a reward, for recovery,” says Shawn Liu, director of communications for the VA Homeless Programs Office, in a 2023 article.
A systematic review of studies from 1992 to 2017, shows that the housing first model leads to quicker exits from homelessness and greater long-term housing stability compared with traditional methods. The VA has also found that doing away with enrollment preconditions helps shorten stays among transitional housing providers, improves rates of permanent housing, and increases access to supportive services when needed.
Evidence suggests that the housing first model may reduce the use of emergency department services, hospitalizations, and hospitalized time compared with traditional treatment methods (although the meta-analysis found “considerable variability” between its examined studies). However, evidence that the Housing First model improves health outcomes associated with mental health, substance abuse, or physical health, remains inconclusive.
In 2010, a demonstration project in the VA setting compared the housing first model with a treatment‐first program for 177 homeless veterans. The study found that the housing first model reduced time to housing placement from 223 to 35 days, significantly increased housing retention rates (98% vs 86%), and significantly reduced emergency room visits.
Over the past decade, the VA has focused on building on the strengths of the program and identifying areas for improvement, such as increasing the prevalence of recovery-oriented philosophies among service providers. “Nearly 48,000 formerly homeless veterans now have a safe, stable place to call home—and there’s nothing more important than that,” said VA Secretary Denis McDonough. “No veteran should experience homelessness in this nation they swore to defend. We are making real progress in this fight, and we will not rest until veteran homelessness is a thing of the past.”
The US Department of Veterans Affairs (VA) exceeded its 2024 goal to house 41,000 veterans, housing 47,935 veterans—an increase of 16.9% and the highest number housed in a single year since 2019. What’s more, it passed that housing goal a month early.
Ending veteran homelessness has been a priority for VA and the Biden-Harris administration. Since 2022, the VA has permanently housed nearly 134,000 homeless veterans. The number of veterans experiencing homelessness in the US has decreased by over 4% since 2020 and by more than 52% since 2010.
The marked decline in homelessness is largely due to the VA’s change in approach. Transitional housing often has followed a linear stepwise model, designed to foster housing readiness by encouraging sobriety and treatment compliance before moving the veteran to the next stage, from emergency shelter to transitional, and finally, permanent housing. While this method worked for some, it posed challenges for those with serious mental illness, substance addiction, or chronic medical conditions.
The VA began shifting its approach in 2012, adopting what it calls its north star—the evidence-based housing first approach. This strategy prioritizes getting veterans into housing as quickly as possible, skipping the intermediate transitional interventions, and then providing wraparound services such as job training and legal and education assistance. “Permanent housing is a critical tool, rather than a reward, for recovery,” says Shawn Liu, director of communications for the VA Homeless Programs Office, in a 2023 article.
A systematic review of studies from 1992 to 2017, shows that the housing first model leads to quicker exits from homelessness and greater long-term housing stability compared with traditional methods. The VA has also found that doing away with enrollment preconditions helps shorten stays among transitional housing providers, improves rates of permanent housing, and increases access to supportive services when needed.
Evidence suggests that the housing first model may reduce the use of emergency department services, hospitalizations, and hospitalized time compared with traditional treatment methods (although the meta-analysis found “considerable variability” between its examined studies). However, evidence that the Housing First model improves health outcomes associated with mental health, substance abuse, or physical health, remains inconclusive.
In 2010, a demonstration project in the VA setting compared the housing first model with a treatment‐first program for 177 homeless veterans. The study found that the housing first model reduced time to housing placement from 223 to 35 days, significantly increased housing retention rates (98% vs 86%), and significantly reduced emergency room visits.
Over the past decade, the VA has focused on building on the strengths of the program and identifying areas for improvement, such as increasing the prevalence of recovery-oriented philosophies among service providers. “Nearly 48,000 formerly homeless veterans now have a safe, stable place to call home—and there’s nothing more important than that,” said VA Secretary Denis McDonough. “No veteran should experience homelessness in this nation they swore to defend. We are making real progress in this fight, and we will not rest until veteran homelessness is a thing of the past.”
Funduscopy: Critical to the Right Diagnosis
It is always good to look the patient in the eye, say researchers from Texas Tech University in Odessa, Texas, and Centro Policlinico Valencia in Venezuela. They report on the case of a patient with atheroembolism, a “rare but feared complication of arteriography.” Most commonly, it affects small-diameter vessels in the skin and kidneys.
The patient, a 69-year-old man, had a history of hypertension, type 2 diabetes, and unstable angina; he had a drug-eluting stent placed in the left anterior descending coronary artery 10 days before he was admitted to the hospital. He arrived at the emergency department with intense abdominal pain, nausea, vomiting, oliguria, and pain in his legs and feet.
Physical examination revealed livedo reticularis (which is caused by small blood clots) in his left foot, and a tender abdomen. His creatinine and blood urea nitrogen levels were increased. Funduscopy showed a Hollenhorst crystal in the right inferotemporal quadrant.
He was treated with methylprednisolone, which improved the abdominal symptoms, renal function, and skin findings; then prednisone. His initial symptoms resolved over the next year.
The clinicians say the usual treatment for atheroembolism is supportive and depends on the affected organ. To their knowledge, they say, no formal studies have evaluated the use of anti-inflammatory therapies for this complication.
Funduscopy was an essential part of their examination, the researchers note, and spared the patient from invasive diagnostic studies such as biopsies. They also say that contrast-induced renal failure might have been the cause of the majority of his symptoms, but the combination of physical exam and differential diagnosis led them to the appropriate cause, as well as allowing for opportune treatment.
It is always good to look the patient in the eye, say researchers from Texas Tech University in Odessa, Texas, and Centro Policlinico Valencia in Venezuela. They report on the case of a patient with atheroembolism, a “rare but feared complication of arteriography.” Most commonly, it affects small-diameter vessels in the skin and kidneys.
The patient, a 69-year-old man, had a history of hypertension, type 2 diabetes, and unstable angina; he had a drug-eluting stent placed in the left anterior descending coronary artery 10 days before he was admitted to the hospital. He arrived at the emergency department with intense abdominal pain, nausea, vomiting, oliguria, and pain in his legs and feet.
Physical examination revealed livedo reticularis (which is caused by small blood clots) in his left foot, and a tender abdomen. His creatinine and blood urea nitrogen levels were increased. Funduscopy showed a Hollenhorst crystal in the right inferotemporal quadrant.
He was treated with methylprednisolone, which improved the abdominal symptoms, renal function, and skin findings; then prednisone. His initial symptoms resolved over the next year.
The clinicians say the usual treatment for atheroembolism is supportive and depends on the affected organ. To their knowledge, they say, no formal studies have evaluated the use of anti-inflammatory therapies for this complication.
Funduscopy was an essential part of their examination, the researchers note, and spared the patient from invasive diagnostic studies such as biopsies. They also say that contrast-induced renal failure might have been the cause of the majority of his symptoms, but the combination of physical exam and differential diagnosis led them to the appropriate cause, as well as allowing for opportune treatment.
It is always good to look the patient in the eye, say researchers from Texas Tech University in Odessa, Texas, and Centro Policlinico Valencia in Venezuela. They report on the case of a patient with atheroembolism, a “rare but feared complication of arteriography.” Most commonly, it affects small-diameter vessels in the skin and kidneys.
The patient, a 69-year-old man, had a history of hypertension, type 2 diabetes, and unstable angina; he had a drug-eluting stent placed in the left anterior descending coronary artery 10 days before he was admitted to the hospital. He arrived at the emergency department with intense abdominal pain, nausea, vomiting, oliguria, and pain in his legs and feet.
Physical examination revealed livedo reticularis (which is caused by small blood clots) in his left foot, and a tender abdomen. His creatinine and blood urea nitrogen levels were increased. Funduscopy showed a Hollenhorst crystal in the right inferotemporal quadrant.
He was treated with methylprednisolone, which improved the abdominal symptoms, renal function, and skin findings; then prednisone. His initial symptoms resolved over the next year.
The clinicians say the usual treatment for atheroembolism is supportive and depends on the affected organ. To their knowledge, they say, no formal studies have evaluated the use of anti-inflammatory therapies for this complication.
Funduscopy was an essential part of their examination, the researchers note, and spared the patient from invasive diagnostic studies such as biopsies. They also say that contrast-induced renal failure might have been the cause of the majority of his symptoms, but the combination of physical exam and differential diagnosis led them to the appropriate cause, as well as allowing for opportune treatment.
HHS Updates Decontamination Guidance With New Research
With help from researchers from the University of Hertfordshire in the United Kingdom, The US Department of Health and Human Services (HHS) has updated guidance on how best to decontaminate after mass chemical exposure. This second edition of Primary Response Incident Scene Management (PRISM) incorporates new scientific evidence on emergency self-decontamination, hair decontamination, and the interactions of chemicals with hair.
The goal of working with the University of Hertfordshire was to help emergency managers and first responders make “fundamental and fast decisions on how to save the greatest number of lives in chemical emergencies,” says Rick Bright, PhD, director of the Biomedical Advanced Research and Development Authority (BARDA).
The study included a large-scale exercise in which > 80 volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different forms of decontamination.
Notably, the research demonstrates that immediate “dry” decontamination—wiping down the victim with any absorbent material (eg, toilet paper, paper towels, wound dressings) can be highly effective on its own and can be done by affected individuals themselves under the instruction of first responders. The dry decontamination step removes up to 99% of contamination and minimizes the accumulation of hazardous material in the subsequent steps.
The new guidance also expands on the effects of the “triple protocol,” a combined decontamination strategy. The 3 steps of that protocol—dry decontamination, wet decontamination using water deluges from fire trucks, and technical decontamination—have been shown to remove 99.9% of chemical contamination. Moreover, the latest clinical evidence indicates that the 3-step approach is faster and more effective than traditional methods for treating chemically contaminated patients.
The guideline also addresses how communities can prepare for chemical emergencies and what to do after the event, such as providing washcloths, towels, blankets, and temporary clothing.
Federal experts and the researchers devised the Algorithm Suggesting Proportionate Incident Response Engagement (ASPIRE), a decision-support tool to help emergency management planners and responders decide which decontamination approach suits a given situation. Using the algorithm, they can tailor plans and responses based on the chemical and type of exposure, how quickly the chemical evaporates, and the amount of time passed since exposure.
ASPIRE and the guidance are integrated into the Chemical Hazards Emergency Medical Management (CHEMM), a web-based resource and suite of preparedness and emergency response tools. The developers also plan to incorporate them into a mobile app.
PRISM is available at www.medicalcountermeasures.gov.
With help from researchers from the University of Hertfordshire in the United Kingdom, The US Department of Health and Human Services (HHS) has updated guidance on how best to decontaminate after mass chemical exposure. This second edition of Primary Response Incident Scene Management (PRISM) incorporates new scientific evidence on emergency self-decontamination, hair decontamination, and the interactions of chemicals with hair.
The goal of working with the University of Hertfordshire was to help emergency managers and first responders make “fundamental and fast decisions on how to save the greatest number of lives in chemical emergencies,” says Rick Bright, PhD, director of the Biomedical Advanced Research and Development Authority (BARDA).
The study included a large-scale exercise in which > 80 volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different forms of decontamination.
Notably, the research demonstrates that immediate “dry” decontamination—wiping down the victim with any absorbent material (eg, toilet paper, paper towels, wound dressings) can be highly effective on its own and can be done by affected individuals themselves under the instruction of first responders. The dry decontamination step removes up to 99% of contamination and minimizes the accumulation of hazardous material in the subsequent steps.
The new guidance also expands on the effects of the “triple protocol,” a combined decontamination strategy. The 3 steps of that protocol—dry decontamination, wet decontamination using water deluges from fire trucks, and technical decontamination—have been shown to remove 99.9% of chemical contamination. Moreover, the latest clinical evidence indicates that the 3-step approach is faster and more effective than traditional methods for treating chemically contaminated patients.
The guideline also addresses how communities can prepare for chemical emergencies and what to do after the event, such as providing washcloths, towels, blankets, and temporary clothing.
Federal experts and the researchers devised the Algorithm Suggesting Proportionate Incident Response Engagement (ASPIRE), a decision-support tool to help emergency management planners and responders decide which decontamination approach suits a given situation. Using the algorithm, they can tailor plans and responses based on the chemical and type of exposure, how quickly the chemical evaporates, and the amount of time passed since exposure.
ASPIRE and the guidance are integrated into the Chemical Hazards Emergency Medical Management (CHEMM), a web-based resource and suite of preparedness and emergency response tools. The developers also plan to incorporate them into a mobile app.
PRISM is available at www.medicalcountermeasures.gov.
With help from researchers from the University of Hertfordshire in the United Kingdom, The US Department of Health and Human Services (HHS) has updated guidance on how best to decontaminate after mass chemical exposure. This second edition of Primary Response Incident Scene Management (PRISM) incorporates new scientific evidence on emergency self-decontamination, hair decontamination, and the interactions of chemicals with hair.
The goal of working with the University of Hertfordshire was to help emergency managers and first responders make “fundamental and fast decisions on how to save the greatest number of lives in chemical emergencies,” says Rick Bright, PhD, director of the Biomedical Advanced Research and Development Authority (BARDA).
The study included a large-scale exercise in which > 80 volunteers were dosed with a chemical warfare agent simulant to quantify the efficacy of different forms of decontamination.
Notably, the research demonstrates that immediate “dry” decontamination—wiping down the victim with any absorbent material (eg, toilet paper, paper towels, wound dressings) can be highly effective on its own and can be done by affected individuals themselves under the instruction of first responders. The dry decontamination step removes up to 99% of contamination and minimizes the accumulation of hazardous material in the subsequent steps.
The new guidance also expands on the effects of the “triple protocol,” a combined decontamination strategy. The 3 steps of that protocol—dry decontamination, wet decontamination using water deluges from fire trucks, and technical decontamination—have been shown to remove 99.9% of chemical contamination. Moreover, the latest clinical evidence indicates that the 3-step approach is faster and more effective than traditional methods for treating chemically contaminated patients.
The guideline also addresses how communities can prepare for chemical emergencies and what to do after the event, such as providing washcloths, towels, blankets, and temporary clothing.
Federal experts and the researchers devised the Algorithm Suggesting Proportionate Incident Response Engagement (ASPIRE), a decision-support tool to help emergency management planners and responders decide which decontamination approach suits a given situation. Using the algorithm, they can tailor plans and responses based on the chemical and type of exposure, how quickly the chemical evaporates, and the amount of time passed since exposure.
ASPIRE and the guidance are integrated into the Chemical Hazards Emergency Medical Management (CHEMM), a web-based resource and suite of preparedness and emergency response tools. The developers also plan to incorporate them into a mobile app.
PRISM is available at www.medicalcountermeasures.gov.
Thyroid Hormones Predict Readmission After Aortic Surgery
Thoracic endovascular aortic repair (TEVAR) is a “young technology with several unknowns,” say researchers from Shantou University Medical College, and Wuhan Asia Heart Hospital, both China. One of those unknowns is the risk factors for prognosis after TEVAR.
After all, thyroid hormones are critical to many areas of heart health, such as vascular remodeling; hypothyroidism can aggravate hypertension; and low levels of free thyroxine (FT4) influence arterial stiffness and C-reactive protein. In spite of the many links, however, the relationship between subclinical hypothyroidism and cardiovascular disease has not been fully elucidated, the researchers say. They conducted a study to evaluate whether thyroid hormones predicted early (30 days) and mid-term (12 months) aorta-related adverse events (AEs), such as death, progression of aortic disease, organ failure, or lower limb ischemia; and aorta-related readmissions.
In their study, 338 patients were stratified according to their levels of FT4 before undergoing TEVAR. Of the enrolled patients, 288 were followed up at 12 months for readmission; 292 were followed up on AEs.
Patients with low normal levels of FT4 had a greater risk of readmission after thoracic endovascular aortic repair. Within 30 days, the incidence of AEs and readmission were 2.7% and 4.1%; within 12 months, 8.9% and 13.5%. After the researchers adjusted for confounders, the patients with the lowest FT4 quartile were at significantly greater risk for readmission than those in the highest-quartile group, at both early and mid-term follow-up.
The same did not hold true for AEs. The researchers say this is not uncommon in studies of predictors of AEs and readmission: Factors that are weak predictors of readmission tend to be strong predictors of AEs, and vice versa.
Thoracic endovascular aortic repair (TEVAR) is a “young technology with several unknowns,” say researchers from Shantou University Medical College, and Wuhan Asia Heart Hospital, both China. One of those unknowns is the risk factors for prognosis after TEVAR.
After all, thyroid hormones are critical to many areas of heart health, such as vascular remodeling; hypothyroidism can aggravate hypertension; and low levels of free thyroxine (FT4) influence arterial stiffness and C-reactive protein. In spite of the many links, however, the relationship between subclinical hypothyroidism and cardiovascular disease has not been fully elucidated, the researchers say. They conducted a study to evaluate whether thyroid hormones predicted early (30 days) and mid-term (12 months) aorta-related adverse events (AEs), such as death, progression of aortic disease, organ failure, or lower limb ischemia; and aorta-related readmissions.
In their study, 338 patients were stratified according to their levels of FT4 before undergoing TEVAR. Of the enrolled patients, 288 were followed up at 12 months for readmission; 292 were followed up on AEs.
Patients with low normal levels of FT4 had a greater risk of readmission after thoracic endovascular aortic repair. Within 30 days, the incidence of AEs and readmission were 2.7% and 4.1%; within 12 months, 8.9% and 13.5%. After the researchers adjusted for confounders, the patients with the lowest FT4 quartile were at significantly greater risk for readmission than those in the highest-quartile group, at both early and mid-term follow-up.
The same did not hold true for AEs. The researchers say this is not uncommon in studies of predictors of AEs and readmission: Factors that are weak predictors of readmission tend to be strong predictors of AEs, and vice versa.
Thoracic endovascular aortic repair (TEVAR) is a “young technology with several unknowns,” say researchers from Shantou University Medical College, and Wuhan Asia Heart Hospital, both China. One of those unknowns is the risk factors for prognosis after TEVAR.
After all, thyroid hormones are critical to many areas of heart health, such as vascular remodeling; hypothyroidism can aggravate hypertension; and low levels of free thyroxine (FT4) influence arterial stiffness and C-reactive protein. In spite of the many links, however, the relationship between subclinical hypothyroidism and cardiovascular disease has not been fully elucidated, the researchers say. They conducted a study to evaluate whether thyroid hormones predicted early (30 days) and mid-term (12 months) aorta-related adverse events (AEs), such as death, progression of aortic disease, organ failure, or lower limb ischemia; and aorta-related readmissions.
In their study, 338 patients were stratified according to their levels of FT4 before undergoing TEVAR. Of the enrolled patients, 288 were followed up at 12 months for readmission; 292 were followed up on AEs.
Patients with low normal levels of FT4 had a greater risk of readmission after thoracic endovascular aortic repair. Within 30 days, the incidence of AEs and readmission were 2.7% and 4.1%; within 12 months, 8.9% and 13.5%. After the researchers adjusted for confounders, the patients with the lowest FT4 quartile were at significantly greater risk for readmission than those in the highest-quartile group, at both early and mid-term follow-up.
The same did not hold true for AEs. The researchers say this is not uncommon in studies of predictors of AEs and readmission: Factors that are weak predictors of readmission tend to be strong predictors of AEs, and vice versa.