VA Health Care Utilization Among U.S. Veterans: The Influence of Social Determinants of Health and Health Factors.

OBJECTIVE

The authors aimed to use data on social determinants of health (SDOH) and health characteristics to differentiate users of VA health care from nonusers in order to inform clinical and policy decisions.

METHODS

Data from 2,636 U.S. veterans in a national study (2025-2026) were analyzed to assess trends in use of VA health care, as well as the SDOH and health characteristics associated with primary use of such care.

RESULTS

Primary use of VA health care was higher in 2025-2026 (27%) than in 2011 (17%) and 2019-2020 (21%; all p<0.001). The strongest correlates of primary use included lifetime psychiatric disorders (relative variance explained [RVE]=17%), younger age (RVE=16%), combat service (RVE=15%), and medical conditions (RVE=10%). Prior homelessness, greater neighborhood deprivation, and lower household income collectively explained an additional 27% of variance.

CONCLUSIONS

SDOH were strongly associated with VA health care use, even after adjustment for major psychiatric and general medical variables.