Primary Users of the VA Health Care System: Prevalence, Correlates, and Implications for Care Delivery.

Objective

To examine the sociodemographic and clinical profiles of veterans who primarily rely on the US Department of Veterans Affairs (VA) health care system for their care.

Methods

Data were analyzed from a nationally representative sample of 4,069 US military veterans who participated in the National Health and Resilience in Veterans Study in 2019-2020.

Results

Overall, 20.5% of veterans reported using the VA as their primary source of health care. Compared to non-VA users, these veterans were more likely to be younger, unmarried or unpartnered, and black/African American and to have lower household incomes (≤$60,000 annually). They also reported greater cumulative trauma exposure and were more likely to have a history of depression, posttraumatic stress disorder, and chronic medical conditions such as chronic pain, sleep disorders, and respiratory illnesses.

Conclusion

VA health care serves a distinct and vulnerable subgroup of veterans who experience more complex psychiatric and medical needs, as well as greater financial insecurity, compared to non-VA users. These findings underscore the importance of expanding comprehensive, integrated services that address both physical and mental health conditions while accounting for socioeconomic factors to better meet the needs of veterans who rely on VA health care. Prim Care Companion CNS Disord 2026;28(3):25m04176. Author affiliations are listed at the end of this article.