Journal article
Changing rural‐urban and racial patterns in VA tele‐mental health use among women Veterans, 2019–2022
The Journal of rural health, Vol.41(4), e70097
09/01/2025
DOI: 10.1111/jrh.70097
PMID: 41376288
Abstract
Purpose To assess whether women veterans accessed synchronous video telehealth for mental health (SVT‐MH) similarly by (1) rurality, (2) race, and (3) race within rural and urban settings. Methods This retrospective cohort study used VA administrative data to examine temporal trends in outpatient VA mental health use from January 1, 2019, through December 31, 2022—a period spanning the pre‐ and post‐COVID‐19 pandemic. The cohort included VA‐enrolled women veterans ages 18–60 years with at least one outpatient mental health visit delivered by a VA provider in‐person (VA‐MH) or via SVT‐MH. Outcomes included (1) any SVT‐MH use and (2) annual SVT‐MH visit counts. Models adjusted for demographics and used Bayesian logistic and Poisson regression to estimate effects and interactions over time. Findings SVT‐MH use increased from 7% in 2019 to 32% in 2022. Rural women Veterans initially had higher SVT‐MH use, but by 2022, urban women had higher use and visit counts. Black and Hispanic women Veterans showed the largest increases, especially in urban areas. American Indian and Alaska Native (AIAN) women Veterans were the only group without significant rural‐urban differences in 2022, though they had lower overall visit counts. Conclusions SVT‐MH use among women veterans increased substantially during the study period, with rural‐urban gaps narrowing over time. These findings suggest SVT‐MH differences may shift rapidly based on infrastructure, outreach, and policy implementation. Ongoing monitoring and tailored strategies are needed to ensure fair access to SVT‐MH for all veterans, especially for AIAN and rural women veterans.
Details
- Title: Subtitle
- Changing rural‐urban and racial patterns in VA tele‐mental health use among women Veterans, 2019–2022
- Creators
- Michelle A. Mengeling - Iowa City VA Health Care SystemAdam Batten - San Francisco VA Health Care SystemM. Bryant Howren - Iowa City VA Health Care SystemB. Josea Kramer - Geriatric Research Education and Clinical CenterKelly R. Miell - Iowa City VA Health Care SystemHeather Davila - University of IowaAnne G. Sadler - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.41(4), e70097
- DOI
- 10.1111/jrh.70097
- PMID
- 41376288
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Publisher
- WILEY
- Number of pages
- 10
- Grant note
- Department of Veterans Affairs, Veterans Health Administration, Office of Rural Health, Veterans Rural Health Resource Center – Iowa City (NOMAD PROJ‐04117)
- Language
- English
- Date published
- 09/01/2025
- Academic Unit
- Psychiatry; Injury Prevention Research Center; General Internal Medicine; Internal Medicine
- Record Identifier
- 9985091812402771
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