Honoring Veterans Through Improved Access & Care Coordination – Michigan Health & Hospital Association

Report on Enhancing Healthcare for Military Veterans in Alignment with Sustainable Development Goals

Introduction: A Commitment to SDG 3 and SDG 10

Improving health outcomes for military service members and their families is a critical objective that aligns with several United Nations Sustainable Development Goals (SDGs). This report outlines the unique health challenges faced by the veteran community and proposes strategic interventions for healthcare organizations. The primary focus is on achieving SDG 3 (Good Health and Well-being) by ensuring access to quality healthcare and promoting mental health, and SDG 10 (Reduced Inequalities) by addressing the specific needs of this distinct population group.

Analysis of Veteran Health Challenges and Systemic Gaps

The Post-Service Health Landscape: An SDG 3 Perspective

Veterans and active service members frequently encounter significant health and well-being challenges upon returning to civilian life. These challenges represent a critical area of focus for achieving the targets within SDG 3, particularly those related to mental health and universal health coverage.

• Common Health Issues: A high prevalence of conditions such as post-traumatic stress disorder, anxiety, depression, substance use disorder, chronic pain, and traumatic brain injuries is observed.
• Military Service as a Health Indicator: There is a growing advocacy to formally recognize military service as a key social determinant of health, acknowledging the profound impact of service environments on long-term well-being.

Fragmented Care and Access to Benefits

Systemic fragmentation presents a significant barrier to care, undermining progress toward universal health access as outlined in SDG 3. Data indicates that approximately 50% of veterans seek medical care from non-VA facilities, and less than half are connected to their full earned benefits. This necessitates improved infrastructure and partnerships, a goal supported by SDG 9 (Industry, Innovation and Infrastructure) and SDG 17 (Partnerships for the Goals). Health systems must enhance the identification of military service members through integrated electronic health records and foster greater care coordination between VA and non-VA facilities.

Strategic Recommendations for Healthcare Systems

Improving Identification and Support Mechanisms

To effectively connect veterans with appropriate resources, a systematic approach is required. The following strategies are recommended to reduce inequalities (SDG 10) and build resilient health infrastructure (SDG 9).

1. Adopt Inclusive Screening Language: Utilize the recommended screening question, “Have you or has someone close to you ever served in the military?” This inclusive language identifies not only service members who may not self-identify as “veterans” but also spouses and caregivers who may require support.
2. Integrate Standardized Screening Tools: Implement standardized tools for assessing medical and social needs, such as PRAPARE, to ensure providers can identify service-related health concerns systematically.
3. Build Organizational Capacity through Education and Partnerships: Move beyond simple identification by investing in staff training on best practices for veteran care. Fostering strong partnerships with local VA hospitals and networks, as exemplified by initiatives like the Veteran Interoperability Pledge, is crucial for achieving SDG 17 (Partnerships for the Goals).

Fostering Collaborative Action through SDG 17: Partnerships for the Goals

Legislative and Community-Based Initiatives

Multi-stakeholder partnerships are fundamental to creating a comprehensive support system for veterans. Michigan hospitals demonstrate this commitment through tailored patient care, research, and support for legislation like the Veterans Comprehensive Prevention, Access to Care and Treatment (COMPACT) Act of 2020. This act, which allows eligible veterans to receive emergent suicide care at any facility at no cost, is a prime example of a public-private partnership advancing SDG 3.

Key Resources and Networks

Effective collaboration relies on leveraging existing networks and resources. Organizations and initiatives that exemplify the spirit of SDG 17 include:

• The Michigan Veterans Affairs Agency
• The Michigan Center for Rural Health I-REACH (Improving Veterans Access to Healthcare) program

These entities serve as vital connectors, linking veterans and their families to essential, life-saving services and support, thereby contributing directly to the goals of ensuring good health, reducing inequality, and building strong institutional partnerships.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being

   This is the primary SDG addressed in the article. The entire text focuses on improving the health outcomes of veterans and their families by addressing specific physical and mental health challenges. The article highlights issues such as post-traumatic stress disorder, anxiety, depression, substance use disorder, suicidal ideation, and chronic pain, all of which fall directly under the purview of ensuring healthy lives and promoting well-being.

2. SDG 10: Reduced Inequalities

   The article implicitly addresses SDG 10 by focusing on a specific, and often vulnerable, population group—veterans. It points out the inequalities they face in accessing healthcare, noting that “less than 50% are connected to all of their earned benefits” and that they must navigate “fragmented healthcare systems.” By advocating for military service to be recognized as a health indicator and calling for tailored care, the article aims to reduce these inequalities and ensure this group has equal access to necessary health services.

3. SDG 17: Partnerships for the Goals

   The article strongly emphasizes the need for collaboration to achieve its goals. It calls for healthcare organizations to “meaningfully work together” and highlights the importance of “coordination of care across VA and non-VA healthcare facilities.” Furthermore, it mentions the value of “local community partnerships and fostering strong relationships with local VA hospitals,” as well as collaborations with entities like the Michigan Center for Rural Health and the Michigan Veterans Affairs Agency. This focus on multi-stakeholder collaboration is the core of SDG 17.

2. What specific targets under those SDGs can be identified based on the article’s content?

Targets under SDG 3: Good Health and Well-being

• Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
  
  Explanation: The article directly addresses this target by focusing on the need to treat mental health issues common among veterans, such as “post-traumatic stress disorder, anxiety, depression, [and] suicidal ideation.” The support for the COMPACT Act, which provides “emergent suicide care,” is a clear action towards promoting mental health and preventing premature mortality.
• Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.
  
  Explanation: The article explicitly lists “substance use disorder” as a common challenge faced by veterans. The call to improve identification and connect veterans with the right resources directly supports the strengthening of treatment for substance abuse.
• Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
  
  Explanation: The article discusses the fragmentation of the healthcare system for veterans and the fact that many seek care outside the VA. The advocacy for better coordination and connection to benefits aims to improve access to quality healthcare. The COMPACT Act, which allows veterans to receive suicide care “at no cost,” is a direct example of providing financial risk protection.

Targets under SDG 10: Reduced Inequalities

• Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
  
  Explanation: Veterans can be considered a group with “other status” who face unique barriers. The article’s goal is to ensure their inclusion in the healthcare system by advocating for specific screening questions (“Have you or has someone close to you ever served in the military?”) and tailored care pathways, thereby empowering them to access the benefits and support they need.

Targets under SDG 17: Partnerships for the Goals

• Target 17.17: Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships.
  
  Explanation: This target is reflected in the article’s call for “coordination of care across VA and non-VA healthcare facilities” (public-private partnership) and the mention of “local community partnerships” (civil society partnership). The article spotlights various organizations working together, such as the MHA, Michigan hospitals, the Michigan Veterans Affairs Agency, and the Michigan Center for Rural Health, as examples of such effective partnerships.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Implied Indicator for Target 3.4 (Suicide mortality rate): The article’s focus on “suicidal ideation” and the COMPACT Act for “emergent suicide care” implies that a key metric for success would be a reduction in the suicide rate among veterans.
• Implied Indicator for Target 3.8 (Proportion of population with access to essential health services): The article provides a baseline metric by stating that “less than 50% [of veterans] are connected to all of their earned benefits.” An increase in this percentage would serve as a direct indicator of improved access to healthcare services for this population.
• Implied Indicator for Target 10.2 (Proportion of population included in healthcare systems): The statistic that “approximately 50% of veterans seek medical care from non-VA facilities” highlights a gap in coordinated care. Progress could be measured by the rate of adoption of integrated screening for military service within electronic health records in both VA and non-VA facilities, indicating a more inclusive system.

4. Table of SDGs, Targets, and Indicators

Source: mha.org