When America leaves veterans behind

Major William Jung shines a light on veteran inequality and helps advise on what America can do to support our service members

INTERESTING ON THE WEB:

• I published an article in Business Insider on the most expensive cities for childcare and what we can do about it - Business Insider

• We had the awesome opportunity to partner with The Beeck Center at Georgetown to visualize how ID requirements can hinder access to state benefits - Digital Benefits Hub and SNAP example

• Employment in the nonprofit sector has grown 33% over the last 15 years, with cool maps about where growth is greatest (Psst: it’s Vermont) - Washington Post

• Black unemployment falls below 5% for the first time since this data was first collected in 1972 - WSJ

Major William Jung is an Army officer with over a decade of service who is currently assigned to the U.S. Army Command and General Staff College at Fort Leavenworth, Kansas. The views expressed are those of the author and do not reflect the official policy or position of the U.S. Army, Department of Defense, or the U.S. Government.

22 veterans die from suicide every day. 1 in every 7 suicides in America is a veteran. This is more than twice as high as one would expect based on how many Veterans are part of the US population (1 in 16 Americans are veterans). With Memorial Day right behind us, it’s time to reflect on veterans and inequality.

Why can’t we give Veterans the support that they deserve? When it comes to inequality in life expectancy, the Americans whom we ask to put their lives on the line are the ones who often have to sacrifice the most when they return from combat. 

Major William Jung with his unit in Paktika Province, Afghanistan circa 2012

Opportunity for Americans returning from war

The US has 18 million Veterans who have fought in wars ranging from WW2 (200,000 veterans) to the prolonged fighting in the gulf region (7 million veterans).  

Veteran earnings outpace that of non-veterans by more than $12,000 annually. Asian Veterans are the only demographic that don’t make more than their non-Veteran peers. 

The U.S. government does provide extensive benefits to veterans. Veterans receive billions of dollars of benefits in college assistance, favorable loan terms, job training, better life insurance, disability benefits, spousal benefits, and caregiver support. As American Inequality has discussed previously, these benefits may be the reason that many Americans join the military: it provides a meaningful way (and usually the only way) to get ahead.  

Despite the fact that many veterans earn high incomes, the data shows growing inequality in outcomes as many veterans end up homeless. While roughly 7% of the US population is homeless, 13% of the veteran population is homeless. The U.S. Department of Housing and Urban Development (HUD) estimates that 40,056 veterans are homeless on any given night. With that said, progress is being made as the number of homeless Veterans has fallen by half in the last 10 years. 

According to a study published by the Department of Veterans Affairs (VA), approximately 70-78% of homeless veterans were in the pay-grades of E1 through E4, which corresponds to the lowest four ranks in the military. Many veterans who leave service as E1-E4 are generally those who enlisted soon after graduating high school and served only their initial contract of 2-4 years. While in service, the military would have generally provided for most living essentials, such as housing in the barracks, meals from the dining facilities, and reliable paychecks. Due to their short service however, Service Members leaving the military as E1-E4 generally would not have had the time to take full advantage of education programs that are designed to prepare Service Members for civilian life. For example, only 3.9% of Service Members ranked E1-E4 have a bachelor degree or higher. Additionally, about 30% of enlisted Service Members are involuntarily separated from the military, which results in loss of a range of veteran services. Transitioning back to being a civilian can be particularly hard for this group. 

Veterans and Suicide

Although veteran suicides have declined over the last two years as several impactful policies have helped provide the support needed to America’s Service Members, many problems still persist. Most significantly, 70% of veteran suicides occur with a firearm. 

It is an annual requirement for all army Service Members to receive a suicide prevention training. Each unit leader is also required to train and maintain a certain number of suicide prevention specialists who attend a more rigorous suicide prevention training. The role of these suicide prevention specialists is to train other soldiers on how to identify signs of suicidal ideation, how to verify suicidal ideation, and how to provide help for soldiers with suicidal ideation. Unfortunately, the tragedy still persists and one suicide is one too many. While in service, a soldier is always under constant eye, from leaders, peers, and subordinates, who can watch for any indications for trouble, as a veteran, they are surrounded by people who likely did not receive training on suicide prevention and may not be prepared to prevent a suicide. 

Nearly 1 in 3 people in Geary County, Kansas is a veteran, the highest in the US. Fort Riley is located in Geary and is one of America’s largest military bases (it actually has its own zip code), covering 100,000 acres and hosting 25,000 personnel. The suicide rate in the county has been increasing for years and is almost double the state’s average. 

Major William Jung shares his reflections on veteran suicide and Fort Riley:

I can’t think of any Service Member who has not been affected by suicide. Personally, I have lost many close friends and mentors due to suicide. Coincidentally, the three closest people who I lost due to suicide were all related to Fort Riley, which also happens to be my first duty station. 

I lost my Platoon Sergeant, who was my advisor and mentor in Afghanistan, due to suicide. He had retired after our deployment and lived near Fort Riley. 

I lost a friend who sat next to me during Captain Career Course (CCC), which is a six-month long training program for newly promoted Captains. He had just been assigned to Fort Riley for a few weeks after completing CCC, when he was found alone in his apartment with a self-inflicted wound. 

I lost a classmate from West Point who I served with in the same Battalion at Fort Riley. He had left the Army and was attending Yale Law School when he died by suicide. 

Montana, Utah, Nevada and New Mexico are the states with the highest rates of veteran suicide. Veterans in these states often need to drive more than 70 miles to reach the nearest VA medical center. The suicide rates in those four states stood at 60 per 100,000 individuals, far above the national veteran suicide rate of 38.4.

The Department of Veterans Affairs indicates that Veterans who experience head trauma are twice as likely to die by suicide. 

Veterans living in rural areas are 20% more likely to die by suicide than those living in urban areas. This is largely due to access to suicide care and distance to hospitals. 1 in 10 veterans has also been diagnosed with a substance abuse disorder. 

In the Army, 47.9% of active duty soldiers live in four southern states, and in those regions they tend to live in rural areas. Texas, Georgia, North Carolina, and Kentucky are home to nearly 1 in 2 active duty soldiers. These States often have loose gun laws as well and gun ownership is a big part of Veterans’ culture, which does not help with suicide prevention.

Suicide rates for veterans in the LGBTQ+ community is 7x higher than for non-LGBTQ+ veterans. The US military’s long history of “don’t-ask, don’t-tell” created feelings of isolation and exclusion for many members of the military, but was fortunately repealed in 2011. 

Black and White Veterans have very different outcomes

Following WWII, the U.S. experienced the greatest expansion of the middle class in its history, in large part due to the G.I. Bill. The G.I. Bill offered free college and cheap home loans to millions of veterans, the only problem was that in 1945 America was still deeply segregated. 

1,154,486 Black Americans served in WWII, but only a tiny fraction of them received G.I. Bill benefits. This is because Southern legislators at the time ensured that even though the Bill would be federally funded, those funds would be administered locally. This meant that in the 18 states where segregation was still the law of the land, Black veterans were unlikely to get aid. In 1947, only 2 of the 3,200 VA-guaranteed home loans in Mississippi went to Black borrowers

Unfortunately, Black veterans often still do not get the support that they need. Black veterans receive only 40% of the value of benefits that White veterans receive, and Black veterans seeking disability benefits for post-traumatic stress disorder (PTSD) were denied 57% of the time, compared to 43% for White veterans.

Black Americans comprise 10.4% of active-duty military personnel, but they represent 40.2% of the homeless veteran population.

The Path Forward

We know programs that can work to help reduce inequality in outcomes for Veterans and we know which service members may be the most vulnerable. Technology and safety equipment has dramatically improved the likelihood that Service Members will return home from war. With the end of the wars in Iraq and Afghanistan, the US needs to continue to care for this returning population. While many will come home with tremendous training and endurance, many still may come home with injuries, disabilities, trauma, or mental health issues. 

4 policies will ensure that we can care for veterans most in need. 

• Proactive suicide intervention  - Half of veteran suicides occur among individuals who have had no Veterans Health Administration (VHA) contact. As mentioned earlier, veterans who experience head trauma are twice as likely to die by suicide. We know some of the predictors ex-ante that can lead to heightened risk. It’s time for more early intervention and to acknowledge that the problems are there. Mental health, physical health, and life expectancy aren’t connected. Programs like REACH-VET identify at-risk veterans and engage them to provide suicide preventative measures. REACH-VET has proven to identify vets who are 30-60x more likely to die by suicide. This program, coupled with the Safety Planning in Emergency Departments (SPED) can assist veterans in their most trying times. SPED has found a reduction in suicidal behaviors by 45% in the 6 months following emergency department visits. 

• Federal, state, local agency collaboration for ending homelessness - I read through dozens of reports on how cities failed or succeeded to end veterans homelessness and the #1 action that worked across areas was collaborating across local agencies. Homelessness is not only about the home - it is also about jobs, healthcare, childcare, social services, and more. When Houston started collaborating across agencies instead of providing start-stop measures or disjointed care, the city was able to decrease homelessness by 55% and house 3,650 homeless veterans. Given the relatively smaller size of homeless veteran populations in cities, lists that better track these individuals by name (known as “name lists”) have proven to be effective at monitoring how well Veterans are doing, where they’re being housed, and making sure that they are treated like humans and not statistics. 

• State requirements for veteran employment - 9 states have requirements for interviewing veterans for public positions. The Texas Military Veterans’ Full Employment Act of 2015 sets a minimum 20% veteran hiring goal for each state agency. These practices not only help veterans earn higher wages, but it also helps reduce suicide rates and decrease homelessness. Every 1% increase in employment for veterans decreases suicide rates by 1%-1.6%. 

• Better transition requirements - The Army has a transition program called Soldiers for Life - Transition Assistance Program (SFL-TAP), which does an exceptional job at supporting soldiers as they leave their military service. But the execution of SFL-TAP is at the unit level, and unit leaders don’t always prioritize the importance of enrolling in the program, especially if it can create a broader challenge for that unit’s mission. TSFL-TAP needs to be prioritized to ensure that upstream interventions can be effective for helping veterans. 

Veterans deserve the very best care from America. It isn’t enough to help pay for college, it isn’t enough to create job support, and it isn’t enough to thank them for their service, or dedicate a federal holiday. When we ask Americans to make sacrifices for their country, we cannot leave them without care. As the Centers for Disease Control (CDC) explained, “Comprehensive suicide prevention requires the coordination of public health, healthcare, jobs and economic development, education, housing and other sectors.” Care for veterans will require working across agencies to have hard conversations about the imperative goals that we set out for veterans across the US. 

In the army, soldiers are always surrounded by a support structure, from other soldiers to various programs, but in the civilian world, one is often left alone. This struggle can be compounded if a soldier deploys and leaves the service within their initial contract. If a soldier experienced a traumatic brain injury (TBI) or some other mental issue during deployment, the soldier is surrounded by leaders and peers who can watch for signs and get the help that they need, even forcing soldiers to get help through the command-directed policy when necessary. When a soldier leaves the Army, however, it is up to that soldier to seek help. And asking for help can be hard.