Differential mortality among US veterans: Social determinants of health, substance use disorder, and substance use treatment
Rattachement africain : us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND AND OBJECTIVES: Veterans face disproportionate suicide and mortality risks driven by intersecting social determinants of health (SDH), including housing instability, unemployment, and justice involvement, and co-occurring substance use disorders (SUD). This study examined how these intersecting factors influence mortality and whether SUD treatment mitigated mortality risks among US veterans. METHODS: Using national Veterans Health Administration data (2014-2019), we identified 215,944 veterans with SUD and an indicator of one of three adverse SDH: housing instability, justice involvement, or unemployment. We tracked suicide and all-cause mortality for 1 year following SDH exposure. We used discrete-time survival models to assess associations between month-specific SUD treatment and mortality outcomes, controlling for demographic, clinical (i.e., mental health conditions, suicidal behavior), and contextual covariates. RESULTS: Nearly half of veterans (48%) received SUD treatment. Those who received treatment had lower all-cause mortality (2.1% vs. 4.3%; p < .001) but no significant difference in suicide mortality (0.14% vs. 0.15%; p = .75). [Correction added on 22 April 2026, after first online publication: The preceding sentence has been revised in this version.] SUD treatment was associated with a 24% (aOR = 1.24; 95% CI: 1.16-1.34) reduction in all-cause mortality, though its interaction with each adverse SDH was not statistically significant. Suicide deaths remained concentrated among White veterans, those aged 18-34, with no service connection, and with time-varying suicidal ideation or attempts (p < .001). DISCUSSION AND CONCLUSIONS: Engagement in SUD treatment reduces all-cause mortality among veterans facing compounded social adversity but does not independently mitigate suicide deaths. SCIENTIFIC SIGNIFICANCE: Integrated approaches that embed suicide prevention within addiction and SDH-focused care are essential to address the multifactorial drivers of veterans' suicidal mortality.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Differential mortality among US veterans: Social determinants of health, substance use disorder, and substance use treatment
- Date Crossref
- 03/04/2026
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Alabama at Birmingham Department of Health Behavior pays non établi dans la noticeUniversité ou école supérieure
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Birmingham VA Medical Center pays non établi dans la noticeÉtablissement de santé
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University of Southern California pays non établi dans la noticeUniversité ou école supérieure
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VA Pittsburgh Healthcare System pays non établi dans la noticeÉtablissement de santé
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Southeast Louisiana Veterans Health Care System pays non établi dans la noticeÉtablissement de santé
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Louisiana State University Health Sciences Center New Orleans pays non établi dans la noticeÉtablissement de santé
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Birmingham VA Health Care System Birmingham Alabama USA pays non établi dans la noticeInstitution
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Louisiana State University Health Science Center New Orleans Louisiana USA pays non établi dans la noticeUniversité ou école supérieure
Department of Health Behavior — University of Alabama at Birmingham, Birmingham VA Medical Center et University of Southern California, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.