Updates from the VA Office of Health Equity

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January 10, 2018

Continuing the Journey to Advance Health Equity for Veterans in 2018

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As we kick-off the new calendar year, the VA Office of Health Equity (OHE) is delighted to share our efforts during the last fiscal year in championing health equity for Veterans. We continue to make great strides in furthering Veteran health equity through partnerships and direct action on behalf of our nation's heroes. Thank you for continuing to engage and make Veteran health equity your business in 2018.

  • OHE published the National Veterans Health Equity Report, which is now available for downloading onto your mobile device via an ePUB version via the OHE website and the following online bookstores: Apple, Barnes and Nobles, and Google.  

  • OHE released Virtual Training Modules to assist clinicians, non-clinicians, Veterans, and stakeholders in understanding the importance of assessing, and increasing competency, of health equity issues for Veterans of all races and ethnicities. 

Register for February’s Focus on Health Equity and Action Cyberseminar titled Pursuing Health Equity for Veterans with a Dedicated National Program Office—Five Years in Review

Some progress is being made to advance health equity for Veterans. Unfortunately, but consistent with the general U.S. population, health disparities and inequities continue to be documented for Veterans regardless of where they receive their care. The VA Office of Health Equity (OHE) was established in the VHA in 2012 as a national program office and given the immediate charge to map VA’s pursuit of Veteran health equity. February’s Focus on Health Equity and Action Cyberseminar will review VA efforts over the last 5 years to advance health equity for Veterans since the establishment of OHE. Presenters will discuss VA’s progress in implementing VA’s strategic plan to advance health equity; OHE supported activities in advancing research, partnerships and tools; and future actions to ensure all Veterans have access and receive high quality, timely, and equitable care.

Pursuing Health Equity for Veterans with a Dedicated National Program Office—Five Years in Review

Thursday, February 22, 2018

3:00 – 4:00 PM EST


Learning Objectives

  1. Describe the development of a national program in the VA to advance Veteran health equity;

  2. Identify strategic goals and metrics of the VA Health Equity Action Plan related to leadership, research, and partnerships to advance health equity; and

  3. Discuss future research, quality improvement efforts, and other actions to reduce and/or eliminate Veteran health disparities.

Confirmed Presenters

  • Uchenna S. Uchendu, MD
    Chief Officer, Office of Health Equity, VA Central Office, Washington, DC

  • Kenneth T. Jones, PhD
    Program Analyst, Office of Health Equity, VA Central Office, Washington, DC


Health Equity Research and Resources

The VA Office of Health Equity is pleased to share recent health equity research and resources from VA researchers and partnering organizations.

The Association Between Neighborhood Environment and Mortality: Results from a National Study of Veterans

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Background: As the largest integrated US health system, the Veterans Health Administration (VHA) provides unique national data to expand knowledge about the association between neighborhood socioeconomic status (NSES) and health. Although living in areas of lower NSES has been associated with higher mortality, previous studies have been limited to higher-income, less diverse populations than those who receive VHA care.

Design: One-year observational cohort of veterans who were alive on December 31, 2011. Data on individual veterans (vital status, and clinical and demographic characteristics) were abstracted from the VHA Corporate Data Warehouse. Census tract information was obtained from the US Census Bureau American Community Survey. Logistic regression was used to model the association between NSES deciles and all-cause mortality during 2012, adjusting for individual-level income and demographics, and accounting for spatial autocorrelation.

Conclusions: Lower neighborhood SES is associated with all-cause mortality among veterans after adjusting for individual-level socioeconomic characteristics. NSES should be considered in risk adjustment models for veteran mortality, and may need to be incorporated into strategies aimed at improving veteran health.

Nelson, K., Schwartz, G., Hernandez, S., Simonetti, J., Curtis, I., & Fihn, S. D. (2017). The Association Between Neighborhood Environment and Mortality: Results from a National Study of Veterans. Journal of General Internal Medicine, 32(4), 416-422.

Communities in Action: Pathways to Health Equity

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Background: In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health.

Only part of an individual’s health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways.

Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.


National Academies of Sciences, Engineering, and Medicine. (2017). Communities in Action: Pathways to Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/24624.

Photo Caption: A conceptual model for community-based solutions to promote health equity. Informed by the Robert Wood Johnson Foundation (RWJF) Culture of Health Action Framework and the Prevention Institute’s Systems Framework to Achieve an Equitable Culture of Health.

Racial/Ethnic Health Disparities Among Rural Adults — United States, 2012–2015


Problem/Condition: Rural communities often have worse health outcomes, have less access to care, and are less diverse than urban communities. Much of the research on rural health disparities examines disparities between rural and urban communities, with fewer studies on disparities within rural communities. This report provides an overview of racial/ethnic health disparities for selected indicators in rural areas of the United States.

Public Health Action: Stratifying data by different demographics, using community health needs assessments, and adopting and implementing the National Culturally and Linguistically Appropriate Services Standards can help rural communities identify disparities and develop effective initiatives to eliminate them, which aligns with a Healthy People 2020 overarching goal: achieving health equity.


James, C. V. (2017). Racial/Ethnic Health Disparities Among Rural Adults—United States, 2012–2015. MMWR. Surveillance Summaries, 66.