Sociology Department, Brigham Young University, 2038 JFSB, Provo, UT, 84602, USA.
Sociology Department, Brigham Young University, 2034 JFSB, Provo, UT, 84602, USA.
J Community Health. 2017 Oct;42(5):887-893. doi: 10.1007/s10900-017-0330-y.
As a growing segment of the military, Native Americans are expected to increase enrollment in Department of Veterans Affairs (VA) healthcare. Currently, 20% of Native American veterans are aged 65-74, which means they served during the Vietnam era. This study explores the experiences of rural American Indian veterans from two Montana reservations with accessing VA health services. Utilizing detailed data obtained in focus group and individual interviews, we examine the experiences, attitudes, barriers and needs of rural Vietnam-era veterans. Analyses indicate that while Native American Vietnam-era veterans experienced a poor reception returning to the US after military service, they had more positive receptions in their home reservation communities. However, reintegration was often impeded by poor local opportunity structures and limited resources. As they have aged and turned to the VA for healthcare, these veterans have encountered barriers such as lack of information regarding eligibility and services, qualifying for care, excessive distances to health services, the cost of travel, and poor quality of assistance from VA personnel. Despite variations in their resources, tribal community efforts to honor veterans have begun to facilitate better access to healthcare. Focusing on the roles and importance of place-based resources, this study clarifies challenges and obstacles that Native American Vietnam-era veterans experience with accessing VA health services in rural, reservation communities. Additionally, findings show how tribal efforts are facilitating access as they begin to implement the 2010 agreement between the VA and Indian Health Services to better serve Native veterans.
随着军人中这一群体的不断壮大，预计美洲原住民在退伍军人事务部 (VA) 医疗保健中的入学率将会提高。目前，20%的美洲原住民退伍军人年龄在 65-74 岁之间，这意味着他们曾在越南战争时期服役。本研究探讨了来自蒙大拿州两个保留地的农村美洲印第安裔退伍军人在获取 VA 医疗服务方面的经历。利用在焦点小组和个人访谈中获得的详细数据，我们考察了农村越南时代退伍军人的经历、态度、障碍和需求。分析表明，尽管美洲原住民越南时代的退伍军人在军事服务后返回美国时受到了不佳的接待，但他们在自己的保留地社区中受到了更积极的接待。然而，重新融入社会常常受到当地机会结构不佳和资源有限的阻碍。随着他们年龄的增长，并转向 VA 寻求医疗保健，这些退伍军人遇到了一些障碍，例如缺乏有关资格和服务的信息、获得护理的资格、前往医疗服务的距离过长、旅行费用以及 VA 人员提供的援助质量差。尽管他们的资源存在差异，但部落社区为纪念退伍军人而做出的努力已开始促进更好地获得医疗保健。本研究重点关注基于地点的资源的作用和重要性，阐明了美洲原住民越南时代退伍军人在农村保留地社区中获取 VA 医疗服务所面临的挑战和障碍。此外，研究结果还表明，随着部落开始实施 VA 和印第安人健康服务部之间于 2010 年签署的协议，以更好地为美国原住民退伍军人提供服务，部落努力正在促进获得医疗保健的机会。
