Exploring Veteran Mental Health Disparities: A Comparative Analysis of Rural and Urban Communities in the Midwest of the United States.

Veterans face unique mental health challenges influenced by their service experiences and post-military transitions into civilian life. Geographic location also plays an integral role in impacting veterans' outcomes and access to proper care. The purpose of this case study is to examine disparities between rural and urban veterans in the Midwest using data collected from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Self-reported bad mental health days among veterans in rural and urban regions across twelve Midwestern states were analyzed through direct rate estimation and small area estimation techniques utilizing RStudio software. Higher rates of poor mental health days were ultimately observed among urban veterans in most states through both analyses. The results of the direct rate analysis revealed 13.5% of veterans reporting 14 + poor mental health days per month versus 9.5% in rural areas. Likewise, the results of the small area analysis demonstrated 12.2% of veterans reporting 14 + days of poor mental health days per month in urban areas versus 9.8% in rural areas. This highlights the significance of environmental stressors and social determinants of health in differentially impacting mental health outcomes. Thus, tailored interventions utilizing interdisciplinary teams are needed to meet the unique barriers for veterans in different geographic contexts. Despite the cross-sectional nature of the study and reliance on self-reported data, this case study provides valuable insights for mental health disparities among Midwest veterans. Creating a more equitable and accessible mental health landscape for veterans will require targeted and collaborative approaches.