Social security during COVID-19: The experiences of military veterans
Abstract: Research published prior to COVID-19 has illustrated some of the difficulties that veterans can experience within the benefits system (Scullion et al, 2018; 2019; Scullion and Curchin, 2021). For example, those with Service-attributed mental health conditions can face challenges interacting with various aspects of the system from Work Capability Assessments (WCAs) through to Work Focused Interviews (WFIs) (Scullion and Curchin, 2021). Accounts within pre-COVID-19 research also highlight the significant role of informal peer networks and third sector organisations in supporting veterans in relation to both benefits processes but also wider issues relating to health and wellbeing, particularly where there is an absence of close family connections and relationships (Scullion et al, 2018; 2019). Drawing on emerging findings from interviews with veterans undertaken during COVID-19, this chapter revisits some of these pre-COVID-19 issues around mental health, benefits processes, and support networks to explore the impact of the pandemic.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.