Military and Mental Health Correlates of Unemployment in a National Sample of Women Veterans

Background: The unemployment rate is currently higher among women Veterans than among male Veterans and civilian women. Employment is a key social determinant of health, with unemployment being strongly associated with adverse health. Objective: To identify military-related and health-related characteristics associated with unemployment in women Veterans. Research Design and Subjects: Secondary analysis of workforce participants (n = 1605) in the National Survey of Women Veterans telephone survey. Measures: Demographics, mental health conditions, health care utilization, and military experiences and effects. Unemployment was defined as being in the labor force but unemployed and looking for work. Analysis: The chi(2) analyses to identify characteristics of unemployed women Veterans; logistic regression to identify independent factors associated with unemployment. Results: Ten percent of women Veterans were unemployed. Independent correlates of unemployment were screening positive for depression [odds ratio (OR) = 4.7; 95% confidence interval [CI], 1.8-12.4], military service during wartime (OR = 2.9; 95%, CI 1.1-7.3), and service in the regular military (vs. in the National Guards/Reserves only) (OR = 6.8; 95% CI, 2.2-20.5). Two postactive duty perceptions related to not being respected and understood as a Veteran were each independently associated with unemployment. Conclusions: Whether depression underlies unemployment, is exacerbated by unemployment, or both, it is critical to identify and treat depression among women Veterans, and also to investigate women Veterans' experiences and identities in civilian life. Community-based employers may need education regarding women Veterans' unique histories and strengths. Women who served in the regular military and during wartime may benefit from job assistance before and after they leave the military. Gender-specific adaptation of employment services may be warranted.