Rural Veterans’ Experiences with Social Risk Factors: Impacts, Challenges, and Care System Recommendations

Social risk factors, such as food insecurity and financial needs, are associated with increased risk of cardiovascular diseases, health conditions that are highly prevalent in rural populations. A better understanding of rural Veterans’ experiences with social risk factors can inform expansion of Veterans Health Administration (VHA) efforts to address social needs. To examine social risk and need from rural Veterans’ lived experiences and develop recommendations for VHA to address social needs. We conducted semi-structured interviews with participants purposively sampled for racial diversity. The interview guide was informed by Andersen’s Behavioral Model of Health Services Use and the Outcomes from Addressing Social Determinants of Health in Systems framework. Rural Veterans with or at risk of cardiovascular disease who participated in a parent survey and agreed to be recontacted. Interviews were recorded and transcribed. We analyzed transcripts using directed qualitative content analysis to identify themes. Interviews (n = 29) took place from March to June 2022. We identified four themes: (1) Social needs can impact access to healthcare, (2) Structural factors can make it difficult to get help for social needs, (3) Some Veterans are reluctant to seek help, and (4) Veterans recommended enhancing resource dissemination and navigation support. VHA interventions should include active dissemination of information on social needs resources and navigation support to help Veterans access resources. Community-based organizations (e.g., Veteran Service Organizations) could be key partners in the design and implementation of future social need interventions.