Association between modifiable social determinants and mental health among post-9/11 Veterans: A systematic review

Abstract

LAY SUMMARY Veterans who served post-9/11 face many challenges as they reintegrate into civilian life. Some of these challenges include securing stable housing, adequate food, employment, and social support, all of which are examples of social determinants of health. Veterans are also at risk for mental health conditions. Thus, this systematic review examined published articles to evaluate what is known about the relationship between social determinants and mental health among U.S. Veterans who served post-9/11. Using four large databases, the authors found 28 articles representing 25 unique studies. The identified studies reported on three social determinants of health: 1) housing stability, 2) employment and finances, and 3) social support. Robust evidence indicates that Veterans with strong social support had better mental health. The evidence for other social determinants of health was either weak or lacking. Studies needed stronger methods to measure housing and employment and finances, as well as more robust statistical analysis. In addition, the majority of U.S. Veterans who participated in the studies were non-Hispanic white men. More research on a wider range of social determinants — such as food security, education, and transportation — that uses stronger study methods is needed. Future research also needs to intentionally include Veterans from diverse racial and ethnic groups.