Prevalence and Determinants of Unmet Social Needs Among Rural and Urban Veterans

Purpose. To examine the prevalence and determinants of nine unmet social needs among rural compared with urban Veterans. Methods. Retrospective study using survey data collected in 2020 merged with Veterans Health Administration (VA) administrative data. For each unmet need, separate logistic regression modes were run predicting the odds of rural compared with urban Veterans endorsing the need adjusting for sociodemographic characteristics and comorbidities. Findings. 2,801 Veterans responded to the survey (53.7% response rate). Veterans experienced high rates of need (e.g., 22% reported food insecurity). Unmet need prevalence varied minimally between rural and urban Veterans and where they did, rural Veterans were less likely to endorse the need (e.g., loneliness). For many unmet needs, Black compared with White Veterans were at higher risk. Regional unmet need disparities were also observed. Conclusions. As VA considers expanding unmet need interventions, tailoring interventions to the sub-populations most at risk may be warranted.