Can community engagement prevent Veteran suicides?

Study looks at participation in community activities


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Social isolation and feelings of loneliness are associated with suicidal thoughts. Consequently, the more people feel disconnected from their friends, peers and colleagues, the more isolated they become.

One antidote for social isolation is social connectedness. That is, people coming together and interacting. But there’s been little research on suicide prevention programs that target social connectedness.

Dr. Jason Chen of the VA Portland Health Care System is leading a study to establish a stronger sense of social connectedness for Veterans at high risk of suicide. He’s doing this by increasing their participation in community activities.

Dr. Jason Chen

Chen and his team have been identifying the community engagement needs and preferences of Veterans who have been hospitalized and evaluated for psychiatric conditions. Specifically, the team interviewed participants within a week of their discharge from an inpatient psychiatric unit. They discovered Veterans analyzed for psychiatric conditions, such as PTSD, are at much greater risk than other cohorts of taking their own lives within three months after leaving the hospital.

Social connection could decrease suicidal thoughts

“When working with Veterans, I noticed that many didn’t have social connections,” Chen says. “We know that feeling connected to others can be a form of protection against suicide. So I thought to myself, if the Veterans I work with don’t have many connections, perhaps we could help them create new connections through community activities. My hope is that by helping Veterans increase their engagement in community activities, they’ll feel a stronger sense of social connection that will, in turn, decrease their level of suicidal thoughts.

“The first part of our study was to learn more from Veterans about what gets in the way of connecting. For example, we interviewed 30 Veterans to learn about their past experiences connecting to the community and their thoughts about what would get in the way in the future. Our Veteran sample varied in age from their 20s through their 70s. The average age was 48. We wanted to understand a broad range of experiences across different eras of conflict and generations.”

Suicide prevention is VA’s top clinical priority

Eventually, Chen and his colleagues plan to create clinical toolkits for VA and community figures. The toolkits will focus on increasing social connectedness for Veterans in this vulnerable population.

VA considers suicide prevention its top clinical priority. The most updated analysis of Veteran suicide rates, issued in 2016, notes Veterans accounted for 18% of all deaths from suicide among U.S. adults. This compares with 22% in 2010.

Chen and his team have identified patterns of Veterans’ needs and preferences for social connectedness.

“Veterans appear to be interested in a broad range of activities,” he says. “However, they noted having difficulty knowing how to access these activities and how to make new social connections. Within our sample, Veterans have discussed needing more hands-on support for engaging in community activities. They generally value and believe these activities are important for their wellness and recovery. But they could use extra support for navigating logistics and interactions with new people. We plan for this support to come from a Veteran peer support specialist. That is a Veteran who has undergone his or her own mental health recovery and is now helping support other Veterans with their experiences.”

Working with communities

Researchers are partnering with communities to provide a broad range of activities tailored to the interests of Veterans who are at high risk for suicide. These activities include engaging with Veterans or non-Veterans in the Chinese martial art tai chi or outdoor activities, such as fly fishing or playing music.

“We do not have good evidence that any one type of activity is more protective than another,” Chen says. “They’re worthwhile as long as folks develop a sense of belonging and feel like they’re giving back to others.”

Author

Mike Richman

Mike Richman is a writer and editor in VA Research Communications. He joined VA in 2016 after working for 15 years at the Voice of America.

Comments

  1. Rena Chev    

    PS The VA needs to stop putting out articles instead physically do something.
    Talk is cheep ACTIONS COUNT.
    You know there are many good even great VA employees. But they are passed by or sidelined because they take a little longer to deal with a veteran than the bean counters want spent with a patient. We are not even a person when we walk into a VA hospital. They call us welfare patients. But they forget they had over 50 years they had to fix the Vietnam Veteran problem and they did NOTHING no research no help just label incorrigible, Loud mouths, stupid, typical Male or Female, hard to please, Again REMFS. While we go to people who actually help us to get through what the military did to us. And I find myself a loaner. It is harder for a woman to be a loaner but I do it gladly rather than put up the the discrimination the VA gives me with exception of one doctor.

  2. Rena Chev    

    I have been attacked by a doctor not physically but she cxled all my scripts. She also went against my wishes but more so against the doctors perscriptions that i had to hire my self to evaluate my condition, and he is a specialist in the field. She also lied and said i yelled at her. And she again lied and said didn’t say “I Know heroes and your not one” sat into her chair and giggled like a school girl. Then she tried to set me up with an appointment with a relative of hers so she could support her own opinion. Then she told me i had to see a social worker so i could get my medication’s and the social worker is a friend of hers she is a lesbian and she lied saying I yelled at her, and she is just a social worker for GLBT movement entrenched in the VA health care system.
    And when i asked her this question. “Why are you sending me to a GLBT person? I am not gay lesbian Bi sexual or Trans?” “I am just a woman, I have no need of her services”.
    After that I was put on a VA rights removal thing called “RED LINE” Red line is used when a veteran is a problem to them selves or to VA employees and has no recourse for the VETERAN. Only the VA has rights under this label yet another label just add it to the Vietnam Veterans list. Lets see lets add them up, Liar, Thief, Angry, Hate Filled, Lazy, Not Wanting to Work, Dumb, Idiot, and the one i love to hate REMF.
    Those things were called to me over and over again in VA hospitals or Clinics. I even at 72 was counseled by a doctor on how to spend my money. And I am a saver and saved a lot of money over the years. a little while out of work but mostly used my $350 a month to live on in my car with my cat. Lucky it was in California and I was in Laguna Beach living in my car.
    I was fired because they found out I was a Vietnam Veteran.
    And that does not mix with photo shop customers I was told.
    But when going to the Combat Vet Center I found out I wasn’t the only one. Lots of Vietnam Veterans were fired because they were Vietnam Veterans.
    So here i am in a VA hospital in Kansas City Missouri Living in the same area. And I apply for a job at the hospital. I was qualified for a position as a records keeper or working in the medical records department. Held that as a mos from my service to my country. After Vietnam.
    But low and behold they didn’t want to hire me instead they hired a woman who had no qualifications at all for the position and wasn’t even a veteran. Here i am a Combat Vietnam veteran and the VA hospital is hiring people with no military service.
    So now we have another problem Doctors who never served. And they dont understand why a Veteran looks fit and is not but actually sick.
    All that aside. Severely Deformed fetuses because of being sprayed, drinking, eating, and wearing clothes and sleeping in and on sheets and clothes washed in it. Besides all that The VA seems to feel that we are a lost item. They have refused me many times only my standing up and saying NO you can not do that. So I have had to educate myself on how to deal with them. STAND UP TELL THEM NO WHEN YOU EVEN SUSPECT THAT THEY ARE SCREWING OVER YOU WITH PHONY RULES AND REGULATIONS. They seem to fall back on that when they Foopa. Yes it is a word in the military it means you Fucked Up BIG TIME.
    I am fighting back to get them to remove all the CRAP an LIES they put into my file. Now the Clinics are closed Fighting a Virus and the doctors and nurses are not available instead we are to drive 100 miles to a hospital in Orlando to get care.
    A very screwed up system. Just as our schools went to regional schools The VA did the same seeing as busing the kids to school 10 miles away worked now they will bus us Veterans most 60+ years old like the 94 year old survivor of ww2 with no cartledge in his knees they ship him 100 miles away to the huge Orlando Lake Nona Hospital. But first we have to go half way to a clinic to be transported to Orlando. So a veteran drives 50 miles to a clinic in Viera Florida from Southern Brevard County Florida and then is transported to Lake Nona In Orlando. And I have a bad back as well as knees that swell up and ankles that swell up when i walk too far and the few times i went to this hospital I walked and walked and walked and came home and couldn’t sleep for 2 or 3 days because of the pain in my knees ankles and back. This poor old man was in bed for days after his visit.
    When I have appointments in my own area I go to a hospital 16 miles from my home. I check into the hospital and only have to walk a short distance to the doctor or to surgery or to blood work or even to pharmacy. In Orlando it is very far from the doctors or the surgery.
    I also have a way of getting help if i need it. The VA is not for the light heart’s as a place to go. You have to be able to stand up for your self and deal with doctors who are sometimes unfeeling or uncaring. I had that kind of doctor, quite a few through the years.
    Yet not one as kind and caring as my present doctor This woman is caring kind and considerate and wants to hear about what your experiencing with your problem not in a hurry to keep some schedule on how to treat a human being. Most Vietnam Veterans dont seem to be able to deal with a bean counters feelings on how long a doctor appointment should last.
    I am not usually so critical but the VA does not understand that not every person who walks into their facilities is the same. But they give the same drugs to keep our frustration over the lack of good quality care at a VA facility. You complain they drug you with med’s that keep you from being able to think and feel. Just so you dont get angry over the lack of proper care of your medical needs.
    And when they get critical with us we get critical back.
    I was having a problem of passing out went to the doctor and they couldn’t figure it out so I ended up getting an appointment with the brain doc. Before my appointment i stopped taking a medication I was taking to control my Blood Pressure. It seems that it was lowering my BP too low. After I stopped taking it all the problems went away. But my doctors 2 each didnt take the time to check the side effects of the medications i was taking just ignored it and sent me to someone else. So here I am having to be a doctor for myself. While others get care i get indifference anger and hate because i dont agree with the doctors.
    So with all that said You need to be able to stand up for yourself when you go to the VA. And you have to double check all the things the doctors, nurses, clerks, and even the people in charge do.

  3. Adrian Blumberg    

    Mr. Richman,

    Marine Adrian P. Blumberg here. You write in your article that there is “there’s been little research on suicide prevention programs that target social connectedness.”

    It is my duty to point out to you, every single veteran I can reach when I author my next article for Medium.com, and the Veteran Administration, about Abraham Maslow’s documented explanation of the importance human connections in his 1954 book, Motivation and Personality. You might of heard about his placement of it within a hierarchy graphic called “Maslow’s,Hierarchy of Needs”?

    Perhaps Mr Richman has not heard of the works of “Edward Deci and Richard Ryan, focuses on 3 basic human needs for sustained, volitional motivation: (a) autonomy, (b) competence, and (c) relatedness. Relatedness is referred to as feeling socially connected to others.”?

    As “The Connection Prescription” also states “Many prominent psychologists and psychiatrists have written extensively about social interactions and their importance in human development”.

    Further, in 1986, Dr Julius Segal, a psychologist and trauma expert who wrote Winning Life’s Toughest Battles: Roots of Human Resilience, which research into social connectedness .

    This article is the laziest attempt at appearing busy I have ever seen and the VA is irresponsible to retain you or your writing. Especially when you say,

    “VA considers suicide prevention its top clinical priority. The most updated analysis of Veteran suicide rates, issued in 2016, notes Veterans accounted for 18% of all deaths from suicide among U.S. adults. This compares with 22% in 2010.”

    The 2019 National Veteran Suicide Prevention Annual Report, VA urges all Americans to come together and take action to prevent suicide. Learn more about how you can support Veteran suicide prevention efforts and access resources at http://www.mentalhealth.va.gov/suicide_prevention.”,from the website https://www.mentalhealth.va.gov/suicide_prevention/data.asp” All lies! If it were true, any of it, this article would not exist!

    In fact, this is an amazing example of how the VA really prioritizes veterans. How many days will Dr Chens “outreach” take with 17-22 vets committing suicide daily? I have a self-guided art therapy free for 4 hrs.The workshops that were happening twice monthly before dementia plagued veteran orgs became convinced, I was sleeping at the bldg., which was false. I have a home. Now I get the run around trying to track down isolated and at risks vets and invite them in person to come, but no one will interact because it is more important to send emails and mailers to vets, and let them die, than to go to their home and show they actually CARE, because it is more important vets orgs get their govt money and tax write offs than to actually help anyone. This is all a disgrace!

    Veterans stop fixating about Vietnam veterans. What happens to one veteran, affects all veterans. Have no fear, I plan to promote this travesty of an article by Mike Richman, as for and wide as I can before we are all starving, broke, or dying to do anything about this absolute crap research for a newsletter.

    And veterans, how is it that none of you caught this? No, your engaging with Mr.Richman as if he knows what he is talking about AT ALL!?! How many of you went out and helped a veteran that wasn’t a 10 to 20 year buddy already?

    Respectfully,

    A. Yobi B.

  4. Cheryl Jablonsky    

    Dr Chen- I believe you have come up with an idea -an approach to helping- that will make an incredible difference. I hope some how, some way, you get the funding you need to make it all work. Thank you thank you for what you are doing.

  5. Cheryl Jablonsky    

    I’m a civilian (nurse) who cares, and is thankful for our military. I read all of the statements and comments above. What’s the best way for me, and others like me, to help? I very much want to. Suicide has touched my life more than once, and I saw how much mental pain was endured those who were lost. I could help with some of it. The only thing I know about the experience of vets is what I was told by someone I happened to meet in a social setting. He told me that neither he nor any get he knew would ever really open up to a VA psych practioner. The reason, he said, was because he and they knew they were diagnosed before they even opened their mouths. Survivor’s guilt, trauma from seeing a friend die. He said “No-one I talked to had the slightest idea of what I went through- but they all thought they did. Why should we talk to someone who is so certain they know it all that they close their ears to what we say, sticking to the script in their heads? It’s useless. No way are we talking to them. It will help nobody.”
    That’s what I heard from one vet. One time. I try to do random acts of kindness when I see vets, or thank them for their service, at the very least. Once I saw a bumpersticker saying My brother is a Marine and I waved the girl to the curb. Silly maybe, but I handed her $20 and said it was to help with postage for a care package. She did say the family loved sending care packages.
    Impulsive one time acts like that only help a little, though. What’s the best way for someone like me to really help support our veterans?

  6. Era J Roberts    

    My sister is a Veteran, honorably discharged in 1988 after 15 years of Navy. I am her caregiver and I cannot believe how badly the VA Doctors in Indiana treat her. My concern right now out of many is that she cannot get a VA Dr to refill her Clopidogrel to prevent her strokes from recurring and Ropinerol for the restless leg syndrome she has had for 12 years. There is not a VA Dr in Indiana that can care for her enough to get these two much needed medications refilled. We moved out of TX in 2017 and she had great care at the VA in San Antonio and always had her medications filled when needed. She had a stroke in 2018 and another stroke in 2019. She has fell twice this past year and the VA Dr in Indiana will not refill until they find out what is causing her to fall. So here we are, still, spinning our wheels trying to find another Neurologist that can evaluate and treat her again so she can have these medications. The previous Neurologist informed us they are no longer a Community Care provider with the VA with no explanation as to why their decision was made but I believe it is due to the low reimbursement for services rendered. So, what is a Veteran to do? I have been her caregiver since 2013 when she received lung cancer treatments in TX and have seen the poor care she has received. I did read somewhere that the VA DR’s hired at the clinics are wanna be Doctors because they did not pass the Board so most of the Drs are not board certified but will work at the VA clinics since that’s the only place that will hire them. This puts our Veterans at great risk and reckless care. She also had a failed hammertoe procedure in 2015 according to a Doctor trying to relieve her toe pain. The Cpap machine equipment for the face has always caused problems and they will give her one new Cpap mask every year but this year has already allotted her one time replacement and is causing the outside of her nose to bleed some due to poor fitting and doesn’t accomplish anything to call the Indiana clinic for another replacement. I am concerned that the Cpap mask is fitted for men and not women since their stock provides for mostly men. I do admire her for the patience she shows all of her VA providers, she told me it’s best not to push too hard about issues because her care is free. She was offered Medicare when honorably discharged but she declined thinking she would always receive the best of care but now realizes that was her mistake for not signing up for Medicare. Medicare has a pretty steep penalty waiting for her indicating Medicare insurance will now cost her $433.00 a month for every year she did not sign up for Medicare the penalty increases. So now, she can not afford Medicare premiums. I ask myself, what’s a Veteran to do? Get sicker from poor care, loss of needed medications and just die from poor care? I am wondering if the VA Administration and politicians just want to cut cost and let the Veterans commit suicide or die of poor health care just to eliminate the cost per Veteran? I keep seeing in print all the wonderful things the VA is doing for the Veterans when they are failing our Veterans. The Community Care program is only three visits per year for a Veteran. Another issue are the low reimbursements to outside Providers, these Doctors cannot afford to take on the care of very sick Veterans due to low reimbursements. What’s a Veteran to do?

  7. Ken Blackstone    

    There is certainly a link between isolation and suicidality. The more one is alone with their thoughts, especially when they are cognitive distortions, the more likely they will spiral. Just the mere act of talking with others about our failures, grief, loss, regrets, etc. goes a long way. I would agree that (as a combat veteran myself) some of the conversations would be best had with someone who has endured trauma and this does not necessarily have to be combat trauma. That being said; there is no magic pill for every circumstance. Everyone’s personal story is different and there is no “one size fits all” approach. However, a common thread I have seen in patients who deal with thoughts and/or a desire to commit, is isolation or lack of social support. Managing this one factor, by way of engaging others and looking outside of our fish bowl, will go a long way in helping to increase the strongest, most powerful weapon we have against suicide and that is “hope”. Without the hope that there is life outside of (or in spite of) our personal circumstances or that there is a chance that things will get better, we are giving way to let despair take over.

  8. Christopher Cremean    

    I am a co-founder of United States Vets, Inc., a non-profit in Nothwest Ohio. We are looking at a community program in gardening for Veteran’s to get involved.
    Reaching out to farmers to set up internships to build gardens and then use produce to supply food banks.

  9. Derrick Iozzio    

    There are many veteran-owned organizations out there that work tirelessly to reach vets in need. These organizations are overlooked by the VA and DSPO, who would rather turn to the larger companies. Those small, veteran-owned organizations have helped many veterans and they do it without funding or support from the government. Just think how many more vets they can help with a little support. Many of the vets that need help will not seek it from the VA for a variety of reasons. Local organizations can reach those vets and connect them to resources that can and will help them. If a vet is disenfranchised with the VA, then someone working for the VA is not going to be able to connect. Another vet is able to connect and help them find resources.
    This is simple, it has worked, and is still working- why do the VA and the government not see this?
    Derrick

    1. Derrick Iozzio    

      Dr. Chen-
      You are on the right track- see my comment above

  10. Bryan A. McGown    

    I’m trying to push nearly limitless opportunities for stress relief, social connectedness, suicide prevention, recreation, improved self esteem, and telework, retail, meetings, and more through Virtual Reality environments without the need for headgear/goggles. We have proof this works! But, you need to feel it to believe it! No additional drugs! Make new friends, have fun again, laugh again!

  11. Dana Phelps    

    This is extremely important information and needs to be publicized. Make your voice heard. As an atty, I’m sure you can.
    VR
    Dana

  12. Paula Minger    

    Since 14 of the 17 (active duty not counted) no longer use the VA or a VSO, community involvement is a must. But the kind that engages POLICE, HOMELESS SHE!TERS, SOCIAL SERVICES, CHURCHES etc etc

    They also need to be informed that VIETNAM Vets remain at highest risk of suicide along with vets over age 55 (70%)

    The false narrative that POST 9/11 vets w PTSD are at highest risk has wasted money and cost Lives

    It’s shameful

  13. ROBERT BOUCHER    

    Actual Vietnam Veterans (boots on ground) 2,709,918.
    390 die each day.
    9M Vietnam “Era” served during that time 8/5 1964 to 5/7 1975. Peak strength 543,482 4/30/1968.
    7484 women, 6250 nurses served in Vietnam.
    Hostile deaths 47,378; non-hostile deaths 10,800 Total 58,202. 8 nurses died 1 was KIA.
    Source for more information: United States Naval Academy 2016; MANY more statistics on this
    source.

    1. Bob Ferretti    

      That one KIA was Sharon Ann Lane. This woman deserves her own statue in Wash. D.C. There is one erected in Ohio, outside the Nursing School she attended. She joined also. She’s my Hero…..Bob Ferretti (V.N.-’68-’70.

  14. Darren    

    Unfortunately all the mental health doctors want to do is add more medication instead of working with the veteran to change his or her situation. No help there.

  15. Len Gravel    

    Only if they treat you well when you ask for help I ask the advocate for help and they embarrassed me and talked down to me.

  16. Arthur Runningbear    

    There are many native viet nam veterans we stay alive with natural substance to remove virus but Americans always ignore our solutions so we just keep to ourselves

    1. Carol Wild Scott, Esq.    

      The VA has long ignored American Indian veterans; veteran suicide on tribal lands is neither identified, tracked or counted – at all, by anyone, let alone the VA. Yes, there is now an Office of Tribal Government Relations (OTGR), but the veterans were not consulted in the selection of the directorate of that office. There are still no American Indian therapists or psychiatrists to speak of (I have not been able to find any) on the VA payroll. Little or no attention has been paid to the very deep need for culturally competent therapy through the use of tribal cultural practices (that have served tribal communities through centuries).and the recognition of the need for such. When VA has used only a fraction of appropriated funds for suicide prevention (Joint Committee hearing, Dec. 19, 2019), it is no wonder that Indian veterans are underserved, despite the fact that they serve this country in a higher proportion than any other ethnicity, especially in the far more hazardous military occupations. Nor is the VA willing to find a path to full accreditation of Tribal Veterans Service Officers in order that they may serve the veterans within their tribal communities in terms of obtaining culturally competent mental health care, including suicide prevention along with advocacy for benefits and entree to the programs and services ostensibly available to all veterans. OTGR has not actively supported full accreditation despite ample opportunity to do so or approached advocates outside VA to ask for support in the establishment of full accreditation. It is only through the employment of Native mental health providers throughout the country, including areas with Urban Indian populations that there will be any opportunity to reduce the suicide rate on tribal lands and among non-reservation veterans.

      Carol Wild Scott, Esq.

  17. Harry Conkle    

    Since it is a known fact that doctors and nurses commit more suicides than Vets, So why should Vets rely on folks that are in the same stress boat, and can’t admit their failures. VA needs to look at who they hire and what real experience they have with Vets before they just jump in and start using us a lab mice. And the volunteer system at VA is an absolute debacle. Why would a Vet want to be vetted for volunteer service like the current system mandates? Any system or treatment plan that does not include the Vet right up front, and practitioners who have been there and done that, is domed. I have almost 325 hours of classroom and intern work dealing with chemical dependency, and the volunteer director wasn’t even interested. And your doctors won’t be either. Why? Because it’s the doctors who authorize the morphine drip at hospitals to make one’s stay less painful, so we will come back I guess. Or is it just that some hospitals just don’t want their nurses tired up in personal administration of medication? Who knows? I do. And I am a Vet that knows what makes someone see demons.

  18. Daniel Hinman    

    First of all im always given a doc or whatever that has no combat experience. All they know is from a book. Everytime i go in im greeted with a damn paper quiz. Then onto tell me the story bullshi\t. I was in the Infantry i got more than 1 affecting me diff days and diff way. And i get the tell me the 1 story. Well ok fk you too and walk out. They are out of touch other than a book. They know nothing you have gone through. There is no switch for this crap. I could go on and on with all the problems with VA phycs.

    1. Michael West    

      If you want to talk to somebody that has already been down the road you’re on, …go to your local Legion, VFW, DAV, AMVETS… The shrinks don’t have a common bond with you. We can help each other.

  19. Elaine Gullotta    

    What a great study. We know that social isolation is detrimental and that having a network of your “Peeps” is good for you. Being able to measure quantitively how good this benefit is via a research study will hopefully lead to funding toward programs that provide this service. For those who may not know, The Wounded Warrior Project provides a wide variety of opportunities to connect with other veterans. Team Rubicon is also a great resource and provided not only connection but an opportunity to work together as veterans doing good in the world. The combination of physical labor and spiritually giving back along with the bonding is a super combination for improving your wellbeing. Sending hugs to my fellow veterans.
    Elaine

    1. Paula Minger    

      Wounded Warrior Project doesn’t serve anyone but IRAQ AFGHAN Veterans and they have the lowest risk of suicide
      VIETNAM vets make up the highest number of both suicides and homelessness.

  20. Paula Minger    

    Since 14 of the 17 vets who Suicide no longer use the V.A. or even a VSO community involvement is a must

    It has to be police, social services, fire department, hospital’s etc etc

    Not this.

    Why is it so hard to focus on vets in greatest need?

    Everything is directed on POST 9/11 Vets claiming PTSD and they have the LOWEST number of suicides and always have

    Thank you

  21. Jim taylor    

    I agree completely. Vietnam-era vets, please move to the back of the bus…..again.

  22. Curt Munson    

    I would like to know how many of the Vietnam era veterans who actually served in combat (approximately 1.7 million) are still alive. The most recent figure I’ve found was on an unofficial site called the “American War Library” in a report dated Feb. 28, 2019, claiming 610,000 in country vets were alive at that time. That number comports with other stats claiming about 1/3 of Vietnam Vets were still living in 2018, but I don’t know how accurate my baseline is.

    Also, as the death rate for COVID-19 exceeds the toll from Vietnam, it seems the Vietnam era Americans are once again under attack. I wish to know what percentage of those being killed by COVID-19 are in fact Vietnam veterans. We are the right age, many have compromised cardiovascular and pulmonary systems and diabetes. Does the VA have statistics reflecting the number of disabled Vietnam vets whose benefits are terminating due to death? Or Vietnam veterans overall who are dying of this scourge.

    Thank you for helping me with this issue. C

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