Adjusting to civilian life after military service can bring challenges that extend far beyond the transition itself. For some veterans, struggles with employment, finances, housing and substance use can overlap, creating circumstances that put their health and lives at risk.
While suicide has long been a concern within the veteran community, the New York Health Foundation is encouraging a broader approach to understanding and preventing premature deaths among veterans.
Derek Coy, senior program officer for veterans' health at the New York Health Foundation and a Marine Corps veteran, said veterans in New York die by suicide at roughly twice the rate of the general population. However, focusing exclusively on suicide statistics may overlook other preventable deaths.
"Maybe we can't fine-tune the exact definition or better understand the exact deaths that are suicide. But if we just look at premature deaths and deaths of despair, like overdosing, drinking to excess, things of that nature, I think that is what really paints a more clear picture," Coy said.
The term "deaths of despair" generally refers to deaths associated with suicide, drug overdoses and alcohol-related conditions. Hoy said determining whether some deaths were intentional can be difficult, especially when substance use is involved.
He said looking at these deaths together could help researchers better understand the underlying challenges veterans face and identify opportunities for prevention.
Compounding challenges increase risks for veterans
Housing insecurity, unemployment, financial instability and limited access to health care can all contribute to increased suicide risk. Coy emphasized that these challenges often build on one another rather than occurring independently.
"Okay, you lose your job and now you're having financial and maybe legal issues, family matters. And then that turns into housing issues. And now you're dealing with all these things at the same time while maybe your mental health probably isn't great. And all those factors continue to compound," Coy said.
According to Coy, a study conducted by Yale University and the Department of Veterans Affairs found that the 5% of veterans experiencing the greatest number of compounding risk factors had suicide rates 20 times higher.
He said these findings underscore the importance of treating access to basic necessities, including stable housing and food, as part of suicide prevention rather than focusing solely on crisis intervention.
"So if we better understand that, then I think we can look at other things like access to food or access to housing as suicide prevention, which a lot of folks might not think," Coy said.
Hoy also raised concerns about emerging issues such as sports gambling and cannabis use. New York experienced a 25% increase in veteran suicide rates in 2023, according to Coy, but researchers have not determined what caused the increase.
"And I tell folks, I have no idea because there's so many things that happened then that we can't go back and say, oh, this one thing happened that contributed to it," Coy said.
Delayed data complicates prevention efforts
One of the greatest challenges in understanding these trends is the delay in federal reporting. Hoy said suicide data from the Department of Veterans Affairs can take as much as two years to become publicly available, making it difficult to identify emerging problems.
"My fear is are we in that spike right now and we're not going to know for two more years?" Coy said.
The New York Health Foundation has developed a county-level data explorer to examine regional differences in veteran suicide rates. Coy also pointed to proposed state legislation that would establish veteran suicide mortality review committees to help officials better understand the circumstances surrounding deaths.
He said more timely, detailed information could help organizations direct prevention resources toward communities facing the greatest risks.
"If we could just get better real-time data, I think that would be tremendous in a lot of the efforts that are already underway," Coy said.
