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One hundred and fifty years ago, the Civil War dramatically altered the makeup of the US military. More than 200 000 freemen and former slaves enlisted in black regiments, and an additional 25% of the Union Army were foreign-born Irish, German, and Dutch immigrants. It was another 80 years before President Harry S. Truman signed Executive Order 9881 officially desegregating the US Armed Forces, declaring “there shall be equality of treatment and opportunity for all persons in the armed services without regard to race, color, religion or national origin.” Since then the makeup of the military and, as a result, that of the veteran population has continued to evolve, with notable recent increases in the number of women, Hispanic, and other minority veterans. The challenge for the Department of Veterans Affairs (VA) in serving this increasingly diverse population is to ensure that we help each veteran achieve the best outcomes possible regardless of who they are, where they live, or what health problems they have. For well over two decades, VA researchers have been helping the Veterans Health Administration (VHA) determine whether we are meeting that challenge.1 Almost a decade ago, the VA Health Services Research and Development Program established the Center for Health Equity Research and Promotion to foster research to accelerate disparities research, following a roadmap that progressed rapidly from detecting and understanding health disparities to testing interventions that sought to eliminate them in the real world.2 In 2012, faced with evidence that we were not yet achieving equal outcomes for all veterans, VHA established the Office of Health Equity under Uchenna S. Uchendu, MD, creating a policy office with a mandate to addressed a wide range of issues to promote health equity.
Atkins et al. (Wed,) studied this question.