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Iowa Vets Prepared by: Stephan Arndt, Ph.D. Iowa Consortium for Substance Abuse Research & Evaluation University of Iowa With funds from the Iowa Department of Public Health

Veterans in Iowa 3 PTSD 6 Depression 9 Substance & Alcohol Problems 12 Table of Contents/Links 2

Roughly 223,000 veterans live in Iowa The average county has over 2,250 veterans 2 in every 27 Iowans are veterans 13,559 Iowans have been deployed in Operation Enduring Freedom and Operation Iraqi Freedom (OIF/OEF) since 2001 The average county has over 137 OIF/OEF veterans Veterans in Iowa 3

Number of Veterans in Iowa Counties Lyon (652) Sioux (1718) Osceola (499) Obrien (1065) Dickinson (1628) Clay (1404) Emmet (780) Palo Alto (804) Kossuth (1297) Winnebago (971) Hancock (1156) Worth (752) Cerro Gordo (3293) Mitchell (926) Floyd (1351) Howard (769) Chickasaw (1081) Winneshiek (1317) Allamakee (1362) Plymouth (2271) Cherokee (901) Buena Vista (1283) Pocahontas (873) Humboldt (749) Wright (957) Franklin (1027) Butler (1234) Bremer (1952) Fayette (1584) Clayton (1624) Woodbury (6735) Monona (931) Harrison (1422) Ida (669) Crawford (1198) Pottawattamie (7596) Mills (1531) Fremont (700) Shelby (1075) Sac (1120) Montgomery (806) Page (1324) Carroll (1699) Audubon (465) Cass (1056) Calhoun (1118) Adams (287) Taylor (492) Greene (670) Guthrie (979) Adair (816) Webster (2694) Union (1120) Ringgold (475) Boone (2039) Dallas (3464) Madison (1307) Hamilton (1245) Clarke (720) Decatur (639) Story (5116) Polk (24454) Warren (3633) Hardin (1467) Lucas (564) Wayne (484) Marshall (2633) Jasper (2807) Marion (2605) Grundy (1089) Tama (1487) Poweshiek (1343) Mahaska (1569) Black Hawk (9767) Benton (2076) Iowa (1279) Keokuk (819) Buchanan (1614) Linn (17133) Johnson (6464) Washington (1393) Delaware (1289) Jones (1997) Cedar (1668) Dubuque (6785) Muscatine (3034) Louisa (774) Monroe Wapello Jefferson (1245) Henry (543) (2948) Des (1277) Moines (3340) Appanoose (911) Davis (602) Van Buren (588) Lee (3314) Jackson (2007) Clinton (4180) Scott (12996) Number of veterans 287-774 1,119-1,404 2,634-24,454 775-1,118 1,405-2,633 Source: Dept of Veteran Affairs, Veteran Population Model (2012) 4

Number of Service Members Deployed to OIF/OEF since September 11, 2001 Lyon (46) Osceola (22) Sioux (106) Obrien (67) Dickinson (51) Clay (75) Emmet (28) Palo Alto (24) Kossuth (47) Winnebago (51) Hancock (40) Worth (22) Cerro Gordo (174) Mitchell (32) Floyd (68) Howard (29) Chickasaw (55) Winneshiek (60) Allamakee (51) Plymouth (175) Cherokee (50) Buena Vista (80) Pocahontas (43) Humboldt (46) Wright (61) Franklin (43) Butler (57) Bremer (93) Fayette (83) Clayton (86) Woodbury (806) Monona (54) Harrison (85) Number of veterans Ida (40) Crawford (91) Shelby (49) Pottawattamie (451) Mills (108) Fremont (27) Sac (31) Montgomery (52) Page (79) Carroll (114) Audubon (28) Cass (52) Calhoun (34) Greene (38) Guthrie (58) Adair (25) Webster (190) Boone (183) Dallas (224) Madison (86) Hamilton (52) Story (480) Polk (2035) Warren (318) Hardin (97) Marshall (154) Jasper (133) Marion (126) Grundy (50) Tama (59) Black Hawk (510) Poweshiek (61) Mahaska (81) Benton (108) Iowa (70) Keokuk (53) Buchanan (81) Linn (849) Johnson (483) Washington (107) Delaware (51) Adams Union Clarke Lucas Monroe Wapello Jefferson (19) (45) (63) Henry (40) (50) (29) (148) (134) Taylor (28) Ringgold (16) Decatur (25) Wayne (31) Van Appanoose Davis Buren (44) (30) (30) Lee (178) Jones (89) Cedar (86) Muscatine (164) Louisa (47) Des Moines (180) Dubuque (374) Jackson (77) Clinton (160) Scott (744) 16-38 39-52 53-81 82-154 155-860 Source: Defense Manpower Data Center, as of 3/31/11 Citizen Soldier Support Program 5

There are between 680 and 2,039 OEF/OIF service members in Iowa with PTSD There are over 5,500 Iowa veterans with current PTSD Roughly 4 in 5 veterans with PTSD symptoms have never been diagnosed (over 4,400) 1 PTSD 1 Smith, T. C., et all. (2009). PTSD prevalence, associated exposures, and functional health outcomes in a large, population-based military cohort. Public Health Rep, 124(1), 90-102. 6

Estimated Number of Service Members Deployed to OIF/OEF with PTSD Lyon (2-7) Sioux (5-16) Osceola (1-3) Obrien (3-10) Dickinson Clay (4-11) Emmet Winnebago Worth Mitchell Howard (1-4) (1-3) (2-5) (1-4) Winneshiek Allamakee Kossuth (3-9) (2-7) Palo Alto (1-4) Hancock (2-6) Cerro Gordo (9-26) Floyd (3-10) Chickasaw Plymouth (9-26) Cherokee Buena Vista (4-12) Pocahontas (2-6) Humboldt (2-7) Wright (3-9) Franklin (2-6) Butler (3-9) Bremer (5-14) Fayette (4-12) Clayton (4-13) Woodbury (40-121) Monona Harrison (4-13) Ida (2-6) Crawford (5-14) Pottawattamie (23-68) Mills (5-16) Fremont (1-4) Shelby (2-7) Number of veterans Sac (2-5) Page (4-12) Carroll (6-17) Audubon (1-4) Cass Calhoun (2-5) Greene (2-6) Guthrie (3-9) Adair (1-4) Webster (10-29) Boone (9-27) Dallas (11-34) Madison (4-13) Hamilton Story (24-72) Polk (102-305) Warren (16-48) Hardin (5-15) Marshall (8-23) Jasper (7-20) Marion (6-19) Grundy Black Hawk (26-77) Tama (3-9) Poweshiek (3-9) Mahaska (4-12) Benton (5-16) Iowa (4-11) Keokuk Buchanan (4-12) Linn (42-127) Johnson (24-72) Washington (5-16) Adams Union Clarke Lucas Monroe Wapello Jefferson (1-3) Henry (2-7) (2-6) (1-4) (7-22) (3-9) (7-20) Taylor (1-4) Ringgold (1-2) Decatur (1-4) Wayne (2-5) Delaware Appanoose (2-7) Davis (2-5) Van Buren (2-5) Lee (9-27) Jones (4-13) Cedar (4-13) Muscatine (8-25) Louisa (2-7) Des Moines (9-27) Dubuque (19-56) Jackson (4-12) Clinton (8-24) Scott (37-112) 2-10 11-23 24-56 57-90 91-150 Source: Defense Manpower Data Center, as of 3/31/11 Citizen Soldier Support Program. Estimates based on Ramchand, R., et al. (2008). 7

Estimated Number of Veterans with PTSD Lyon (16) Sioux (43) Osceola Obrien (27) Dickinson (41) Clay (35) Emmet Winnebago Worth Mitchell Howard (20) (24) (19) (23) (19) Winneshiek Allamakee Kossuth (33) (34) (32) Palo Alto (20) Hancock (29) Cerro Gordo (82) Floyd (34) Chickasaw (27) Plymouth (57) Cherokee (23) Buena Vista (32) Pocahontas (22) Humboldt (19) Wright (24) Franklin (26) Butler (31) Bremer (49) Fayette (40) Clayton (41) Woodbury (168) Ida (17) Sac (28) Calhoun (28) Webster (67) Hamilton (31) Hardin (37) Grundy (27) Black Hawk (244) Buchanan (40) Delaware (32) Dubuque (170) Monona (23) Harrison (36) Crawford (30) Pottawattamie (190) Mills (38) Fremont (18) Number of veterans Shelby (27) Page (33) Carroll (42) Audubon Cass (26) Adams (7) Taylor Greene (17) Guthrie (24) Adair (20) Union (28) Ringgold Dallas (87) Boone (51) Madison (33) Clarke (18) Decatur (16) Story (128) Polk (611) Warren (91) Lucas (14) Wayne Marshall (66) Jasper (70) Marion (65) Monroe (14) Tama (37) Poweshiek (34) Mahaska (39) Wapello (74) Benton (52) Iowa (32) Keokuk (20) Jefferson (31) Linn (428) Johnson (162) Washington (35) Henry (32) Appanoose Davis Van Buren (15) (15) (23) Lee (83) Jones (50) Cedar (42) Muscatine (76) Louisa (19) Des Moines (84) Jackson (50) Clinton (105) Scott (325) 7-19 20-28 29-36 37-66 67-429 Source: Defense Manpower Data Center, as of 3/31/11 Citizen Soldier Support Program. Estimates based on Smith, T.C. et al. (2009). 8

Prevalence of depression is somewhat less than that of PTSD among OEF/OIF veterans Depression prevalence may increase up to 1 year after returning from deployment Older veterans from previous duty (e.g., Korea) and veterans in general show levels of depression comparable with the US population Depression 9

Estimated Number of Service Members Deployed to OIF/OEF with Positive Depression Screen Clay (10) Palo Alto Cerro Gordo (24) Buena Vista (11) Ida Black Hawk (70) Linn (116) Polk (279) Iowa (10) Mills (15) Des Moines (25) Van Buren Number of veterans 2-5 6-7 8-12 13-24 25-279 Source: Defense Manpower Data Center, as of 3/31/11 Citizen Soldier Support Program. Estimates based on (Thomas et al., 2010). 10 Note: Depression with some impairment

Estimated Number of Veterans with Positive Depression Screen Lyon (88) Worth (101) Sioux (231) Clay (189) Cerro Gordo (444) Buena Vista (173) Butler (166) Ida (90) Jones (269) Iowa (172) Cedar (225) Mills Union (206) Henry (151) Des (172) Moines (450) Number of veterans 39-104 105-151 152-192 193-355 356-2313 Source: Defense Manpower Data Center, as of 3/31/11 Citizen Soldier Support Program. Estimates based on (Britton et al., 2011). 11

Alcohol problems and overuse are strongly to moderately related to PTSD and depression Combat exposure and being younger are risk factors for alcohol misuse Rural veterans are less likely to drink, but those who do are more likely to binge drink and drink and drive Population studies suggest veterans generally are less prone to hazardous drinking than non-veterans Substance Abuse 12

Number of Service Members Admitted to Community-Based Substance Abuse Treatment (2011) Lyon Sioux Plymouth Osceola (0) Obrien (1) Cherokee (13) Dickinson Clay (8) Buena Vista Emmet Palo Alto Pocahontas Kossuth Humboldt Winnebago Hancock Wright Worth (1) Cerro Gordo (24) Franklin (0) Mitchell (0) Floyd (15) Butler Howard Chickasaw (7) Bremer (8) Winneshiek Fayette (16) Allamakee (7) Clayton (9) Woodbury (48) Ida Sac Calhoun Webster (29) Hamilton Hardin Grundy (0) Black Hawk (52) Buchanan Delaware Dubuque (52) Monona Harrison Crawford Shelby Carroll Audubon Greene Guthrie Dallas (13) Boone Story (34) Polk (169) Marshall (17) Jasper (10) Tama Poweshiek (11) Benton Iowa (1) Linn (93) Johnson (19) Jones Cedar Jackson (10) Clinton (22) Scott (130) Pottawattamie (17) Cass Adair (1) Madison Warren Marion Mahaska Keokuk Washington Muscatine (22) Louisa Mills Fremont (1) Montgomery (10) Page Adams Union Clarke Lucas Monroe Wapello Jefferson Henry (1) (0) (1) Des Moines (7) Van Taylor Ringgold Decatur Wayne Appanoose Davis Buren (0) (0) Lee Number of veterans 0-5 6-10 11-25 26-130 Source: IDPH, Central Repostory (accessed by Iowa Consortium for Substance Abuse Research and Evaluation) 13

Service Number Percent Armed Forces/On Active Duty/Combat History 217 6.7 Armed Forces/On Active Duty/No Combat History 279 8.6 Military Dependent 11 0.3 National Guard/Combat History 51 1.6 National Guard/No Combat History 281 8.7 National Guard/On Active Duty/Combat History 47 1.5 National Guard/On Active Duty/No Combat History 107 3.3 Retired From Military/Combat History 116 3.6 Retired From Military/No Combat History 116 3.6 Served In Armed Forces/Combat History 530 16.4 Served In Armed Forces/No Combat History 1,336 41.3 Admissions to Substance Abuse Treatment (2011) with Military History 14

We will be adding material over time. Thank you for your interest. Contact: stephan-arndt@uiowa.edu More Coming 15