The Building Veteran Healthy Communities Project shifts from traditional health care’s focus on individual diagnosis and treatment to a public health approach, concentrating on community-level systems change to improve veterans’ well-being. This innovative model holds great promise for enhancing the well-being of veteran populations nationwide and serves as a beacon for similar public health initiatives to be implemented across the United States.

The project seeks to delineate social determinants of health (SDOH) and community assets, coordinate and raise awareness of existing resources, and promote interconnections between community organizations, health care providers and the veterans impacted by these relationships. This concerted effort to create a supportive environment where veterans can thrive needs to be scaled up. The BVHC project aims to empower communities in the Durham Veterans Affairs 27-county region in North Carolina and beyond to support veterans in leading healthy and meaningful lives. By leveraging local resources and fostering interconnections, public health professionals can achieve that goal.

By harnessing the collective strength of communities, we can strive toward a future where veterans receive the comprehensive support they need to lead fulfilling and resilient lives post-service. Over the past year, the BVHC team found a disproportionate suicide rate for veterans compared to non-veterans. Notably, in 2020, the age-and-sex-adjusted suicide rate for veterans was 57.3% higher than that of their non-veteran peers.

This statistic underscores the urgent need for comprehensive strategies to combat this alarming public health crisis. Many Department of Veterans Affairs-sponsored strategies predominantly focus on individual interventions that support veterans already connected to treatment options. The insights provided by the BVHC team not only highlight the severity of the issue but also point toward actionable solutions that prioritize collaboration between health care providers, community organizations and veterans themselves. There is a clear call for broader community-based approaches. Public health practitioners need to emphasize interventions that involve community support as veterans transition from military to civilian life.

By emphasizing community-level support systems, public health practitioners can complement existing VA efforts and create a more holistic approach to veteran mental health care. Community-based interventions are science-based approaches to changing community systems and contexts to improve population health outcomes, and these have been shown to effectively reduce suicide rates in diverse communities around the world. Community-based interventions offer a promising avenue for addressing the root causes of veteran suicide by targeting systemic factors and leveraging local resources.

No factor influencing veteran mental health exists in a vacuum. This reinforces the need for public health experts to fund interventions that promote relationship-building and support networks for veterans. Community prevention focuses on addressing social determinants of health outside the VHA health care system to promote early awareness and prevention before times of crisis, while also expanding collaboration and coordination of services across all veterans, families, non-VHA health care systems, other community partners, and VA. By recognizing the interconnectedness of various factors impacting veteran well-being, interventions can be tailored to address the multifaceted nature of mental health challenges faced by this population. Suicide prevention is the top clinical priority for the VA and a priority for public health across the globe.

By expanding coordination of services and enhancing collaboration across sectors, community prevention efforts can create a more comprehensive support system for veterans. VA has embarked on a comprehensive program of clinically-based and community-based strategies within a public health framework guided by the research currently available. A concerted effort involving diverse stakeholders is imperative to effectively combat this crisis.

Although suicide prevention is a core responsibility of the VA and all health care systems, the mission of suicide prevention cannot be fully achieved by any system. This is an urgent matter that requires a broad public response but one that is adapted to each circumstance. This adaptive approach acknowledges the heterogeneity of veteran populations and the importance of context-specific interventions. By fostering collaboration, innovation and adaptability, we can work toward a future where suicide prevention efforts are comprehensive, inclusive, and ultimately effective in safeguarding the well-being of veterans.

Throughout BVHC’s duration, the team has enhanced communication and collaboration among partners in pilot communities. BVHC’s overarching goal is to create a local veteran-support model that will be transparent, scalable and sustainable for other communities in North Carolina and nationwide. Future programs need to build upon existing groundwork, with a focus on deepening engagement with community partners. Overall, BVHC’s holistic approach, coupled with its emphasis on collaboration, evidence-based practices and accountability, positions it as a trailblazer in the field of veteran support services.

As members of the community, all of us can increase our awareness and interest in learning more about individuals transitioning to civilian life. By fostering a culture of empathy and curiosity, we can create a more inclusive and supportive environment for veterans as they navigate this significant life transition. Health care providers can prevent unintentional injuries, mental health crises, and suicide attempts by asking about military service, using screening tools like the SDOH screening questions, and inquiring about social support, volunteerism, and community connection. The BVHC project envisions a brighter future for veterans in the Durham VA region and beyond. The project offers evidence-based community approaches to providing protective factors that reduce veteran suicidal ideation and attempts, ensuring a comprehensive approach to veteran support.

The success of initiatives like the BVHC project hinges on the active engagement and collaboration of all stakeholders, from community members to health care providers. By working together and embracing evidence-based practices, we can create a more resilient and supportive ecosystem that empowers veterans to thrive in civilian life.

Alisa Andrews is a first-year master’s in public health candidate at Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. She is currently working as a climate health intern with Military Veterans of America. She received bachelor’s degrees in Agricultural Science and Science, Technology, and Society from North Carolina State University in 2023.