Needs Assessment - MVCCmvcc-sa.org/images/upload/2016 MVCC Needs Assessment.pdf · • 18-24...

Understanding Characteristics and Needs of Service Members,Veterans and Family Members in San Antonio, Texas

2016 Military City USANeeds Assessment

Together We Do MoreMILITARY AND VETERAN COMMUNITY COLLABORATIVE

Table of Contents

Prepared for theMilitary and VeteranCommunity Collaborative

Prepared by:

Jonathan Wivagg, Ph.D.

Gloria Martinez-Ramos, Ph.D.

Colin Pierson, MA

“As we express our gratitude, we must never forget that the highest appreciation is not to

utter words, but to live by them”

- John F. Kennedy35th President of the United States

Veteran, United States Navy

EXECUTIVE SUMMARY

BACKGROUND OF THE STUDY

SERVICE MEMBER AND VETERAN CHARACTERISTICS

Active Duty Population

Veteran Population

INCOME AND EMPLOYMENT

Income, Unemployment and Underemployment

Veteran Business Owner Demographics

HEALTH AND WELLNESS

Health Care Services

Suicide and Mental Health

HOUSING AND HOMELESSNESS

Housing

Homelessness

LEGAL

LIMITATIONS AND FUTURE RESEARCH

ACKNOWLEDGMENTS AND SOURCES

Sources

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Made possible in large part by a grant from theSan Antonio Area Foundation

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A Note from Major General Alfred Valenzuela (US Army, Retired) President and Chair, Military and Veteran Community Collaborative

We enjoy this presence because the military at large as well as individual veterans find that this is a great place to live, work and raise families, with valuable community resources available to support their missions and enrich their lives. Yet many of these great Patriots struggle with unemployment, poverty, inadequate housing, physical and mental illness and other personal and family challenges that require community assistance to overcome. We can do more, and we should do more, to support the needs of those who have given so much to protect our nation.

Our mission at the Military and Veteran Community Collaborative (MVCC) is to promote focused collaboration—to align the efforts of public, private and nonprofit organizations to better support military members, veterans and their families. MVCC was organized in 2015 as a 501(3) nonprofit corporation, building on 3 years of grassroots-level work overseen and enabled by the San Antonio Area Foundation. Hundreds of individuals from over 125 organizations and businesses across the community have been involved in this effort along the way, and this spring we formally launched full-time operations with the hire of our first Executive Director.

As a first step toward developing the type of coordinated, outcomes-oriented community plan that we envision, we chartered the report you are about to read in order to better understand the characteristics and needs of our military and veteran population. The pages that follow contain information we believe you’ll find insightful, and perhaps even surprising:

A Note from Major General Alfred Valenzuela (US Army, Retired) President and Chair, Military and Veteran Community Collaborative

Serving our Military and Veterans in Military City USA

We are proud to live in Military City USA. San Antonio and the immediate surrounding areas represent one of the largest military and veteran communities in the United States. In fact, San Antonio alone accounts for a quarter of the state’s active duty population and our veteran residents place us 9th among the 100 largest cities in the country. Bexar County is home to 153,000 veterans, the 6th largest county-level population in the country and the most densely-populated veteran community in Texas.

We enjoy this presence because the military at large as well as individual veterans find that this is a great place to live, work and raise families, with valuable community resources available to support their missions and enrich their lives. Yet many of these great Patriots struggle with unemployment, poverty, inadequate housing, physical and mental illness and other personal and family challenges that require community assistance to overcome. We can do more, and we should do more, to support the needs of those who have given so much to protect our nation.

Our mission at the Military and Veteran Community Collaborative (MVCC) is to promote focused collaboration—to align the efforts of public, private and nonprofit organizations to better support military members, veterans and their families. MVCC was organized in 2015 as a 501(3) nonprofit corporation, building on 3 years of grassroots-level work overseen and enabled by the San Antonio Area Foundation. Hundreds of individuals from over 125 organizations and businesses across the community have been involved in this effort along the way, and this spring we formally launched full-time operations with the hire of our first Executive Director.

As a first step toward developing the type of coordinated, outcomes-oriented community plan that we envision, we chartered the report you are about to read in order to better understand the characteristics and needs of our military and veteran population. The pages that follow contain information we believe you’ll find insightful, and perhaps even surprising:

• 65% of veteran suicides are by veterans over age 50 • 18-24 year-old veterans experience double the unemployment rate of other veterans • Female veterans experience elevated risks for suicide (double that of non-veteran females);

post-traumatic stress, anxiety and depression (up to 67% higher than male vets); and unemployment (up to 4 times higher than male veterans, depending on age group)

Armed with this information, we think you’ll agree that these problems deserve community-wide attention. While this assessment focuses on the Alamo Region proper, another important consideration is the use of San Antonio-based services by underserved veterans in the regions to our South and West, including the Rio Grande Valley. We hope that you’ll join us toward building high-payoff strategies that harness our collective potential to improve the quality of life for our military and veteran neighbors in and around Military City USA. Much work lies ahead, but this is a powerful community with great passion and energy, and we know that by working together we can do more.

[SIGNATURE IMAGE]

Serving our Military and Veterans in Military City USA

We are proud to live in Military City USA. San Antonio and the immediate surrounding areas represent one of the largest military and veteran communities in the United States. In fact, San Antonio alone accounts for a quarter of the state’s active duty population and our veteran residents place us 9th among the 100 largest cities in the country. Bexar County is home to over 153,000 veterans, the 6th largest county-level population in the country and the most densely-populated veteran community in Texas.

• 65% of veteran suicides are by veterans over age 50• 18-24 year-old veterans experience double the unemployment rate

of other veterans• Female veterans experience elevated risks for suicide (double

that of non-veteran females); post-traumatic stress, anxiety and depression (up to 67% higher than male vets); and unemployment (up to 4 times higher than male veterans, depending on age group)

Armed with this information, we think you’ll agree that these problems deserve community-wide attention. While this assessment focuses on the Alamo Region proper, another important consideration is the use of San Antonio-based services by underserved veterans in the regions to our South and West, including the Rio Grande Valley. We hope that you’ll join us toward building high-payoff strategies that harness our collective potential to improve the quality of life for our military and veteran neighbors in and around Military City USA. Much work lies ahead, but this is a powerful community with great passion and energy, and we know that by working together we can do more.

“Bexar County is home to

over 153,000 veterans...the most densely

populated veteran

community in Texas. We can

do more, and we should do more, to support them.

We hope that you’ll join us.”

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Executive Summary

Background

This executive summary highlights some of the key statistics collected from available sources about service members and veterans in San Antonio and the surrounding area. The data were compiled for the Military and Veterans Community Collaborative (MVCC) to gain insight and understanding of the service member and veteran population in and around San Antonio to help identify needs and prioritize service initiatives.

The main report presents further details about the size and characteristics of the service member and veteran populations in and around San Antonio and about issues such as health care access, income, housing, homelessness, and legal concerns. From an analysis of the various data items researched for this report, the demographics of age and gender emerged as key characteristics associated with different potential needs among veterans. In addition to presenting overall demographics, this Executive Summary focuses on some of the specific challenges that disproportionally confront 3 particular sub-groups of the veteran population:

• Older Veterans• Younger Veterans• Female Veterans

Demographics

Active Duty

• Texas has the 3rd largest population of active duty service members in the nation (117,623 members).

• Joint Base San Antonio accounts for about ¼ of the total active duty service members for Texas (31,720 members).

• Based on the nationwide distribution, more than half of all active duty service members are under the age of 30 and are overwhelmingly male (85%)

• About 7,000 active duty service members from Joint Base San Antonio will transition into civilian life in 2016 alone.

Gender Distribution ofU.S. Active Duty Service Members

Source: Department of Defense, 2014

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Executive Summary (continued)

Source: U.S. Census, 2014 American Community Survey

*Veterans that served in multiple wars are counted in totals for all wars they may have served in individually, so the percentages will add up to more than 100%. Veterans that only served between wars are counted as serving in the war closest to their time of service

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• Older veterans (veterans who served in Vietnam or prior wars) comprise a substantial proportion of the local veteran population and tend to live outside of Bexar County in higher proportions.

• Veterans in Bexar County tend to be younger and more educated, with higher proportions of female, non-white, and Hispanic veterans than the surrounding counties.

San Antonio Area Veterans by Era of Service*

Source: U.S. Census, 2014 American Community Survey. *Veterans that served in multiple wars are counted in totals for all wars they may have served in individually, so the percentages will add up to more than 100%. Veterans that only served between wars are counted as serving in the war closest to their time of service Gender Distribution of Alamo Region Veterans

Source: U.S. Census, 2014 American Community Survey.

Veterans make up 12.9%

of the adult population in San Antonio.

Age Distribution ofU.S. Active Duty Service Members

Veteran

• The 13-county Alamo Region has an estimated 211,563 veterans as of 2014, with about 153,122 of them in Bexar County (the 6th-most heavily veteran-resident county in the United States).

• San Antonio ranks 9th out of the 100 largest cities in the country when it comes to veteran population – veterans make up 12.9% of the population in the city itself.

• Older veterans (veterans who served in Vietnam or prior wars) comprise a substantial proportion of the local veteran population and tend to live outside of Bexar County in higher proportions.

• Veterans in Bexar County tend to be younger and more educated, with higher proportions of female, non-white, and Hispanic veterans than the surrounding counties.

San Antonio Area Veteransby Era of Service*

Source: Department of Defense, 2014

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Gender Distribution ofAlamo Region Veterans

Age Distribution ofAlamo Region Veterans



Older Veterans• In 2014, 65% of veteran suicides nationwide were by veterans

age 50 or older, showing that suicide is an important issue among older veterans. Further, male veterans demonstrated a suicide rate approximately double that of female veterans. Consequently, while there is no direct data are available establishing the particular number of such cases within the Alamo Region, the national data suggest that older male veterans likely represent a local population segment with disproportionally higher suicide risk.

• Older veterans in the 55-to-64 year old age range also experience relatively high unemployment. At the Bexar County, MSA and Alamo Region levels the unemployment rate for these veterans exceeds that of their non-veteran counterparts by about 10%.

65% of veteran suicides

nationwide were by

veterans age 50 or older.Locally, the

unemployment rate for

veterans 55-to-65 years old exceeds that of non-veterans by about 10%.

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Younger Veterans• While younger veterans age 18-34 in the Alamo Region have

slightly lower unemployment rates than younger veterans nationwide (10.9% vs 11.7%), this gap is much smaller than for other age groups and the unemployment rate of Alamo Region veterans in this youngest age group is higher than non-veterans in this age group (10.7%).

• As veterans in the 18-34 age range comprise a much larger proportion of the veteran population in the Alamo Region (12.0% vs. 8.4% nationwide with 14.3% in Bexar County), the high rates of unemployment among younger veterans are an important local issue.

2014 VeteranUnemployment Rates by Age


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2014 Veteran Unemployment Rates by Age


Female Veterans

• While suicide rates among females tend to be lower than rates among males (for both veterans and non-veterans), national statistics indicate that the risk for suicide among female veterans is 2.6 times that of female civilians. 2014 Adult Suicides per 100,000 Population

Source: U.S. Department of Veterans Affairs, 2016.

Female Veterans• While suicide rates among females tend to be lower than rates

among males (for both veterans and non-veterans), national statistics indicate that the risk for suicide among female veterans is 2.6 times that of female civilians.

Local veterans in the 18-34 age group experience

unemployment at twice

the rate of veterans in other age groups.

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2014 Adult Suicides Per100,000 Population


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2014 Veteran Unemployment Rates by Age


Female Veterans

• While suicide rates among females tend to be lower than rates among males (for both veterans and non-veterans), national statistics indicate that the risk for suicide among female veterans is 2.6 times that of female civilians. 2014 Adult Suicides per 100,000 Population

Source: U.S. Department of Veterans Affairs, 2016.

• Female veterans in the region tend to have unique mental health needs. Particularly, female veterans are more likely than their male counterparts to have diagnoses of Mood Disorder (including depression) and Anxiety. Female veterans are slightly more likely to be diagnosed with PTSD and less likely than male veterans to have a diagnosed Substance Use Disorder.

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• Female veterans in the region tend to have unique mental health needs. Particularly, female veterans are more likely than their male counterparts to have diagnoses of Mood Disorder (including depression) and Anxiety. Female veterans are slightly more likely to be diagnosed with PTSD and less likely than male veterans to have a diagnosed Substance Use Disorder. Prevalence of Mental Health Diagnoses Among Bexar County Veterans

Male Veterans Female Veterans PTSD 17% 18% Mood Disorder 21% 35% Anxiety 11% 17% Substance Use Disorder 11% 7% Source: Veterans Health Administration, provided by UTHSCSA.

• Nationwide data from the Bureau of Labor Statistics (July 2015) suggests that unemployment rates are particularly high among female veterans age 18-24. The Alamo Region has relatively high percentages of both younger veterans and female veterans, making unemployment among young female veterans potentially an important issue.

• In addition, the average median income of female veterans is about 10% less than that of male veterans across the Alamo Region.

Median Income for Veterans and Non-Veterans by Gender Bexar MSA Alamo Region All Veterans $44,051 $44,870 $44,406 Male Veterans $44,496 $45,436 $44,975 Female Veterans $41,434 $41,419 $40,769



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• Female veterans in the region tend to have unique mental health needs. Particularly, female veterans are more likely than their male counterparts to have diagnoses of Mood Disorder (including depression) and Anxiety. Female veterans are slightly more likely to be diagnosed with PTSD and less likely than male veterans to have a diagnosed Substance Use Disorder. Prevalence of Mental Health Diagnoses Among Bexar County Veterans

Male Veterans Female Veterans PTSD 17% 18% Mood Disorder 21% 35% Anxiety 11% 17% Substance Use Disorder 11% 7% Source: Veterans Health Administration, provided by UTHSCSA.



Median Income for Veterans and Non-Veterans by Gender Bexar MSA Alamo Region All Veterans $44,051 $44,870 $44,406 Male Veterans $44,496 $45,436 $44,975 Female Veterans $41,434 $41,419 $40,769

Female veterans

experience a suicide risk 2.6 times

greater than non-veteran females, a

diagnosis rate for anxiety and mood

disorders 1.6 times that of

male veterans, and earnings that average

10% less than male veterans.

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Background of the Study

This report, commissioned

by MVCC, represents the

first known comprehensive

needs assessment for military

members and veterans in

San Antonio.

The mission of MVCC is to align the efforts of

public, private and nonprofit organizations

to better support military

members, veterans and their families.

This report was commissioned by the Military and Veteran Community Collaborative (MVCC). MVCC is a 501(c)3 registered nonprofit corporation based in San Antonio, Texas. MVCC exists to align the efforts of public, private and nonprofit organizations to better support military members, veterans and their families in Military City USA. The purpose of this report is to consolidate available data about military service members, veterans, and families of service members and veterans living in and around San Antonio. The report will provide MVCC and other community organizations with reliable estimates about the size, characteristics and need for community services among these populations.

Geographically, this report focuses on San Antonio and surrounding areas at 3 levels:

1. Bexar County2. San Antonio Metropolitan Statistical Area (MSA) – includes Bexar

County and 7 surrounding counties3. Alamo Region – includes the 8 counties comprising the San Antonio

MSA plus 5 additional surrounding counties

The specific counties that comprise the San Antonio MSA and the Alamo Region are listed at the beginning of Section 3.A.

Data for this report comes from a variety of sources, primarily from websites of government agencies (Census, Veterans Affairs, etc.) and from direct contact with representatives of local agencies and organizations. A full list of sources is included as Section 5. The data were compiled by a team of researchers led by Dr. Jon Wivagg with contributions from Dr. Gloria Martinez-Ramos and Mr. Colin Pierson. All 3 team members are Sociology faculty at Texas State University at San Marcos, though this project was contracted directly with the researchers and not through the University.

Work on this project began in June 2016 with an assessment of the potential availability of the data sought by MVCC. This assessment was delivered in July 2016 and MVCC determined that sufficient data existed (or was likely available) to proceed with this report. This report was prepared and delivered in August 2016.

This report begins with presenting the data that the research team was able to obtain during the project timeframe. Section 3 below includes tables and explanatory text that describe the San Antonio area on 5 key dimensions related to service members and veterans:

• General Demographics and Characteristics• Education and Employment• Health and Wellness• Housing and Homelessness• Legal

Section 4 identifies some limitations and suggestions for future research. Finally, Section 5 documents the sources used and acknowledges people who provided assistance with this report.

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Service Member and Veteran Characteristics

The area covered by this report is geographically organized in a variety of ways. While San Antonio itself is located in Bexar County, many of the surrounding counties have substantial veteran populations as well. Table A-1 reveals the county composition of the San Antonio metropolitan statistical area (MSA) and the Alamo Region. The San Antonio MSA is comprised of 8 counties surrounding the city. The Alamo Region is a politically-recognized 13-county planning region situated within south-central Texas.

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SERVICE MEMBER AND VETERAN CHARACTERISTICS The area covered by this report is geographically organized in a variety of ways. While San Antonio itself is located in Bexar County, many of the surrounding counties have substantial veteran populations as well. Table A-1 reveals the county composition of the San Antonio metropolitan statistical area (MSA) and the Alamo Region. The San Antonio MSA is comprised of 8 counties surrounding the city. The Alamo Region is a politically-recognized 13-county planning region situated within south-central Texas. Table A-1: County Composition of Areas Assessed Area Counties

Bexar County Bexar

San Antonio Metropolitan Statistical Area (MSA)

Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, Wilson

Alamo Region Atascosa, Bandera, Bexar, Comal, Frio, Gillespie, Guadalupe, Karnes, Kendall, Kerr, McMullen, Medina, Wilson

Active Duty Population According to the 2014 Demographics Report from the Department of Defense, there are currently about 1,326,273 active duty service members in the country (Table A-2). Of all states, Texas has the 3rd largest active duty population at 117,623 (representing 8.9% of the national total). Table A-2: Population of Active Duty Service Members Number of Active Duty Service Members National 1,326,273 Texas 117,623 San Antonio Area: Fort Sam Houston 10,991 Lackland AFB 17,950 Randolph AFB 2,329 Total JBSA 31,720 Source: Department of Defense, 2014. There are no available data showing the number of active duty service members by county. However, using the Fiscal Year (FY) 2015 data found in the Base Structure Report from the Department of Defense, we can estimate the active duty population in San Antonio’s three military installations that comprise Joint Base San Antonio (JBSA): Fort Sam Houston, Lackland

Active Duty Population

According to the 2014 Demographics Report from the Department of Defense, there are currently about 1,326,273 active duty service members in the country (Table A-2). Of all states, Texas has the 3rd largest active duty population at 117,623 (representing 8.9% of the national total).

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SERVICE MEMBER AND VETERAN CHARACTERISTICS The area covered by this report is geographically organized in a variety of ways. While San Antonio itself is located in Bexar County, many of the surrounding counties have substantial veteran populations as well. Table A-1 reveals the county composition of the San Antonio metropolitan statistical area (MSA) and the Alamo Region. The San Antonio MSA is comprised of 8 counties surrounding the city. The Alamo Region is a politically-recognized 13-county planning region situated within south-central Texas. Table A-1: County Composition of Areas Assessed Area Counties

Bexar County Bexar

San Antonio Metropolitan Statistical Area (MSA)

Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, Wilson

Alamo Region Atascosa, Bandera, Bexar, Comal, Frio, Gillespie, Guadalupe, Karnes, Kendall, Kerr, McMullen, Medina, Wilson

Active Duty Population According to the 2014 Demographics Report from the Department of Defense, there are currently about 1,326,273 active duty service members in the country (Table A-2). Of all states, Texas has the 3rd largest active duty population at 117,623 (representing 8.9% of the national total). Table A-2: Population of Active Duty Service Members Number of Active Duty Service Members National 1,326,273 Texas 117,623 San Antonio Area: Fort Sam Houston 10,991 Lackland AFB 17,950 Randolph AFB 2,329 Total JBSA 31,720 Source: Department of Defense, 2014. There are no available data showing the number of active duty service members by county. However, using the Fiscal Year (FY) 2015 data found in the Base Structure Report from the Department of Defense, we can estimate the active duty population in San Antonio’s three military installations that comprise Joint Base San Antonio (JBSA): Fort Sam Houston, Lackland

There are no available data showing the number of active duty service members by county. However, using the Fiscal Year (FY) 2015 data found in the Base Structure Report from the Department of Defense, we can estimate the active duty population in San Antonio’s three military installations that comprise Joint Base San Antonio (JBSA): Fort Sam Houston, Lackland Air Force Base, and Randolph Air Force Base. The Joint Base San Antonio population of service members is 31,720 which accounts for about one-fourth of all service members in Texas.

Table A-3 includes estimated demographics for active duty members in the San Antonio area (based on the JBSA population) found using the national profile of the active duty population. While this estimate is helpful in understanding the size of the active duty population, the actual number of active duty service members in each of these categories will likely differ somewhat from these estimates.

San Antonio is home to

roughly one-fourth of

the active duty military

members stationed

across Texas.

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Service Member and Veteran Characteristics (continued)

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Air Force Base, and Randolph Air Force Base. The Joint Base San Antonio population of service members is 31,720 which accounts for about one-fourth of all service members in Texas. Table A-3 includes estimated demographics for active duty members in the San Antonio area (based on the JBSA population) found using the national profile of the active duty population. While this estimate is helpful in understanding the size of the active duty population, the actual number of active duty service members in each of these categories will likely differ somewhat from these estimates. Table A-3: National Profile of Active Duty Population and San Antonio Estimates Percentages

(National) San Antonio Active Duty

Population Estimates Sex: Male 84.9% 26,930 Female 15.1% 4,790 Race/Ethnicity: White 60.9% 19,318 Non-white 27.1% 8,596 Hispanic 12.0% 3,806 Age: Less than 25 43.2% 13,703 26 to 30 22.1% 7,010 31 to 35 15.2% 4,821 36 to 40 10.4% 3,299 41+ 9.2% 2,918 Education: Less than high school 0.2% 63 High school/some college 77.0% 24,424 Bachelor’s degree 12.6% 3,997 Advanced Degree 8.1% 2,569 Marital Status: Married 55.3% 17,541 Never married 40.5% 12,847 Other 4.2% 1,332 Have children: 42.2% 13,386

Source: Nationwide percentages are from Department of Defense, FY 2015. Numbers for San Antonio are estimates based on these percentages. Using the estimates, most active duty service members are white (non-Hispanic) males. More than half of the active duty population is under the age of thirty and about three-fourths have a high school diploma or associates degree. More than half are currently married, and 42% of all active duty service members have children.

Source: Nationwide percentages are from Department of Defense, FY 2015. Number for San Antonio are estimates based on these percentages

Using the estimates, most active duty service members are white (non-Hispanic) males. More than half of the active duty population is under the age of thirty and about three-fourths have a high school diploma or associates degree. More than half are currently married, and 42% of all active duty service members have children.

Projections provided from staff at Joint Base San Antonio (which includes the vast majority of service members living in the San Antonio area) show that approximately 7,000 service members will leave military service in the San Antonio area in 2016 (Table A-4). While many will likely re-locate, if even a moderate percentage of them stay in the area, this will be a substantial number of recent service members going through transition from military to civilian life, which can be a time when they are more likely to need services.

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Projections provided from staff at Joint Base San Antonio (which includes the vast majority of service members living in the San Antonio area) show that approximately 7,000 service members will leave military service in the San Antonio area in 2016 (Table A-4). While many will likely re-locate, if even a moderate percentage of them stay in the area, this will be a substantial number of recent service members going through transition from military to civilian life, which can be a time when they are more likely to need services. Table A-4: Projected 2016 Separations from Joint Base San Antonio Officer Enlisted Warrant Officer TOTAL Army 614 4,170 36 4,820 Air Force 154 724 N/A 878 Navy 90 1,228 N/A 1,318 Total 585 6,122 36 7,016 Source: 502d Force Support Group Executive Director email, August 2016.

Veteran Population According to 2014 data from the American Community Survey (ACS) conducted by the U.S. Census Bureau, San Antonio area veterans make up about 12% of the civilian adult population (age 18 and over excluding active duty military personnel), most residing in San Antonio itself (Table A-5). Of the top 100 largest cities in the country, San Antonio has the 9th largest veteran population – 12.9% of the population in the city itself. Most veterans in the area served in wars during the last three decades. As more rural counties are incorporated into the San Antonio MSA and region, the proportion of veterans that served during the Vietnam War and prior wars slightly increases. Table A-5: San Antonio Area Veterans

Bexar MSA

Alamo Region

Total Civilian Adult Population: 1,293,726 1,629,404 1,715,669 Veteran Population: 153,122 200,880 211,563 Veterans (% of pop.): 11.8% 12.3% 12.3% Period of service*: Pre-WWII 0.1% 0.1% 0.1% WWII 4.3% 4.3% 4.7% Korean War 8.4% 8.7% 9.2% Vietnam War 37.9% 39.5% 40.0% Gulf Wars (pre-9/11) 45.1% 44.8% 43.6% Gulf Wars (post-9/11) 26.3% 24.4% 23.6%

Source: U.S. Census 2014 American Community Survey. *Veterans that served in multiple wars are counted in totals for all wars they may have served in individually, so the percentages will add up to more than 100%. Veterans that only served between wars are counted as serving in the war closest to their time of service

More than 7,000 service

members stationed in the San

Antonio area will separate from active

duty in 2016.

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Veteran Population

According to 2014 data from the American Community Survey (ACS) conducted by the U.S. Census Bureau, San Antonio area veterans make up about 12% of the civilian adult population (age 18 and over excluding active duty military personnel), most residing in San Antonio itself (Table A-5). Of the top 100 largest cities in the country, San Antonio has the 9th largest veteran population – 12.9% of the population in the city itself. Most veterans in the area served in wars during the last three decades. As more rural counties are incorporated into the San Antonio MSA and region, the proportion of veterans that served during the Vietnam War and prior wars slightly increases.

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Projections provided from staff at Joint Base San Antonio (which includes the vast majority of service members living in the San Antonio area) show that approximately 7,000 service members will leave military service in the San Antonio area in 2016 (Table A-4). While many will likely re-locate, if even a moderate percentage of them stay in the area, this will be a substantial number of recent service members going through transition from military to civilian life, which can be a time when they are more likely to need services. Table A-4: Projected 2016 Separations from Joint Base San Antonio Officer Enlisted Warrant Officer TOTAL Army 614 4,170 36 4,820 Air Force 154 724 N/A 878 Navy 90 1,228 N/A 1,318 Total 585 6,122 36 7,016 Source: 502d Force Support Group Executive Director email, August 2016.

Veteran Population According to 2014 data from the American Community Survey (ACS) conducted by the U.S. Census Bureau, San Antonio area veterans make up about 12% of the civilian adult population (age 18 and over excluding active duty military personnel), most residing in San Antonio itself (Table A-5). Of the top 100 largest cities in the country, San Antonio has the 9th largest veteran population – 12.9% of the population in the city itself. Most veterans in the area served in wars during the last three decades. As more rural counties are incorporated into the San Antonio MSA and region, the proportion of veterans that served during the Vietnam War and prior wars slightly increases. Table A-5: San Antonio Area Veterans

Bexar MSA

Alamo Region

Total Civilian Adult Population: 1,293,726 1,629,404 1,715,669 Veteran Population: 153,122 200,880 211,563 Veterans (% of pop.): 11.8% 12.3% 12.3% Period of service*: Pre-WWII 0.1% 0.1% 0.1% WWII 4.3% 4.3% 4.7% Korean War 8.4% 8.7% 9.2% Vietnam War 37.9% 39.5% 40.0% Gulf Wars (pre-9/11) 45.1% 44.8% 43.6% Gulf Wars (post-9/11) 26.3% 24.4% 23.6%

Source: U.S. Census 2014 American Community Survey. *Veterans that served in multiple wars are counted in totals for all wars they may have served in individually, so the percentages will add up to more than 100%. Veterans that only served between wars are counted as serving in the war closest to their time of service

Table A-6 shows the Texas counties with the largest number of veterans. Bexar County has the second largest veteran population in the state – only surpassed by much larger Harris County – and it has the highest proportion of veterans (among the civilian adult population) of any of these counties.

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Table A-6 shows the Texas counties with the largest number of veterans. Bexar County has the second largest veteran population in the state – only surpassed by much larger Harris County – and it has the highest proportion of veterans (among the civilian adult population) of any of these counties. Table A-6: Top Five Veterans Population Texas Counties Civilian Adult Population Veterans Percent Veteran Harris 3,092,972 175,509 5.7% Bexar 1,293,726 153,122 11.8% Tarrant 1,361,940 116,751 8.6% Dallas 1,782,306 104,062 5.8% Travis 835,710 53,605 6.4% Statewide 19,004,447 1,564,501 8.2% Source: U.S. Census 2014 American Community Survey.

Table A-7 reveals the demographic profile of area veterans. Veterans in the San Antonio area are predominantly white (non-Hispanic) males. Almost half of these veterans are between the ages of 18 and 54, although that proportion decreases as rural counties are incorporated into the region. This suggests that a larger number of young veterans reside in the city itself, where higher proportions of older veterans are found in surrounding counties. About a third of veterans in the area have a bachelor’s degree or more.

Table A-7 reveals the demographic profile of area veterans. Veterans in the San Antonio area are predominantly white (non-Hispanic) males. Almost half of these veterans are between the ages of 18 and 54, although that proportion decreases as rural counties are incorporated into the region. This suggests that a larger number of young veterans reside in the city itself, where higher proportions of older veterans are found in surrounding counties. About a third of veterans in the area have a bachelor’s degree or more.

Bexar County’s veterans represent 11.8% of the adult

population--highest of any county in the state and nearly

1.5 times the statewide average.

Table A-6: Top Five Texas County Veteran Populations

11



13

Table A-7: Profile of Area Veterans Bexar MSA Alamo Region National

Number of veterans 153,122 200,880 211,563 20,700,711 Sex: Male 130,198 (85.0%) 172,065 (85.7%) 181,939 (86.0%) 92.4% Female 22,924 (15.0%) 28,815 (14.3%) 29,624 (14.0%) 7.6% Race/Ethnicity: White 74,317 (48.5%) 109,630 (54.6%) 118,658 (56.1%) 79.6% Non-white 24,443 (16.0%) 28,247 (14.1%) 28,572 (13.5%) 14.6% Hispanic 54,362 (35.5%) 63,003 (31.4%) 64,333 (30.4%) 5.8% Age: 18 to 34 21,856 (14.3%) 24,691 (12.3%) 25,373 (12.0%) 8.4% 35 to 54 50,525 (33.0%) 65,881 (32.8%) 67,524 (31.9%) 24.7% 55 to 64 32,694 (21.4%) 43,762 (21.8%) 45,591 (21.5%) 21.9% 65 to 74 25,269 (16.5%) 35,847 (17.8%) 38,723 (18.3%) 22.4% 75+ 22,778 (14.9%) 30,699 (15.3%) 34,352 (16.2%) 22.7% Education: Less than high school 7,515 (5.0%) 10,230 (5.2%) 10,963 (5.3%) 7.4% High school 28,714 (19.2%) 38,697 (19.7%) 41,665 (20.1%) 29.3% Some college / associates 62,514 (41.8%) 80,818 (41.1%) 84,246 (40.6%) 36.6% Bachelor degree or more 50,653 (33.9%) 66,978 (34.0%) 70,402 (34.0%) 26.6%

Source: U.S. Census 2014 American Community Survey.

Figure A-1 shows that veterans are much more prevalent among the older adult population in Bexar County. In the oldest age range of age 75 and over (approximately 84,000 people), more than 1 in 4 adults are veterans.

Figure A-1: Veterans as a Percentage of Bexar County Population by Age Range



13

Table A-7: Profile of Area Veterans Bexar MSA Alamo Region National

Number of veterans 153,122 200,880 211,563 20,700,711 Sex: Male 130,198 (85.0%) 172,065 (85.7%) 181,939 (86.0%) 92.4% Female 22,924 (15.0%) 28,815 (14.3%) 29,624 (14.0%) 7.6% Race/Ethnicity: White 74,317 (48.5%) 109,630 (54.6%) 118,658 (56.1%) 79.6% Non-white 24,443 (16.0%) 28,247 (14.1%) 28,572 (13.5%) 14.6% Hispanic 54,362 (35.5%) 63,003 (31.4%) 64,333 (30.4%) 5.8% Age: 18 to 34 21,856 (14.3%) 24,691 (12.3%) 25,373 (12.0%) 8.4% 35 to 54 50,525 (33.0%) 65,881 (32.8%) 67,524 (31.9%) 24.7% 55 to 64 32,694 (21.4%) 43,762 (21.8%) 45,591 (21.5%) 21.9% 65 to 74 25,269 (16.5%) 35,847 (17.8%) 38,723 (18.3%) 22.4% 75+ 22,778 (14.9%) 30,699 (15.3%) 34,352 (16.2%) 22.7% Education: Less than high school 7,515 (5.0%) 10,230 (5.2%) 10,963 (5.3%) 7.4% High school 28,714 (19.2%) 38,697 (19.7%) 41,665 (20.1%) 29.3% Some college / associates 62,514 (41.8%) 80,818 (41.1%) 84,246 (40.6%) 36.6% Bachelor degree or more 50,653 (33.9%) 66,978 (34.0%) 70,402 (34.0%) 26.6%



Figure A-1: Veterans as a Percentage of Bexar County Population by Age Range


Figure A-1: Veterans as a Percentage ofBexar County Population by Age Range


12


Income and Employment

Income, Unemployment and Underemployment

The median income for veterans age 18+ in Bexar County is $44,051 per year (Table B-1). Veterans in the wider San Antonio MSA and Alamo Region have similar median incomes. Median income for veterans is high relative to non-veterans (about 1.9 times higher). Both veteran and non-veteran females have lower median income than males with their same status. However, the median income for women veterans is about 91% of the level for male veterans in the region while non-veteran women have only about 73% of the income level of non-veteran males.

14

INCOME AND EMPLOYMENT Income, Unemployment and Underemployment The median income for veterans age 18+ in Bexar County is $44,051 per year (Table B-1). Veterans in the wider San Antonio MSA and Alamo Region have similar median incomes. Median income for veterans is high relative to non-veterans (about 1.9 times higher). Both veteran and non-veteran females have lower median income than males with their same status. However, the median income for women veterans is about 91% of the level for male veterans in the region while non-veteran women have only about 73% of the income level of non-veteran males. Table B-1: Median Annual Income and Poverty

Bexar

MSA Alamo Region

All Veterans $44,051 $44,870 $44,406 Male Veterans $44,496 $45,436 $44,975 Female Veterans $41,434 $41,419 $40,769 All Non-Veterans $23,206 $23,778 $23,648 Male Non-veterans $26,628 $28,137 $28,101 Female Non-veterans $20,541 $20,573 $20,445 Percentage of veterans (currently in the labor force) with income below poverty*:

7.1%

6.5%

6.6%

Of those in poverty: percent who are disabled** 34.9% 34.5% 34.8%

Source: U.S. Census 2014 American Community Survey. * “Poverty” levels vary by household size and whether a person is age 65 or over. In 2014 (the date of these statistics), the poverty level was $15,379 for a two-person family unit and $24,230 for a family of four. **”Disabled” refers to veterans with a serious difficulty with at least one of four basic areas of functioning –hearing, vision, cognition, and/or ambulation.

In general, Table B-2 shows that veterans tend to have lower unemployment rates than non-veterans and the Alamo region tends to have lower unemployment rates than the national average. Nationally, younger veterans age 18-34 have considerably higher unemployment rates than older veterans and this holds true for the Alamo Region as well. While younger veterans age 18-34 in the Alamo Region have slightly lower unemployment than younger veterans nationwide (10.9% vs 11.7%), this gap is much smaller than for other age groups and the unemployment rate of Alamo Region veterans in this youngest age group is higher than non-veterans in this age group (10.7%). As veterans in the 18-34 age range comprise a much larger proportion of the veteran population in the Alamo Region (12.0% vs. 8.4% nationwide) and an even larger proportion in Bexar County (14.3%), the high rates of unemployment among younger veterans are an important local issue.

In general, Table B-2 shows that veterans tend to have lower unemployment rates than non-veterans and the Alamo region tends to have lower unemployment rates than the national average. Nationally, younger veterans age 18-34 have considerably higher unemployment rates than older veterans and this holds true for the Alamo Region as well. While younger veterans age 18-34 in the Alamo Region have slightly lower unemployment than younger veterans nationwide (10.9% vs 11.7%), this gap is much smaller than for other age groups and the unemployment rate of Alamo Region veterans in this youngest age group is higher than non-veterans in this age group (10.7%). As veterans in the 18-34 age range comprise a much larger proportion of the veteran population in the Alamo Region (12.0% vs. 8.4% nationwide) and an even larger proportion in Bexar County (14.3%), the high rates of unemployment among younger veterans are an important local issue.

Another group demonstrating disproportionally higher unemployment is the 55-to-64 year old veteran population. At the Bexar County, MSA and Alamo Region levels the unemployment rate for these veterans exceeds that of their non-veteran counterparts by about 10%.

15

Another group demonstrating disproportionally higher unemployment is the 55-to-64 year old veteran population. At the Bexar County, MSA and Alamo Region levels the unemployment rate for these veterans exceeds that of their non-veteran counterparts by about 10%. Table B-2: Veteran (and Non-veteran) Unemployment Rates

Bexar

MSA Alamo Region

National

Unemployment*: Overall 6.4% (7.9%) 6.4% (7.6%) 6.4% (7.6%) 8.2% (9.1%) 18 to 34 year olds 10.6% (10.8%) 10.9% (10.6%) 10.9% (10.7%) 11.7% (12.5%) 35 to 54 year olds 5.1% (6.0%) 5.2% (5.6%) 5.1% (5.6%) 7.3% (7.2%) 55 to 64 year olds 5.4% (5.1%) 5.4% (4.9%) 5.5% (4.9%) 7.8% (6.4%)

Source: U.S. Census 2014 American Community Survey. *Percentage found using number of veterans who are in the labor force who are currently unemployed divided by the total number of veterans who are in the labor force. Nonveteran unemployment rates are in parentheses. In addition, nationwide data from the Bureau of Labor Statistics (July 2015) suggests that unemployment rates are particularly high among female veterans age 18-24, as much as double that of their non-veteran counterparts (17.0% vs 9.6%) and 4 times greater than that of their young male veteran colleagues (17.0% vs 3.6%). While direct data on gender-specific unemployment is unavailable at the local level, these national statistics suggest young female veterans likely may suffer disproportionally-higher unemployment within the Alamo Region. About 7% of veterans who are currently in the labor force and working currently have incomes below poverty and about one third of that group are currently disabled. Veteran Business Owner Demographics Demographic characteristics of veterans who are business owners is available from the 2015 U.S. Bureau of Labor statistics (Table B-3). Businesses are separated into two categories: employer businesses (those that have paid employees) and non-employer businesses (those that do not or are self-employed only). Table B-3: Percentage of Businesses that are Veteran-Owned

Bexar MSA

Alamo Region

Total number of businesses (employer) 33,910 42,361 45,312 Percent that are veteran-owned 12.0% 11.6% 11.4% Total number of businesses (non-employer) 120,595 157,377 167,839 Percent that are veteran-owned 10.3% 10.6% 10.5% Source: U.S. Bureau of Labor Statistics, 2015.

The majority of employer and non-employer businesses in the region are located in Bexar County. Of the employer businesses about 12% are veteran-owned, and that figure decreases

Veterans under 35

and over 54 experience

elevated unemployment

rates.

13


Income and Employment (continued)

In addition, nationwide data from the Bureau of Labor Statistics (July 2015) suggests that unemployment rates are particularly high among female veterans age 18-24, as much as double that of their non-veteran counterparts (17.0% vs 9.6%) and 4 times greater than that of their young male veteran colleagues (17.0% vs 3.6%). While direct data on gender-specific unemployment is unavailable at the local level, these national statistics suggest young female veterans likely may suffer disproportionally-higher unemployment within the Alamo Region. About 7% of veterans who are currently in the labor force and working currently have incomes below poverty and about one third of that group are currently disabled.

Veteran Business Owner Demographics

Demographic characteristics of veterans who are business owners is available from the 2015 U.S. Bureau of Labor statistics (Table B-3). Businesses are separated into two categories: employer businesses (those that have paid employees) and non-employer businesses (those that do not or are self-employed only).

15

Another group demonstrating disproportionally higher unemployment is the 55-to-64 year old veteran population. At the Bexar County, MSA and Alamo Region levels the unemployment rate for these veterans exceeds that of their non-veteran counterparts by about 10%. Table B-2: Veteran (and Non-veteran) Unemployment Rates

Bexar

MSA Alamo Region

National

Unemployment*: Overall 6.4% (7.9%) 6.4% (7.6%) 6.4% (7.6%) 8.2% (9.1%) 18 to 34 year olds 10.6% (10.8%) 10.9% (10.6%) 10.9% (10.7%) 11.7% (12.5%) 35 to 54 year olds 5.1% (6.0%) 5.2% (5.6%) 5.1% (5.6%) 7.3% (7.2%) 55 to 64 year olds 5.4% (5.1%) 5.4% (4.9%) 5.5% (4.9%) 7.8% (6.4%)

Source: U.S. Census 2014 American Community Survey. *Percentage found using number of veterans who are in the labor force who are currently unemployed divided by the total number of veterans who are in the labor force. Nonveteran unemployment rates are in parentheses. In addition, nationwide data from the Bureau of Labor Statistics (July 2015) suggests that unemployment rates are particularly high among female veterans age 18-24, as much as double that of their non-veteran counterparts (17.0% vs 9.6%) and 4 times greater than that of their young male veteran colleagues (17.0% vs 3.6%). While direct data on gender-specific unemployment is unavailable at the local level, these national statistics suggest young female veterans likely may suffer disproportionally-higher unemployment within the Alamo Region. About 7% of veterans who are currently in the labor force and working currently have incomes below poverty and about one third of that group are currently disabled. Veteran Business Owner Demographics Demographic characteristics of veterans who are business owners is available from the 2015 U.S. Bureau of Labor statistics (Table B-3). Businesses are separated into two categories: employer businesses (those that have paid employees) and non-employer businesses (those that do not or are self-employed only). Table B-3: Percentage of Businesses that are Veteran-Owned

Bexar MSA

Alamo Region

Total number of businesses (employer) 33,910 42,361 45,312 Percent that are veteran-owned 12.0% 11.6% 11.4% Total number of businesses (non-employer) 120,595 157,377 167,839 Percent that are veteran-owned 10.3% 10.6% 10.5% Source: U.S. Bureau of Labor Statistics, 2015.

The majority of employer and non-employer businesses in the region are located in Bexar County. Of the employer businesses about 12% are veteran-owned, and that figure decreases The majority of employer and non-employer businesses in the region are

located in Bexar County. Of the employer businesses about 12% are veteran-owned, and that figure decreases as surrounding counties are considered. Of the non-employer businesses about 10% are veteran-owned, and that figure actually increases as surrounding counties are considered. Table B-4 below combines employer and non-employer businesses to look at the overall numbers and prevalence of veteran-owned businesses. Table B-4 shows that in the Alamo Region, the most common types of veteran-owned businesses in terms of total numbers are:

1. Professional, Scientific, and Technical Services2. Construction3. Health Care and Social Assistance4. Real Estate and Rental and Leasing5. Retail

National employment figures show

female veteran unemployment

rates, particularly

for those age 18-24, may be as much

as two to four times greater

than for their female non-veteran counterparts or for male veterans.

14


Income and Employment (continued)

16

as surrounding counties are considered. Of the non-employer businesses about 10% are veteran-owned, and that figure actually increases as surrounding counties are considered. Table B-4 below combines employer and non-employer businesses to look at the overall numbers and prevalence of veteran-owned businesses. Table B-4 shows that in the Alamo Region, the most common types of veteran-owned businesses in terms of total numbers are:

1. Professional, Scientific, and Technical Services 2. Construction 3. Health Care and Social Assistance 4. Real Estate and Rental and Leasing 5. Retail

Table B-4: Number and Percentage of Businesses that are Veteran-Owned, by Industry Sector

Bexar

MSA

Alamo Region

All Sectors 16,496 (10.7%) 21,603 (10.8%) 22,812 (10.7%) Prof., Scientific, and Technical Services 2,934 (15.7%) 3,735 (15.6%) 3,855 (15.2%) Construction 2,170 (10.2%) 3,023 (10.7%) 3,229 (10.7%) Health Care and Social Assistance 1,545 (10.8%) 1,890 (11.1%) 1,922 (10.7%) Real Estate, Rental & Leasing 1,448 (11.9%) 1,709 (10.5%) 1,849 (10.6%) Retail 1,417 (9.9%) 1,816 (9.6%) 1,816 (9.0%) Other 1,333 (7.1%) 1,661 (6.9%) 1,786 (6.9%) Admin, Support, Waste Mgmt. & Rem. 1,307 (8.0%) 1,605 (7.9%) 1,718 (7.9%) Finance & Insurance 928 (14.6%) 1,266 (15.0%) 1,301 (14.5%) Transportation & Warehousing 678 (10.5%) 957 (11.6%) 957 (11.0%) Arts, Entertainment & Recreation 638 (10.3%) 778 (9.8%) 778 (9.3%) Wholesale 484 (13.6%) 646 (13.9%) 646 (13.2%) Educational Services 414 (12.3%) 463 (10.9%) 463 (10.5%) Manufacturing 250 (10.5%) 462 (13.5%) 462 (12.3%) Accommodation & Food Services 244 (4.0%) 330 (4.3%) 330 (4.0%) Information 201 (11.0%) 245 (10.9%) 245 (10.4%) Mining 94 (5.2%) 141 (5.7%) 187 (6.7%) Agriculture 49 (16.4%) 133 (14.9%) 157 (13.7%) Source: U.S. Census, 2012 Survey of Business Owners

However, looking at the relative percentage of veteran-owned businesses, businesses in the following industries have the highest concentration of veteran owners:

1. Professional, Scientific, and Technical Services 2. Finance and Insurance 3. Agriculture 4. Wholesale 5. Manufacturing

However, looking at the relative percentage of veteran-owned businesses, businesses in the following industries have the highest concentration of veteran owners:

1. Professional, Scientific, and Technical Services2. Finance and Insurance3. Agriculture4. Wholesale5. Manufacturing

There are also some regional differences when looking at Bexar County as compared to the San Antonio MSA and Alamo Region. For example, businesses related to Agriculture, Real Estate, and Educational Services in Bexar County are more likely to be veteran-owned, while business related to Manufacturing and Mining in the surrounding area are more likely to be veteran-owned.

15


Health and Wellness

Health Care Services

Health care represents a widespread need for military service members and veterans. This report includes measures of how many veterans use health care services provided by the VA and TRICARE. While data about the prevalence of illnesses and injuries among veterans and service members are not publicly available, this report does provide some data about mental health conditions and suicide.

VA data from FY 2015 show that almost 70,000 Alamo Region veterans received care from the VA with total expenditures of around $712.7 million (Table C-1). Veterans in the region account for about 15% of the total veterans served statewide. About 1 in 3 veterans in the area (33%) received VA care in the past year.

18

HEALTH AND WELLNESS Health Care Services Health care represents a widespread need for military service members and veterans. This report includes measures of how many veterans use health care services provided by the VA and TRICARE. While data about the prevalence of illnesses and injuries among veterans and service members are not publicly available, this report does provide some data about mental health conditions and suicide. VA data from FY 2015 show that almost 70,000 Alamo Region veterans received care from the VA with total expenditures of around $712.7 million (Table C-1). Veterans in the region account for about 15% of the total veterans served statewide. About 1 in 3 veterans in the area (33%) received VA care in the past year. Table C-1: Veterans Receiving VA Care Bexar MSA Alamo Region VA Patients 51,646 65,921 69,739 Source: U.S. Department of Veteran Affairs, 2014.

According to FY 2015 data compiled by the National Center for Veterans Analysis & Statistics, the region had over 80,000 veterans receiving compensation. Comparing Table C-2 with Table C-1, it seems that most (89%) of veterans with a VA disability rating did receive at least some VA care. However, the number of these disabled veterans exceeds the number of patients served by the VA by almost 9,000. Even assuming that all of the veterans seen by the VA had a disability rating, this could mean that many veterans do not need frequent treatment, get their treatment outside of the VA, or fail to get the treatment they need.

According to FY 2015 data compiled by the National Center for Veterans Analysis & Statistics, the region had over 80,000 veterans receiving compensation. Comparing Table C-2 with Table C-1, it seems that most (89%) of veterans with a VA disability rating did receive at least some VA care. However, the number of these disabled veterans exceeds the number of patients served by the VA by almost 9,000. Even assuming that all of the veterans seen by the VA had a disability rating, this could mean that many veterans do not need frequent treatment, get their treatment outside of the VA, or fail to get the treatment they need.

19

Table C-2: Number Veterans Receiving Compensation Bexar MSA Alamo Region Number of Veterans 61,031 78,497 80,783 VA Disability Rating 0%-20% 14,158 (23.2%) 18,193 (23.2%) 18,804 (23.3%) 30%-40% 10,202 (16.7%) 13,112 (16.7%) 13,471 (16.7%) 50%-60% 10,028 (16.4%) 12,902 (16.4%) 13,208 (16.3%) 70%-90% 17,393 (28.5%) 22,383 (28.5%) 22,930 (28.4%) 100% 7,583 (12.4%) 9,891 (12.6%) 10,188 (12.6%) Pension Only 1,667 (2.7%) 2,006 (2.6%) 2,181 (2.7%) Age

Under 35 6,812 (11.2%) 8,047 (10.3%) 8,221 (10.2%) 35 to 44 9,015 (14.8%) 11,140 (14.2%) 11,298 (14.0%) 45 to 54 13,114 (21.5%) 17,493 (22.3%) 17,681 (21.9%) 55 to 64 12,846 (21.0%) 16,570 (21.1%) 16,919 (20.9%) 65 to 74 12,426 (20.4%) 16,476 (21.0%) 17,275 (21.4%) 75+ 6,818 (11.2%) 8,767 (11.2%) 9,385 (11.6%) Sex

Male 51,360 (84.2%) 66,397 (84.6%) 68,522 (84.8%) Female 9,671 (15.8%) 12,101 (15.4%) 12,256 (15.2%)

Source: U.S. Department of Veteran Affairs, FY 2015. Many veterans also receive health benefits through TRICARE. While county-level data are not available, the Department of Defense’s FY2015 report to Congress stated that there were 516,427 total TRICARE enrollees in Texas (including veterans and eligible family members). Assuming that beneficiaries in the San Antonio area participate at statewide rates, the estimated number of TRICARE beneficiaries is shown in Table C-3. Table C-3: Estimated TRICARE Beneficiaries Bexar MSA Alamo Region Estimated TRICARE Beneficiaries 55,046 72,215 76,055 Source: Department of Defense, FY 2015.

Suicide and Mental Health In July of 2016, the VA released new nationwide statistics about suicide among veterans through 2014. County and state-level data were not provided. While there may be characteristics of the San Antonio area that may contribute to different suicide rates than the national average (either higher or lower), the data do provide national rates that can be used to provide a rough estimate of the number of veteran suicides in the area shown in Table C-4.

Many veterans also receive health benefits through TRICARE. While county-level data are not available, the Department of Defense’s FY2015 report to Congress stated that there were 516,427 total TRICARE enrollees in Texas (including veterans and eligible family members). Assuming that beneficiaries in the San Antonio area participate at statewide rates, the estimated number of TRICARE beneficiaries is shown in Table C-3.

Nearly 70,000 Alamo Region

veterans (33%) received

VA health care in 2015.

Almost 81,000 received

some level of disability

compensation.

16


Health and Wellness (continued)

Suicide and Mental Health

In July of 2016, the VA released new nationwide statistics about suicide among veterans through 2014. County and state-level data were not provided. While there may be characteristics of the San Antonio area that may contribute to different suicide rates than the national average (either higher or lower), the data do provide national rates that can be used to provide a rough estimate of the number of veteran suicides in the area shown in Table C-4.

19

Table C-2: Number Veterans Receiving Compensation Bexar MSA Alamo Region Number of Veterans 61,031 78,497 80,783 VA Disability Rating 0%-20% 14,158 (23.2%) 18,193 (23.2%) 18,804 (23.3%) 30%-40% 10,202 (16.7%) 13,112 (16.7%) 13,471 (16.7%) 50%-60% 10,028 (16.4%) 12,902 (16.4%) 13,208 (16.3%) 70%-90% 17,393 (28.5%) 22,383 (28.5%) 22,930 (28.4%) 100% 7,583 (12.4%) 9,891 (12.6%) 10,188 (12.6%) Pension Only 1,667 (2.7%) 2,006 (2.6%) 2,181 (2.7%) Age

Under 35 6,812 (11.2%) 8,047 (10.3%) 8,221 (10.2%) 35 to 44 9,015 (14.8%) 11,140 (14.2%) 11,298 (14.0%) 45 to 54 13,114 (21.5%) 17,493 (22.3%) 17,681 (21.9%) 55 to 64 12,846 (21.0%) 16,570 (21.1%) 16,919 (20.9%) 65 to 74 12,426 (20.4%) 16,476 (21.0%) 17,275 (21.4%) 75+ 6,818 (11.2%) 8,767 (11.2%) 9,385 (11.6%) Sex

Male 51,360 (84.2%) 66,397 (84.6%) 68,522 (84.8%) Female 9,671 (15.8%) 12,101 (15.4%) 12,256 (15.2%)

Source: U.S. Department of Veteran Affairs, FY 2015. Many veterans also receive health benefits through TRICARE. While county-level data are not available, the Department of Defense’s FY2015 report to Congress stated that there were 516,427 total TRICARE enrollees in Texas (including veterans and eligible family members). Assuming that beneficiaries in the San Antonio area participate at statewide rates, the estimated number of TRICARE beneficiaries is shown in Table C-3. Table C-3: Estimated TRICARE Beneficiaries Bexar MSA Alamo Region Estimated TRICARE Beneficiaries 55,046 72,215 76,055 Source: Department of Defense, FY 2015.

Suicide and Mental Health In July of 2016, the VA released new nationwide statistics about suicide among veterans through 2014. County and state-level data were not provided. While there may be characteristics of the San Antonio area that may contribute to different suicide rates than the national average (either higher or lower), the data do provide national rates that can be used to provide a rough estimate of the number of veteran suicides in the area shown in Table C-4.

20

Table C-4: Estimated Veteran Suicides in 2014 Bexar MSA Alamo Region Male 48 64 67 Female 4 5 6 Total 52 69 73 Source: Local estimation based on nationwide data from U.S. Department of Veteran Affairs, 2014

Further data from the report emphasize that the suicide rate among veterans is much higher than among non-veterans (shown in Figure C-1 below) and that the rate of veteran suicide increased considerably from 2001 to 2014. Some other key findings include:

• After adjusting for differences in age and gender, the risk for suicide was 21% higher among Veterans when compared to U.S. civilian adults. (2014)

• After adjusting for differences in age, the risk for suicide was 2.4 times higher among female Veterans when compared to U.S. civilian adult females and 18% higher among male veterans compared to non-veteran males. (2014)

• There is continued evidence of high suicide rates among middle-aged and older adult Veterans. In 2014, approximately 65% of all Veterans who died from suicide were aged 50 years or older.

• Since 2001, the age-adjusted rate of suicide among U.S. Veterans has increased by 32.2%.

Figure C-1: 2014 Adult Suicides per 100,000 Population

Source: Department of Veterans Affairs, 2016. According to Veterans Health Administration (VHA), the top four mental health diagnoses among veterans served by the VA in Bexar County are:

1. PTSD 2. Depression






Figure C-1: 2014 Adult Suicides per100,000 Population

Source: Department of Veterans Affairs, 2016

20

Table C-4: Estimated Veteran Suicides in 2014 Bexar MSA Alamo Region Male 48 64 67 Female 4 5 6 Total 52 69 73 Source: Local estimation based on nationwide data from U.S. Department of Veteran Affairs, 2014






Figure C-1: 2014 Adult Suicides per 100,000 Population

Source: Department of Veterans Affairs, 2016. According to Veterans Health Administration (VHA), the top four mental health diagnoses among veterans served by the VA in Bexar County are:

1. PTSD 2. Depression

The national veteran

suicide rate is 21% higher then for non-veterans, and has increased 32.2% in the

past 15 years.

17


Health and Wellness (continued)

According to the Veterans Health Administration (VHA), the top four mental health diagnoses among veterans served by the VA in Bexar County are:

1. PTSD2. Depression3. Anxiety4. Substance use disorder

The prevalence of mental health issues varies by gender. As shown in Table C-5, women veterans are slightly more likely to be diagnosed with PTSD, mood disorders, and anxiety, while male veterans are more likely to be diagnosed with a substance use disorder. The prevalence of mood disorders among veterans is higher than the rate among the general population, which is estimated as 16.2% (Kessler, et al., 2003, JAMA).

According to a 2015 needs assessment by the Meadows Mental Health Policy Institute (provided by researchers from UTHSCSA), the available mental health services in Bexar County do not meet the current demand. According to the 2008 Invisible Wounds of War study by the RAND Corporation, providing effective evidence-based care to veterans saves $3,000 to $12,000 per person versus letting mental illness condition remain untreated. With proven cost-effectiveness and insufficient resources to meet demand, expanding mental health services seems to be a clear need for veterans in the San Antonio area.

21

3. Anxiety 4. Substance use disorder

The prevalence of mental health issues varies by gender. As shown in Table C-5, women veterans are slightly more likely to be diagnosed with PTSD, mood disorders, and anxiety, while male veterans are more likely to be diagnosed with a substance use disorder. The prevalence of mood disorders among veterans is higher than the rate among the general population, which is estimated as 16.2% (Kessler, et al., 2003, JAMA). Table C-5: Prevalence of Mental Health Diagnoses Among Bexar County Veterans Male veterans Female veterans PTSD 17% 18% Mood Disorder 21% 35% Anxiety 11% 17% Substance Use Disorder 11% 7%

Source: Veterans Health Administration, provided by UTHSCSA. According to a 2015 needs assessment by the Meadows Mental Health Policy Institute (provided by researchers from UTHSCSA), the available mental health services in Bexar County do not meet the current demand. According to the 2008 Invisible Wounds of War study by the RAND Corporation, providing effective evidence-based care to veterans saves $3,000 to $12,000 per person versus letting mental illness condition remain untreated. With proven cost-effectiveness and insufficient resources to meet demand, expanding mental health services seems to be a clear need for veterans in the San Antonio area.

Male veterans are diagnosed

with substance

abuse disorder at a rate nearly

60% greater than female

veterans.

18


Housing and Homelessness

Housing

One measure of the housing status of veterans is the number of VA loans and Table D-1 shows the number of VA loans issued in 2014 as tracked by the Federal Financial Institutions Examination Council (FFIEC) under the Home Mortgage Disclosure Act.

22

HOUSING AND HOMELESSNESS Housing One measure of the housing status of veterans is the number of VA loans and Table D-1 shows the number of VA loans issued in 2014 as tracked by the Federal Financial Institutions Examination Council (FFIEC) under the Home Mortgage Disclosure Act. Table D-1: 2014 VA Loans Bexar MSA Alamo Region 2014 VA Loans 6,954 9,335 9,442 Percentage of all VA loans statewide 15.4% 20.7% 20.9% Source: Federal Financial Institutions Examination Council, 2014.

VA loans issued in the San Antonio area comprise a significant percentage of all VA loans issued in Texas. While the Region has about 13.5% of the Texas veteran population, it accounts for almost 21% of VA loans in Texas (Table D-1). This seems to indicate that veterans in the area are more likely than other Texas veterans to use the VA to purchase homes (and/or more likely to purchase homes rather than rent). Homelessness Accurately measuring levels of homelessness and the characteristics of homeless people is difficult because homelessness is often a temporary status and because of difficulties in locating homeless people. Agencies that attempt to estimate the size and nature of the homeless population use a Point in Time (PIT) count to provide usable data about homelessness. For the San Antonio area, the San Antonio Regional Alliance for the Homeless (SARAH) is the designated agency for Bexar County tasked with obtaining data about the homeless. SARAH’s most recent PIT estimate was for January 21, 2016 and reported that there were about 263 homeless veterans in Bexar County. They further reported that this number was a 7% decrease from 2015. The Texas Homeless Network (THN) is responsible for collecting homelessness data from most rural areas in the state, including the counties other than Bexar that make up the San Antonio MSA and the Alamo Region. While THN does not make county-level data readily accessible, extrapolating the homelessness rate of Bexar County to the overall region would estimate that there are approximately 100 additional homeless veterans throughout the remaining area.

VA loans issued in the San Antonio area comprise a significant percentage of all VA loans issued in Texas. While the Region has about 13.5% of the Texas veteran population, it accounts for almost 21% of VA loans in Texas (Table D-1). This seems to indicate that veterans in the area are more likely than other Texas veterans to use the VA to purchase homes (and/or more likely to purchase homes rather than rent).

Homelessness

Accurately measuring levels of homelessness and the characteristics of homeless people is difficult because homelessness is often a temporary status and because of difficulties in locating homeless people. Agencies that attempt to estimate the size and nature of the homeless population use a Point in Time (PIT) count to provide usable data about homelessness. For the San Antonio area, the San Antonio Regional Alliance for the Homeless (SARAH) is the designated agency for Bexar County tasked with obtaining data about the homeless.

SARAH’s most recent PIT estimate was for January 21, 2016 and reported that there were about 263 homeless veterans in Bexar County. They further reported that this number was a 7% decrease from 2015. The Texas Homeless Network (THN) is responsible for collecting homelessness data from most rural areas in the state, including the counties other than Bexar that make up the San Antonio MSA and the Alamo Region. While THN does not make county-level data readily accessible, extrapolating the homelessness rate of Bexar County to the overall region would estimate that there are approximately 100 additional homeless veterans throughout the remaining area.

19


Legal

Much of the legal data requested were either not obtained as of the preparation of this report or are currently not collected. These data items include:

1. Number of veterans diverted to mental health treatment related to combat stress

2. Number of veterans with “other than honorable” discharge3. Number of veterans in bankruptcy proceedings

Table E-1 shows the total number of veterans currently in veteran treatment court in Bexar County. Data were not available for the surrounding counties. There is also limited or no data readily available statewide or nationwide to make reasonable estimates for the region.

23

3.E - LEGAL Much of the legal data requested were either not obtained as of the preparation of this report or are currently not collected. These data items include:

1. Number of veterans diverted to mental health treatment related to combat stress 2. Number of veterans with “other than honorable” discharge 3. Number of veterans in bankruptcy proceedings

Table E-1 shows the total number of veterans currently in veteran treatment court in Bexar County. Data were not available for the surrounding counties. There is also limited or no data readily available statewide or nationwide to make reasonable estimates for the region. Table E-1: Number of Veterans in Treatment Court Bexar MSA Alamo Region Total Veterans 100 N/A N/A Source: Bexar County Department of Judicial Services email, July 2016

In order to better serve veterans in Bexar County and the surrounding region, it would be helpful if more data were collected about the legal issues veterans face. As mentioned in Section 3.A, JBSA estimates that about 7,000 locally-assigned active duty service members will transition into civilian life in 2016, and we currently have very limited information about the legal obstacles that may confront them.

In order to better serve veterans in Bexar County and the surrounding region, it would be helpful if more data were collected about the legal issues veterans face. As mentioned earlier, JBSA estimates that about 7,000 locally-assigned active duty service members will transition into civilian life in 2016, and we currently have very limited information about the legal obstacles that may confront them.

20


Limitations and Future Research

Much of the data obtained for this report comes from very reliable sources (U.S. Census, VA, etc.). These data provide actual (or closely estimated) veteran statistics, although many estimates have an associated margin of error and/or are a few years old. Tables that show extrapolations based on statewide or nationwide percentages are noted as such, and it is likely that some of the actual veteran statistics for the Alamo Region will vary to some extent. The San Antonio veteran and service member population will likely differ from peers in other areas of the state or throughout the country in their characteristics (e.g. racial/ethnic composition) or use of services.

Another limitation of this report is that not all of the data items initially identified and requested by MVCC were available in the timeframe allocated for this research effort. Some data requests were sent to organizational representatives who did not provide requested data within the timelines associated with preparation of this report. For several key data items related to the population of active duty service members and the nature of veterans’ medical needs, the agencies with access to the requested data (Department of Defense and Department of Veterans Affairs) provided referrals to their Freedom of Information Act (FOIA) request channels. While these FOIA request were submitted, no responses were obtained as of the preparation of this report. Key data items identified by MVCC but not obtained (either directly or through reasonable estimation) were:

1. Number and demographics of family members of active duty service members and veterans

2. Occupational information about veterans (other than veteran-owned businesses)

3. Underemployment among veterans4. Percentage of service members remaining in San Antonio after

separation5. Prevalence of injuries and health conditions among veterans6. Number of veterans diverted to mental health treatment related to

combat stress7. Number of veterans with “other than honorable” discharge8. Number of veterans in bankruptcy proceedings

In addition to further efforts to obtain the data items in the list above and to find local data to validate estimates derived from statewide and nationwide data, further efforts to understand the service member and veteran population should include efforts to collect, maintain, and share data about this population. Much of the data we were unable to obtain (or only obtain at the statewide or nationwide level) likely exists. Making source agencies aware of the need for this data and how the data can inform efforts to better serve the military and veteran community may encourage them to track the data and make it more readily accessible (either publicly or through quicker responses to requests).

The goal of MVCC is to improve the lives of military service members, veterans and their families, and further research can help identify and prioritize services that will address the most important needs and generate the highest return on investment. Some needs are significant because of their frequency (e.g. health care services), while others are significant because of their intensity (e.g. suicide). Efficiently helping service members and veterans in San Antonio requires an understanding of the gaps between needs and available services. Because some significant needs may already have corresponding high levels of current resources, research to assess the various resources available might identify some important unmet needs.

Other research that may be helpful includes collecting data directly from veterans and service members to better understand their experiences around finding and using the services they need. This could reveal important communication channels as well as possible barriers to the use of available services. Finally, research to evaluate programs would help determine program effectiveness and provide insight for continuous program improvement.

More research is required to

fully understand the needs of

family members and other

needs facing our military

members and veterans to identify root causes and to assess

service gaps. In particular,

capturing individual data

directly through surveys and

focus groups, and increasing

access to existing public and nonprofit agency -level

data will lead to more meaningful

support outcomes.

21


Acknowledgements and Sources

Key portions of the data and analysis used in preparing the mental health material for this report were provided by researchers from the University of Texas Health Science Center at San Antonio’s Military Health Institute, through the gracious allowance of Dr. Mary Jo Pugh, Co-Director of the Research to Advance Community Health (ReACH) Center; Roxana E. Delgado, PhD, Postdoctoral Fellow; and Kimberly McConnell, EdD, Senior Research Scientist.

Other individuals who helped the research team search for requested data were:

• Fernando “Fuzzy” Conejo – Texas Veterans Commission• Luke Leppla – South Alamo Regional Alliance for the Homeless• Queta Marquez – Bexar County Veterans Service Office• Laly Cholak – Grace After Fire• Serafina De Los Santos – 502d Force Support Group

Sources

Bexar County Veterans Service Office. Personal communications with Queta Marquez. July 2016

Defense Health Agency (DHA). 2015. The Evaluation of the TRICARE Program: Access, Cost, and Quality, Fiscal Year 2015 Report to Congress. Office of the Assistant Secretary of Defense (Health Affairs), Washington, D.C. Published online at http://www.health.mil/Military-Health-Topics/Access-Cost- Quality-and-Safety/Health-Care-Program-Evaluation/Annual-Evaluation-of-the-TRICARE-Program.

Federal Financial Institutions Examination Council. Home Mortgage Disclosure Act web site. Available online at http://www.ffiec.gov/hmda/default.htm

502d Force Support Group, Joint Base San Antonio. Personal communications with Serafina De Los Santos. July 2016

Grace After File. Personal communications with Laly Cholak. July 2016.

Kessler, Ronald C., Patricia Berglund, Olga Demler, Robert Jin, Doreen Koretz, Kathleen R. Merikangas, John Rush, Ellen E. Walters, and Philip S. Wang. “The Epidemiology of Major Depressive Disorder: Results From the National Comorbidity Survey Replication (NCS- R)”, Journal of the American Medical Association, 2003; 289(23):3095-3105.

Meadows Mental Health Policy Institute. “Bexar County Community Mental Health Needs Assessment.” Presented February 26, 2016. (Provided by University of Texas Health Science Center at San Antonio’s Military Health Institute).

Office of the Deputy Assistant Secretary of Defense. 2014 Demographics: Profile of the Military Community. Published online at http://download.militaryonesource.mil/12038/MOS/Reports/2014-Demographics-Report.pdf

San Antonio Regional Alliance for the Homeless. Personal communications with Luke Leppla. July 2016.

Tanielian, Terri, Lisa H. Jaycox, Terry L. Schell, Grant N. Marshall, M. Audrey Burnam, Christine Eibner, Benjamin R. Karney, Lisa S. Meredith, Jeanne S. Ringel and Mary E. Vaiana. 2008. Invisible Wounds of War: Summary and Recommendations for Addressing Psychological and Cognitive Injuries. Santa Monica, CA: RAND Corporation. Published on line at http://www.rand.org/pubs/monographs/MG720z1.html.

Texas Veterans Commission. Personal communications with Fernando Conejo. July 2016.

University of Texas Health Science Center at San Antonio’s Military Health Institute. Personal communications with Dr. Mary Jo Pugh, Co-Director of the Research to Advance Community Health (ReACH) Center; and Roxana E. Delgado, PhD, Postdoctoral Fellow; and Kimberly McConnell, EdD, Senior Research Scientist. July 2016.

U.S. Bureau of Labor Statistics. 2016. Employment Situation of Veterans, 2015.

USDL-16-0611. United States Department of Labor, Washington, DC. Published online at http://www.bls.gov/news.release/vet.nr0.htm.

U.S. Bureau of Labor Statistics. 2016. Southwest Regional Unemployment Statistics 2016. United States Department of Labor. Washington, D.C. Published online at http://www.bls.gov/regions/southwest/summary/blssummary_sanantonio.pdf.

U.S. Census Bureau. “Employment, Income, Education and Selected Social Characteristics of Veterans and non-Veterans for The San Antonio Area, and Texas.” Tables, B21002, B21001, B21003, B21004, C21001H, C21001I, C21007, S2301 and S2101. 2010-2014, American Community Survey 5 Year Estimates. Washington, D.C.

U.S. Census Bureau. “Veteran Owned Businesses in Texas and U.S.” 2010-2014 American Community Survey 5 year Estimates. Washington, D.C.

U.S. Census Bureau. “Type of Industry of Veteran Owned Businesses by County.” 2012 Survey of Business Owners (SBO), and American Community Survey. U.S. Department of Commerce, Economic and Statistics Administration. Washington, D.C.

U.S. Department of Defense. Base Structure Report: Fiscal Year 2015 Baseline: a summary of real property inventory. Available online at http://www.acq.osd.mil/eie/Downloads/Reports/Base%20Structure%20Report%20FY15.pdf

U.S. Department of Veteran Affairs. National Center for Veterans Analysis and Statistics. Published on line at site. http://www.va.gov/vetdata/.

U.S. Department of Veterans Affairs Office of Suicide Prevention. 2016. Suicide Among Veterans and Other Americans 2001-2014. Washington, D.C. Published online at http://www.mentalhealth.va.gov/docs/2016suicidedatareport.pdf.

22

Military and Veteran Community CollaborativeSan Antonio, Texas

September 2016

www.mvcc-sa.org

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