Evidence map›Paper›PMID 41782147›Full record

ArticleInjury epidemiology2026

Trends in unintentional injury death among post-9/11 Army Veterans who do and do not use Veteran Health Administration services.

Rachel Sayko Adams, Jeri E Forster, Claire A Hoffmire, Jaimie L Gradus, Trisha A Hostetter, Mary Jo Larson, Alexandra L Schneider, Alexandra A Smith, Colin G Walsh, Lisa A Brenner

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In one paragraph

Article in Injury epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rachel Sayko AdamsDepartment of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA. adamsr@bu.edu.
Jeri E ForsterVeterans Affairs Rocky Mountain Mental Illness Research Education and Clinical Center, 1700 North Wheeling Street, Aurora, CO, 80045, USA.
Claire A HoffmireVeterans Affairs Rocky Mountain Mental Illness Research Education and Clinical Center, 1700 North Wheeling Street, Aurora, CO, 80045, USA.
Jaimie L GradusDepartment of Epidemiology, Boston University School of Public Health, Boston University, 715 Albany Street, Boston, MA, 02118, USA.
Trisha A HostetterVeterans Affairs Rocky Mountain Mental Illness Research Education and Clinical Center, 1700 North Wheeling Street, Aurora, CO, 80045, USA.
Mary Jo LarsonInstitute for Behavioral Health, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA, 02453, USA.
Alexandra L SchneiderVeterans Affairs Rocky Mountain Mental Illness Research Education and Clinical Center, 1700 North Wheeling Street, Aurora, CO, 80045, USA.
Alexandra A SmithVeterans Affairs Rocky Mountain Mental Illness Research Education and Clinical Center, 1700 North Wheeling Street, Aurora, CO, 80045, USA.
Colin G WalshDepartments of Biomedical Informatics, Medicine, and Psychiatry, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
Lisa A BrennerAnschutz Medical Campus, Departments of PM&R, Psychiatry and Neurology, University of Colorado, 12631 E 17th Ave, Aurora, CO, 80045, USA.

Funding

Trajectories of non-pharmacologic and opioid health services for pain management in association with military readiness and health status outcomes: SUPIC renewalR01AT008404 · NCCIH · BRANDEIS UNIVERSITY · PI ADAMS, RACHEL SAYKO, LARSON, MARY JO · 2014 to 2023
$7.2M
First Longitudinal Study of Missed Treatment Opportunities Using DOD and VA DataR01DA030150 · NIDA · BRANDEIS UNIVERSITY · PI LARSON, MARY JO · 2010 to 2013
$1.9M
Integrating signals of suicide risk from DoD and VHA data to improve upon suicide risk prevention strategies for combat VeteransR01MH120122 · NIMH · UNIVERSITY OF COLORADO DENVER · PI ADAMS, RACHEL SAYKO, BRENNER, LISA A · 2019 to 2022
$1.9M
NCCIH NIH HHS R01 AT008404NCCIH NIH HHS R01AT008404NIDA NIH HHS R01 DA030150NIDA NIH HHS R01DA030150NIMH NIH HHS R01 MH120122NIMH NIH HHS R01MH120122
6 · The paper itself

Abstract

backgroundIt is unknown if unintentional injury death rates vary among Army Veterans who do and do not use the Veterans Health Administration (VHA). We estimated, and compared by VHA-use group, age-adjusted average annual unintentional injury death rates and time-dependent hazard rates (HRs) after separation.

methodsData were from the Substance Use and Psychological Injury Combat Study, a longitudinal cohort of Army soldiers returning from an Afghanistan/Iraq deployment in FYs 2008-2014 using administrative data from the Military Health System, Veterans Health Administration and National Death Index. We selected soldiers who separated from active duty service by 9/30/2017 (n = 649,811). The exposure was time since separation, moderated by VHA-use group. The outcome was unintentional injury death (all, motor vehicle crash [MVC], overdose) through 2018.

resultsThe HR for all unintentional injury and MVC death for 0-2 years post-separation were higher for the no VHA-use group than the VHA-use group (e.g., MVC, year 0-1 HR: 75.1 (95% CI: 61.7, 88.4) vs. 16.4 (95% CI: 12.8, 20.0)). This changed to either no difference or higher risk for the VHA-use group as time since separation increased. For unintentional overdose, there was no difference in HRs between groups in 0-2 years post-separation; risk was higher for the VHA-use group for the remainder of follow-up (e.g., no VHA use, years 3-5 HR: 8.7 (95% CI: 5.1, 12.3) vs. 28.9 (95% CI: 25.2, 32.5) for VHA use group).

conclusionsThe risk for unintentional MVC and overdose death since separation differed based on use of VHA services among post-9/11 Veterans. Intervention strategies that address differences in time since separation and whether Veterans use the VHA or not may be required.

Indexed as

DeploymentMilitaryMotor vehicle crashUnintentional injury deathUnintentional overdoseVeteransVeterans Health Administration

Identifiers

PMID41782147
PMCPMC13069699

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.