The Western U.S. and rural areas have the highest rate of veteran suicides, according to data released by the Department of Veterans Affairs on Friday.
The findings examined the suicide rate state-by-state, and determined New Mexico, Nevada, Utah and Montana represent the highest rate at 60 per 100,000 individuals – nearly double the national rate of 38.4.
Many veterans in those states must drive 70 miles or more in order to find the nearest VA medical center.
Regions in the United Sates outside the West, which had an overall suicide rate of 45.5, were all below the national rate.
Kentucky, West Virginia and Oklahoma also had high veteran suicide rates, which can be attributed to the greater prescription drug use, particularly opioids; veterans who received higher doses of opioid painkillers were twice as likely to die by suicide, compared to those who received minimal doses, according to a VA study last year.
Demographics also played a key in the most recent VA report. Women veterans had a suicide rate 2.5 times greater than their civilian counterpart, with the risk 19 percent higher among male veterans compared to civilians.
The majority of military suicides comes from elderly veterans, roughly 65 percent of which were 50 or older.
Rajeev Ramchand, an epidemiologist who studies suicide for the RAND Corp pointed out the significance of the report, which indicated “no state is immune.” He added, social isolation, limited health care access, gun ownership and opioids were likely contributing factors to suicide among veterans.
“This requires closer investigation into why suicide rates by veteran status are higher, including the role that opiates play,” Ramchand told the Associated Press.
The VA’s latest report breaks down national figures released last year, which determined 20 veterans commit suicide each day, as the agency looks for ways to increase suicide prevention efforts.
“These findings are deeply concerning, which is why I made suicide prevention my top clinical priority,” said VA Secretary David Shulkin, reported AP. “This is a national public health issue.”
The report’s release comes following a recent upswing in veterans seeking medical care upon returning from missions in the Middle East, and may impact the Trump administration’s push for expanding private-sector care.
“Veterans often have more complex injuries,” Allison Jaslow, executive director of Iraq and Afghanistan Veterans of America told AP. She also noted the challenges civilian doctors might face when trying to determine a proper diagnosis without understanding the unique situation of veterans.
Improving the care of the nation’s veterans remains a priority for President Donald Trump, who in a statement this week said the U.S. “must do more” to help veterans struggling with mental issues.
The Associated Press contributed to this report.