Leveraging diversity for military effectiveness: Diversity, inclusion and belonging in the UK and US Armed Forces
Abstract: In an evolving strategic environment, the Armed Forces need to effectively leverage all available advantages, including those stemming from their workforces, to maximise strategic and operational effectiveness. To support this effort, RAND researchers conducted a study to examine the opportunities for leveraging workforce diversity to enhance military effectiveness.
The study comprised a large-scale literature review as well as semi-structured interviews with subject matter experts and practitioners from the UK and United States to produce three outputs. Firstly, the study provided a framework to help guide the UK and US Armed Forces in their assessments of links between different kinds of diversity and military effectiveness, and how these links may be better leveraged in future. Secondly, the study team developed six vignettes illustrating the framework in relation to various operational and strategic requirements identified by the UK and US Armed Forces. Lastly, the study identified key implications and options for the Armed Forces as they consider leveraging the various operational and strategic advantages provided by diversity.
The study findings show that there are significant opportunities for leveraging workforce diversity to enhance military effectiveness across a wide spectrum of Defence activity. These opportunities cumulatively position diversity as a strategic enabler for the UK and US Armed Forces.
Abstract: Background: Enactment of the Veterans Choice Act (VCA) in 2014 and expansion of Medicaid programs led to greater options for Veterans to receive health care outside of the U.S. Department of Veterans Affairs (VA). However, little is known about how much care women Veterans receive in VA or non-VA settings paid by VA or other insurance types. We explore trends in inpatient care received by women Veterans before and after implementation of the VCA, focusing on hospitalizations, as these patients are often higher risk. Methods: Data for women Veterans were linked to hospital discharge data for 2013-2017 from 11 diverse states. Patient and hospital characteristics by VA and non-VA payer and age group (less than 65 years and 65 years and older) were compared for acute hospitalizations in Pearson's chi-square and analysis of variance tests. We compared the odds of a hospitalization occurring before and after VCA implementation for each specific setting/payer using separate logistic regressions. Results: Our sample included 117,177 acute medical/surgical hospitalizations. For younger women, the most common hospital setting/payer was VA hospitals (36%); older women most frequently received hospital care in non-VA hospitals covered by Medicare (61%). After the VCA, the probability of receiving VA-purchased care increased significantly for older women only. Younger women saw a significant decrease in VA hospitalizations post-VCA. Conclusions: We found that after multiple expansions in non-VA health care options, women Veterans sought more VA-purchased community hospital care.