Military service, healthcare needs, and healthcare engagement among post-9/11 veterans from the BRAVO Cohort Study.

Post-9/11 veterans are increasingly diverse, yet prior studies of behavioral health and healthcare engagement have been underpowered for sex-by-race/ethnicity contrasts. The BRAVO cohort was designed to address this gap by deliberately oversampling women and racial/ethnic minority veterans. Recruitment proceeded in two parallel streams with rigorous identity verification yielding a final baseline N = 2,083. At baseline, 37.3% were female; mean age was 38.5 years. Race/ethnicity composition: Non-Hispanic White 34.4%, Hispanic 35.1%, Non-Hispanic Black 19.0%, with smaller proportions Asian, American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and multiracial. Descriptives summarize binary clinical indicators and care utilization. Inferential models cross-classified sex by race/ethnicity and used modified Poisson for binary outcomes and negative binomial for counts. Whole-sample prevalence: probable depression 48.9%, anxiety 44.6%, post‑traumatic stress disorder (PTSD) 44.4%, alcohol use disorder (AUD) 11.5%, and elevated suicide risk 40.7%. Military sexual violence and harassment were 35.7% and 50.0%, respectively. Adjusted contrasts showed higher PTSD risk among several women's groups and Non-Hispanic Black men; women had lower AUD risk than Non-Hispanic White men; Hispanic men had lower suicide-risk prevalence. Women had higher counts of health care problems treated. All female groups had substantially higher risk of military sexual violence and harassment. Baseline findings show heavy behavioral-health burden and concentrated disparities: elevated PTSD among several women's groups and Black men, lower AUD among women, and pronounced sex differences in sexual harm. For women, mental-health visit volume did not scale with need after adjustment, suggesting potential under-intensity of care relative to burden.