Understanding the intersectionality of the rural Hispanic/Latino Veteran population: a scoping review of health-related challenges

Introduction: The rural Veteran population is becoming more racially and ethnically diverse, with Hispanic/Latino (H/L) Veterans representing a growing proportion of rural Veterans. Despite experiencing similar challenges to those of other rural Veteran populations, rural H/L Veterans face additional health-related challenges due to sociocultural factors. A gap in knowledge for rural H/L Veterans exists; thus, research on this population is warranted. Objective: We conducted a scoping review to examine literature on rural H/L Veterans. We synthesized health-related issues, needs, and services for rural H/L Veterans, including health disparities, tailored interventions to address health disparities, and whether studies employed an intersectional approach to understand and address challenges for rural H/L Veterans. Methods: We followed Arksey and O'Malley's framework. Inclusion criteria were limited to English language articles published between 2007-2024 focusing on rural H/L Veterans in the United States and U.S. state equivalents. Two reviewers assessed selected articles. Results: Sixteen articles were included. Most articles (75%) were retrospective cohort or retrospective cross-sectional studies. Studies examined health disparities related to diabetes, suicide, depression, traumatic brain injury, PTSD, chronic pain, COVID-19 vaccination, primary care access, goals of care documentation, and multimorbidity. 'Hispanic' and/or 'Latino' terms were often used as descriptive characteristics and/or covariates and lacked clear definitions. Few studies thoroughly highlighted the intersectionality of geographic location and H/L ethnicity for Veterans. Additionally, limitations in data were noted by some studies. Conclusions: Increased research on health-related challenges experienced by rural H/L Veterans is needed. Of specific importance is research that emphasizes the intersectionality of rural H/L Veterans, acknowledges intra-ethnic diversity and cultural influence, prioritizes culturally relevant interventions, addresses data limitations, and focuses on providing equitable care. Knowledge gained can inform the development of Veteran-centric and culturally appropriate policies and practices to improve the health outcomes of rural H/L Veterans and achieve health equity.