The faces of Minnesota's veterans are changing. As time goes by, they are more likely to be younger, more likely to be female and less likely to be white.
Those changes will filter throughout society for years and have an impact on what it means to be a veteran, as well as put new strains on resources and tax dollars.
Simple demographics will bring some big changes, as well.
The bubble of Vietnam veterans in Minnesota is so huge that the state's 330,000 veteran population is projected to dramatically decrease to about 186,000 by 2036 as Vietnam-era veterans die off. Nearly 70,000 of those who remain will be post-9/11 Gulf War veterans.
Even with the decline, getting care to those veterans will present a challenge. The greatest number of veterans — more than 56,000 — are in Hennepin County, the state's most populous, but they account for just 6 percent of the population. Rural counties, especially in the northern part of the state, have rates that are more than 12 percent, setting the stage for more debate about getting them access to care.
Advances in technology and battlefield medical care have kept many post-9/11 veterans alive after what would have been mortal wounds in Vietnam and Korea, or during World War II.
A 2005 study conducted at Harvard estimated that in World War II, 30 percent of soldiers died from combat wounds, and in Vietnam, 24 percent of the wounded died. In Iraq and Afghanistan, despite the horrific increase in the destructibility of weapons, mortality has dropped to 10 percent.
Those who have survived with injuries are likely to linger, and their injuries will become more chronic as they age.
Nearly one in five Minnesota veterans have a service-connected disability with a rating of 70 percent or higher. The Minneapolis Veterans Medical Center saw 103,551 unique patients in 2016, up from 88,000 just six years earlier.
Women make up just 8 percent of Minnesota's overall veteran population, but more than a third of them are under age 40.
As the number of male veterans declines, women will make up a larger share. Nationwide, more than 345,000 women have deployed since 9/11.
That will have implications for the Department of Veterans Affairs as female vets grow older and demand their share of services.
The VA has to adjust to accommodate specific needs of female vets for things like obstetrics and gynecology services, and to make VA facilities more accessible. The VA also has a history of failing to properly recognize female vets in things like VA loans and other benefits, and in establishing services such as child care at clinics and hospitals.
Recognizing the need, the organization Iraq and Afghanistan Veterans of America has launched "She Who Borne The Battle," a campaign focused on changing the underlying male-dominated culture of the VA. In a recent member survey, only 22 percent of women veterans rated the VA's support to women veterans as good or better.
The organization says the problem is even exemplified in the outdated motto that greets every person, male and female, who walks through the door:
"To care for him who shall have borne the battle and for his widow, and his orphan."
Last week the organization sent a letter to the U.S. secretary of Veterans Affairs asking that the wording be changed to something more gender-neutral.