Hamilton Alison B, Williams Lindsay, Washington Donna L
*VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System †Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles (UCLA) David Geffen School of Medicine ‡School of Nursing, University of California Los Angeles §Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA.
Med Care. 2015 Apr;53(4 Suppl 1):S32-8. doi: 10.1097/MLR.0000000000000297.
The unemployment rate is currently higher among women Veterans than among male Veterans and civilian women. Employment is a key social determinant of health, with unemployment being strongly associated with adverse health.
To identify military-related and health-related characteristics associated with unemployment in women Veterans.
Secondary analysis of workforce participants (n=1605) in the National Survey of Women Veterans telephone survey.
Demographics, mental health conditions, health care utilization, and military experiences and effects. Unemployment was defined as being in the labor force but unemployed and looking for work.
The χ analyses to identify characteristics of unemployed women Veterans; logistic regression to identify independent factors associated with unemployment.
Ten percent of women Veterans were unemployed. Independent correlates of unemployment were screening positive for depression [odds ratio (OR)=4.7; 95% confidence interval [CI], 1.8-12.4], military service during wartime (OR=2.9; 95%, CI 1.1-7.3), and service in the regular military (vs. in the National Guards/Reserves only) (OR=6.8; 95% CI, 2.2-20.5). Two postactive duty perceptions related to not being respected and understood as a Veteran were each independently associated with unemployment.
Whether depression underlies unemployment, is exacerbated by unemployment, or both, it is critical to identify and treat depression among women Veterans, and also to investigate women Veterans' experiences and identities in civilian life. Community-based employers may need education regarding women Veterans' unique histories and strengths. Women who served in the regular military and during wartime may benefit from job assistance before and after they leave the military. Gender-specific adaptation of employment services may be warranted.
目前，女性退伍军人的失业率高于男性退伍军人和平民女性。就业是健康的关键社会决定因素，失业与不良健康状况密切相关。
确定与女性退伍军人失业相关的军事相关特征和健康相关特征。
对全国女性退伍军人电话调查中的劳动力参与者（n = 1605）进行二次分析。
人口统计学、心理健康状况、医疗保健利用情况以及军事经历和影响。失业定义为处于劳动力队伍中但失业且正在寻找工作。
采用χ分析确定失业女性退伍军人的特征；采用逻辑回归确定与失业相关的独立因素。
10%的女性退伍军人失业。失业的独立相关因素包括抑郁症筛查呈阳性[优势比（OR）=4.7；95%置信区间（CI），1.8 - 12.4]、战时服役（OR = 2.9；95%CI，1.1 - 7.3）以及在正规军队服役（相对于仅在国民警卫队/预备役服役）（OR = 6.8；95%CI，2.2 - 20.5）。与作为退伍军人未得到尊重和理解相关的两种退役后认知各自独立与失业相关。
无论抑郁症是失业的潜在原因、因失业而加剧，还是两者皆有，识别和治疗女性退伍军人中的抑郁症，以及调查她们在平民生活中的经历和身份认同都至关重要。社区雇主可能需要接受有关女性退伍军人独特经历和优势的教育。在正规军队和战时服役的女性在离开军队前后可能会从就业援助中受益。就业服务可能需要进行针对性别的调整。
