Dittrich Kristina A, Lutfiyya M Nawal, Kucharyski Catherine J, Grygelko John T, Dillon Cassandra L, Hill Taylor J, Rioux Matthew P, Huot Krista L
Essentia Health System, Acute Care Pharmacy Residency Program, Duluth, MN 55805.
University of Minnesota-Twin Cities Campus, Academic Health Center, Office of Education, Minneapolis, MN 55455.
Mil Med. 2015 Apr;180(4):428-35. doi: 10.7205/MILMED-D-14-00101.
With involvement in two wars over the past decade, there has been a documented increase in depression prevalence and suicide incidence among U.S. military veterans. Because higher proportions of veterans come from rural communities, access to care may be an issue when behavioral health care is needed. Although the Veterans Administration has expanded health services in rural areas, this has not always resulted in increased service utilization. This study examined the prevalence of depression and associated health service deficits (HSDs) for rural versus nonrural U.S. military veterans. Using bivariate and multivariate techniques, 2006 Behavioral Risk Factor Surveillance System data were analyzed. Bivariate analysis revealed that rural veterans had greater odds of having at least one HSD, being currently depressed as measured by the Personal Health Questionnaire-8, and having lifetime depression. Logistic regression analysis confirmed that rural veterans had higher odds of both current and lifetime depression than nonrural veterans when controlling for socioeconomic status and race/ethnicity. Additionally, logistic regression analysis also revealed that rural veterans with current depression had higher odds of being Hispanic or Other/Multiracial than Caucasian, not employed for wages than employed for wages, <65 years of age, and reported having at least one HSD.
在过去十年中，美国卷入了两场战争，有记录显示美国退伍军人中抑郁症患病率和自杀率有所上升。由于退伍军人中来自农村社区的比例较高，在需要行为健康护理时，获得护理可能会成为一个问题。尽管退伍军人管理局已在农村地区扩大了医疗服务，但这并不总是能带来服务利用率的提高。本研究调查了美国农村与非农村退伍军人的抑郁症患病率及相关的医疗服务不足情况。使用双变量和多变量技术，对2006年行为危险因素监测系统的数据进行了分析。双变量分析显示，农村退伍军人出现至少一项医疗服务不足、按照《个人健康问卷-8》测量目前患有抑郁症以及有终生抑郁症的几率更高。逻辑回归分析证实，在控制社会经济地位和种族/族裔因素后，农村退伍军人目前患抑郁症和有终生抑郁症的几率高于非农村退伍军人。此外，逻辑回归分析还显示，目前患有抑郁症的农村退伍军人是西班牙裔或其他/多种族的几率高于白人，未就业挣钱的几率高于有工资收入的，年龄小于65岁，并且报告至少有一项医疗服务不足。
