VA Connecticut Healthcare System, West Haven, Connecticut, USA.
Department of Internal Medicine (Cardiovascular Medicine), Yale School of Medicine, New Haven, Connecticut, USA.
J Womens Health (Larchmt). 2021 Jul;30(7):944-955. doi: 10.1089/jwh.2020.8732. Epub 2021 Jan 13.
With the unprecedented expansion of women's roles in the U.S. military during recent (post-9/11) conflicts in Iraq and Afghanistan, the number of women seeking healthcare through the Veterans Health Administration (VHA) has increased substantially. Women Veterans often present as medically complex due to multiple medical, mental health, and psychosocial comorbidities, and consequently may be underserved. Thus, we conducted the nationwide Women Veterans Cohort Study (WVCS) to examine post-9/11 Veterans' unique healthcare needs and to identify potential disparities in health outcomes and care. We present baseline data from a comprehensive questionnaire battery that was administered from 2016 to 2019 to a national sample of post-9/11 men and women Veterans who enrolled in Veterans Affairs care (WVCS2). Data were analyzed for descriptives and to compare characteristics by gender, including demographics; health risk factors and symptoms of cardiovascular disease, chronic pain, and mental health; healthcare utilization, access, and insurance. WVCS2 included 1,141 Veterans (51% women). Women were younger, more diverse, and with higher educational attainment than men. Women also endorsed lower traditional cardiovascular risk factors and comorbidities (, weight, hypertension) and greater nontraditional cardiovascular risk factors (, trauma, psychological symptoms). More women reported single-site pain (, neck, stomach, pelvic) and multisite pain, but did not differ from men in posttraumatic stress disorder (PTSD) symptoms or treatment for PTSD. Women seek care at VHA medical centers more frequently, often combined with outside health services, but do not significantly differ from men in their insurance coverage. Overall, this investigation indicates substantial variation in risk factors, health outcomes, and healthcare utilization among post-9/11 men and women Veterans. Further research is needed to determine best practices for managing women Veterans in the VHA healthcare system.
随着女性在美国军队中角色的空前扩大，在最近（9/11 后）的伊拉克和阿富汗冲突中，通过退伍军人健康管理局（VHA）寻求医疗保健的女性人数大幅增加。由于多种医疗、心理健康和心理社会合并症，女性退伍军人通常表现出病情复杂，因此可能得不到充分的服务。因此，我们进行了全国性的女性退伍军人队列研究（WVCS），以研究 9/11 后退伍军人的独特医疗需求，并确定健康结果和护理方面的潜在差异。我们展示了 2016 年至 2019 年期间向在退伍军人事务护理中登记的全国性样本的后 9/11 男性和女性退伍军人进行的综合问卷电池的基线数据（WVCS2）。对数据进行了描述性分析，并按性别比较了特征，包括人口统计学；心血管疾病、慢性疼痛和心理健康的健康风险因素和症状；医疗保健的利用、获取和保险。WVCS2 包括 1141 名退伍军人（51%为女性）。女性比男性更年轻、更多样化、教育程度更高。女性也报告了较低的传统心血管风险因素和合并症（体重、高血压）和更高的非传统心血管风险因素（创伤、心理症状）。更多的女性报告了单一部位疼痛（颈部、胃部、骨盆）和多部位疼痛，但 PTSD 症状或 PTSD 治疗与男性无差异。女性更频繁地在 VHA 医疗中心寻求医疗服务，通常与外部医疗服务相结合，但在保险覆盖方面与男性没有显著差异。总体而言，这项调查表明，9/11 后男性和女性退伍军人的风险因素、健康结果和医疗保健利用存在很大差异。需要进一步研究，以确定在 VHA 医疗保健系统中管理女性退伍军人的最佳实践。
