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美国退伍军人健康特征中的种族和民族差异。

Racial and Ethnic Disparities in U.S. Veteran Health Characteristics.

机构信息

Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA 02130, USA.

New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA.

出版信息

Int J Environ Res Public Health. 2021 Mar 2;18(5):2411. doi: 10.3390/ijerph18052411.

Abstract

Racial/ethnic health disparities persist among veterans despite comparable access and quality of care. We describe racial/ethnic differences in self-reported health characteristics among 437,413 men and women (mean age (SD) = 64.5 (12.6), 91% men, 79% White) within the Million Veteran Program. The Cochran-Mantel-Haenszel test and linear mixed models were used to compare age-standardized frequencies and means across race/ethnicity groups, stratified by gender. Black, Hispanic, and Other race men and women reported worse self-rated health, greater VA healthcare utilization, and more combat exposure than Whites. Compared to White men, Black and Other men reported more circulatory, musculoskeletal, mental health, and infectious disease conditions while Hispanic men reported fewer circulatory and more mental health, infectious disease, kidney, and neurological conditions. Compared to White women, Black women reported more circulatory and infectious disease conditions and Other women reported more infectious disease conditions. Smoking rates were higher among Black men, but lower for other minority groups compared to Whites. Minority groups were less likely to drink alcohol and had lower physical fitness than Whites. By identifying differences in burden of various health conditions and risk factors across different racial/ethnic groups, our findings can inform future studies and ultimately interventions addressing disparities.

摘要

尽管退伍军人享有可比的医疗服务机会和质量,但他们之间仍然存在种族/民族健康差异。我们描述了百万退伍军人计划中 437413 名男性和女性(平均年龄(SD)=64.5(12.6),91%为男性,79%为白人)自我报告的健康特征的种族/民族差异。Cochran-Mantel-Haenszel 检验和线性混合模型用于比较按性别分层的种族/民族群体的年龄标准化频率和平均值。黑人、西班牙裔和其他种族的男性和女性比白人自我报告的健康状况更差、VA 医疗保健利用率更高、战斗经历更多。与白人男性相比,黑人男性和其他男性报告了更多的循环系统、肌肉骨骼、心理健康和传染病状况,而西班牙裔男性报告了更少的循环系统和更多的心理健康、传染病、肾脏和神经系统状况。与白人女性相比,黑人女性报告了更多的循环系统和传染病状况,而其他女性报告了更多的传染病状况。黑人男性的吸烟率较高,但与白人相比,其他少数族裔群体的吸烟率较低。少数群体饮酒的可能性较低,身体素质也低于白人。通过确定不同种族/民族群体各种健康状况和风险因素的负担差异,我们的研究结果可以为未来的研究并最终解决差异问题提供信息。

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