University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Uniformed Services University of the Health Sciences, Daniel K. Inouye Graduate School of Nursing, Bethesda, Maryland.
Womens Health Issues. 2021 Aug 25;31 Suppl 1:S11-S21. doi: 10.1016/j.whi.2020.12.006.
U.S. military women's health (MWH) is influenced by unique life experiences while serving in combat and combat support roles in the armed forces. Daily accomplishment of the military mission exposes women to occupational, physical, and psychosocial factors that affect their health status. Here, we present the theoretical framework for a social ecological model (SEM) for MWH.
By synthesizing the common elements of various SEMs for health, we describe the layers in the military social ecological system that are typical of the milieu of servicewomen. With the individual's knowledge, beliefs, behaviors, and physiology at the center of the model, relevant components of the microsystem, mesosystem, exosystem, and macrosystem are identified.
Support for the SEM-MWH can be found in all layers of the social ecological system. Distinguishing factors of the SEM-MWH include characteristics of the military environment, community, health care system, regulations and policies, and the military culture in which women live and work. Servicewomen's life experiences in the microsystem, mesosystem, exosystem, and macrosystem occur in a nested, interactive system that affects their health behaviors and their health status.
The social ecological system of servicewomen is unique and must be fully explored and appreciated to ensure the health of women who serve. Investigation of the effects of policies throughout all layers of the SEM-MWH on the individual servicewoman is warranted.
美国女性军人健康(MWH)受到在武装部队中担任战斗和战斗支援角色时独特的生活经历的影响。完成日常军事任务使女性接触到职业、身体和社会心理因素,这些因素影响她们的健康状况。在这里,我们提出了一个用于 MWH 的社会生态模型(SEM)的理论框架。
通过综合各种健康 SEM 的共同要素,我们描述了在女性服务环境中典型的军事社会生态系统的各个层次。以个体的知识、信仰、行为和生理为中心,确定了微观系统、中观系统、外部系统和宏观系统的相关组成部分。
可以在社会生态系统的所有层次找到对 SEM-MWH 的支持。SEM-MWH 的区别因素包括军事环境、社区、医疗保健系统、法规和政策以及女性生活和工作的军事文化的特点。女性在微观系统、中观系统、外部系统和宏观系统中的生活经历发生在一个嵌套的、相互作用的系统中,影响她们的健康行为和健康状况。
服务女性的社会生态系统是独特的,必须进行充分的探索和理解,以确保女性的健康。值得研究 SEM-MWH 所有层次的政策对个体服务女性的影响。