Chu Gage M, Almklov Erin, Wang Clarice, McLean Caitlin L, Pittman James O E, Lang Ariel J
VA San Diego Healthcare System.
Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System.
Psychol Serv. 2024 May;21(2):294-304. doi: 10.1037/ser0000807. Epub 2023 Oct 12.
Racial, ethnic, and gender health care disparities in the United States are well-documented and stretch across the lifespan. Even in large integrated health care systems such as Veteran Health Administration, which are designed to provide equality in care, social and economic disparities persist, and limit patients' achievement of health goals across multiple domains. We explore Veterans' Whole Health priorities among Veteran demographic groups. Participants who were enrolling in Veteran Health Administration provided demographics and Whole Health priorities using eScreening, a web-based self-assessment tool. Veterans had similar health care goals regardless of demographic characteristics but differences were noted in current health appraisals. Non-White and women Veterans reported worse health-relevant functioning. Black Veterans were more likely to endorse a low rating for their personal development/relationships. Multiracial Veterans were more likely to endorse a low rating of their surroundings. Asian Veterans were less likely to provide a high rating of their surroundings. Women Veterans reported lower appraisals for body and personal development but higher appraisals of professional care. Results indicated that demographic factors such as race and gender, and to a lesser extent ethnicity, were associated with health disparities. The Whole Health model provides a holistic framework for addressing these disparities. These findings may inform more culturally sensitive care and enhance Veteran Health Administration equal access initiatives. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
美国的种族、族裔和性别医疗保健差异有充分记录,且贯穿整个生命周期。即使在像退伍军人健康管理局这样旨在提供平等医疗服务的大型综合医疗保健系统中,社会和经济差异依然存在,并限制了患者在多个领域实现健康目标。我们探讨了退伍军人不同人口群体中的退伍军人整体健康优先事项。参与退伍军人健康管理局登记的参与者使用基于网络的自我评估工具eScreening提供了人口统计信息和整体健康优先事项。无论人口特征如何,退伍军人都有相似的医疗保健目标,但在当前的健康评估中存在差异。非白人和女性退伍军人报告的与健康相关的功能较差。黑人退伍军人更有可能对自己的个人发展/人际关系给出低评分。多族裔退伍军人更有可能对自己的周围环境给出低评分。亚裔退伍军人对自己周围环境给出高评分的可能性较小。女性退伍军人对身体和个人发展的评价较低,但对专业护理的评价较高。结果表明,种族和性别等人口因素,以及程度较轻的族裔因素,与健康差异有关。整体健康模式为解决这些差异提供了一个全面的框架。这些发现可能为更具文化敏感性的护理提供参考,并加强退伍军人健康管理局的平等获取倡议。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)