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Women Veterans: Race/Ethnicity Differences in VA Health Care Need, Perception, and Use
Mengeling M, Booth B, Torner J, Cretzmeyer MT, Sadler AG. Women Veterans: Race/Ethnicity Differences in VA Health Care Need, Perception, and Use. Poster session presented at: VA HSR&D Field-Based Equity Conference; 2010 Sep 13; Boston, MA.
Identify race/ethnicity differences in need, perception, and use of VA health care by women Veterans.
1004 women veterans (ages 20 -52) participated in a retrospective cohort study of current health, health risk behaviors, sexual assault history and , health care utilization. Participants had enrolled in Iowa's Iowa City and Des Moines Veterans Administration Medical Centers or their outlying clinics I within the 5 years preceding research interview.
Racial majority was white (80%). Racial minority (20%) was 8% Black, 6% Native American/Alaskan Native, 3% Hispanic, 1% Asian or Pacific Islander and 2% identified as more than two raCial/ethnic groups. Analyses were dichotomized as White/Minority. Mean age of participants was 38 yrs (sd = 8.8), at least some college or technical training (85%) and a median income of $21,750. There were no statistical differences between groups by age, income, or education. Similar percentages had served during OEF/OIF (35% majority, 37% minority). More minorities had served in both thE! Regular Military and the RING (33% v. 27%, p < .01). Whites were more likely to have served in a combat area (31% v. 24%, p < .05), in the Reserve/National Guard (RING) only (14% v. 6%), and as officers (6% v. 4%, p < .Ol). Racial minorities were less likely to have insurance (78% v. 85%, p < .05) and more likely to use the VA for all of their care (40% v. 30%, p < .05). There were no statistical differences in rates of PTSD or depression. Rates of lifetime sexual assault (62%) and sexual assault during military service were similar (32%). Current physical and mental health status were similar.
Differences were found for VA care preferences. Racial minorities assigned greater importance to separate waiting areas for men and women (28CVo v. 20%, p < .01). The majority of women placed importance on having a female "chaperone" in the examination room (63%), having their primary care provider perform the annual Pap smear and gynecologic exam (60-62%), having health care services specific to women's needs (96-98%), and having a choice of being treated by a male or female health care provider (63-68%), although there were no statistical differences by race/ethnicity. Differences were also found in perceptions of VA care. Whites were more likely to feel VA health care fadlities serve the needs of men and women Veterans equally (62% v. 56%, p < .01) and view the VA as a place women can feel safe from sexual harassment (82% v. 70%, p < .Ol).
The racial minority placed greater importance on separate waiting areas for men and women and was less likely to feel safe from sexual harassment at a VA facility. Regardless of race/ethnicity, women Veterans had common preferences and perceptions regarding VA health care.
Women seeking VA health care have spedfic environment of care concerns and needs. Concerns about disparities in services for men and women Veterans and the care environment were prevalent among women regardless of race/ethnicity; however, the unique concems of racial minorities (e.g., waiting rooms and safety) require further investigation. Clarification of perceptions between users and non-users of VA care is indicated