This review summarizes the epidemiology of posttraumatic stress disorder (PTSD) and related mental health problems among persons who served in the armed forces during the Iraq and Afghanistan conflicts, as reflected in the literature published between 2009 and 2014. One-hundred and sixteen research studies are reviewed, most of which are among non-treatment-seeking US service members or treatment-seeking US veterans. Evidence is provided for demographic, military, and deployment-related risk factors for PTSD, though most derive from cross-sectional studies and few control for combat exposure, which is a primary risk factor for mental health problems in this cohort. Evidence is also provided linking PTSD with outcomes in the following domains: physical health, suicide, housing and homelessness, employment and economic well-being, social well-being, and aggression, violence, and criminality. Also included is evidence about the prevalence of mental health service use in this cohort. In many instances, the current suite of studies replicates findings observed in civilian samples, but new findings emerge of relevance to both military and civilian populations, such as the link between PTSD and suicide. Future research should make effort to control for combat exposure and use longitudinal study designs; promising areas for investigation are in non-treatment-seeking samples of US veterans and the role of social support in preventing or mitigating mental health problems in this group.
BACKGROUND-As a new model of care in the United States (US), retail clinics have generated much interest. Located physically within a retail store, they provide simple acute and preventive care services for a fixed price and without an appointment.
Purpose: As a rapidly growing new health care delivery model in the United States, retail clinics have been the subject of much debate and controversy. Located physically within a retail store, retail clinics provide simple acute and preventive services for a fixed price and without an appointment. Some hope that retail clinics can be a new safety-net provider for the poor and those without a primary care physician. To better understand the potential for retail clinics to achieve this goal, we describe the sociodemographic characteristics of the communities in which they operate.Methods: We created an inventory of all retail clinics in the United States and determined the proportion that are in a health professional shortage area (HPSA). We defined each retail clinic's catchment area as all census blocks that were less than a 5-minute driving distance from the clinic. We compared the sociodemographic characteristics of the population within and outside of these retail clinic catchment areas.Results: Of the 982 clinics in 32 states, 88.4% were in an urban area and 12.5% were in an HPSA (20.9% of the US population lives within an HPSA). Compared with the rest of the urban population, the population living within a retail clinic catchment area has a higher median household income ($52,849 vs $46,080), is better educated (32.6% vs 24.9% with a college degree), and is as likely to be uninsured (17.7% vs 17.0%). In a multivariate model, the census block's median household income had the strongest association with whether the census block was in a retail clinic catchment area (odds ratio, 3.
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