Obesity and Health Care Experiences among Women and Men Veterans

Abstract

Background: Obesity is highly stigmatized, especially for women, and therefore may negatively affect health care experiences. Past findings on the relationship between obesity and health care experiences are mixed, perhaps because few studies examine relationships by gender and obesity class. Our objective was to evaluate whether women and men with more severe obesity report worse health care experiences related to Veterans Health Administration (VA) care. Methods: Health care experiences (self-management support, mental health assessments, office staff courtesy, communication with providers) and overall provider ratings were assessed with the 2014 VA Survey of Health Care Experiences of Patients. Using multiple regression analyses (n ¼ 13,462 women, n ¼ 268,180 men), we assessed associations among obesity classes, health care experiences, and overall provider ratings, adjusting for sociodemographic, health, and primary care use characteristics. Results: The greatest differences in health care experiences between patients with and without obesity were in selfmanagement support experiences, which were more favorable among women and men of all obesity classes. There were gender differences in associations between obesity and mental health assessments: for men, but not women, those in any obesity class gave higher ratings than those without obesity. For most other health care experiences and provider ratings, men with obesity reported slightly less favorable experiences than those without. There was no consistent pattern for women. Conclusions: It is promising that VA patients with obesity report more self-management support, given the behavior change required for weight management. Lower health care experience and provider ratings among men with obesity suggest a need to further investigate possible obesity-related stigma in VA primary care.

Obesity and Morbidity Risk in the U.S. Veteran

“…Furthermore, as this unwelcome trend impacts all ethnic, socio-economic, and geographic regions of the U.S. population, one particular sub-group which displays higher levels of obesity is made up of those who served in the U.S. Armed Forces: the U.S. Veteran [11][12][13][14]. Particularly striking is the fact that not only is there a disproportionate number of Veterans who are obese, but there also exists an overall disproportionate poorer health status among elderly Veterans when compared to the health of the older non-Veteran population enrolled in Medicare-managed care programs [15].…”

Accelerating the Growth of Evidence-Based Care for Women and Men Veterans

“…These articles take advantage of the multiple opportunities offered by the VA as a large, national health care system with a robust electronic medical record and multiple, well-established research entities. The included works stem from not only trials (Danan, Sherman, et al, 2019a) and cohort studies (Dursa et al, 2019;Harrington et al, 2019;Naylor et al, 2019;Brown et al, 2019), but also clinical program evaluations (Kumpula et al, 2019), VA patient experience surveys (Breland et al, 2019), and research process metrics (Goldstein et al, 2019). Multiple VA research entities are represented in this collection, including the Cooperative Studies Program (e.g., Harrington et al, 2019;Brown et al, 2019), the VA Evidence Synthesis Program (Danan, Ullman, et al, 2019b), Health Services Research & Development (Combellick et al, 2019;Danan, Sherman, et al, 2019a;Goldstein et al, 2019), and Mental Illness Research Education Clinical Centers of Excellence (Naylor et al, 2019).…”

“…research.va.gov/topics/pain.cfm). Finally, Breland et al (2019) explored the relationship between obesity, a common health condition with a range of associated health risks, and experiences within the health care system using the VA Survey of Healthcare Experiences of Patients. Specifically, they looked at patients' ratings of providers by gender and obesity status to better understand the relationship between weight and patient satisfaction among men and women.…”

Women Veterans Experience with the VA MOVE! Weight Management Program

“…This need for better understanding is especially true considering that research shows that women veterans are more likely to enroll in VA-sponsored lifestyle programs than men and endorse high levels of self-management support. 10 …”

“…This need for better understanding is especially true considering that research shows that women veterans are more likely to enroll in VA-sponsored lifestyle programs than men and endorse high levels of selfmanagement support. 10 Prior research theorizes that lack of social support, high childcare burden, post-traumatic stress disorder (PTSD), and depression are possible barriers to weight loss for women veterans. 9 Similar barriers exist for women in the general population.…”