The Military Health Care System May Have the Potential to Prevent Health Care Disparities

Pierre-Louis, Bosny; Moore, Angelo D.; Hamilton, Jill B.

doi:10.1007/s40615-014-0067-6

Cited by 18 publications

(6 citation statements)

References 33 publications

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“…Prior studies have suggested that racial/ethnic disparities in health outcomes may be driven by differences in insurance coverage and associated access to care [ 10 , 11 ]. Widespread access to health insurance coverage could explain why several large-scale studies have not found racial/ethnic minority differences in mental health outcomes among military spouses [ 3 , 12 , 13 ]. However, other studies examining military spouses’ mental health have found increased risk for spouses from minority racial/ethnic groups [ 4 , 14 ].…”

Section: Mental Health Among Minority Spousesmentioning

confidence: 99%

Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives

Dodge

Sullivan

Miech

et al. 2023

J. Racial and Ethnic Health Disparities

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Objective To explore the social determinants of mental health (SDoMH) by race/ethnicity in a sample with equal access to healthcare. Using an adaptation of the World Health Organization’s SDoMH Framework, this secondary analysis examines the socio-economic factors that make up the SDoMH by race/ethnicity. Method This paper employed configurational comparative methods (CCMs) to analyze various racial/ethnic subsets from quantitative survey data from (N = 327) active-duty Army wives. Data was collected in 2012 by Walter Reed Army Institute of Research. Results Initial exploratory analysis revealed the highest-scoring factors for each racial/ethnic subgroup: non-Hispanic Black: employment and a history of adverse childhood events (ACEs); Hispanic: living off post and a recent childbirth; junior enlisted non-Hispanic White: high work-family conflict and ACEs; non-Hispanic other race: high work-family conflict and not having a military history. Final analysis showed four models consistently explained clinically significant depression symptoms and four models consistently explained the absence of clinical depression symptoms, providing a solution for each racial/ethnic minority group (non-Hispanic Black, Hispanic, junior enlisted non-Hispanic White, and non-Hispanic other). Discussion These findings highlight that Army wives are not a monolithic group, despite their collective exposure to military-specific stressors. These findings also highlight the potential for applying configurational approaches to gain new insights into mental health outcomes for social science and clinical researchers.

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Section: Mental Health Among Minority Spousesmentioning

confidence: 99%

Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives

Dodge

Sullivan

Miech

et al. 2023

J. Racial and Ethnic Health Disparities

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“…This coverage, TRICARE, should ideally provide a platform that creates equal opportunity in terms of access to healthcare resources irrespective of race, rank, marital status, employment status, or other outlying factors. 9 The Affordable Care Act requires TRICARE to cover patients irrespective of preexisting medical conditions or if they develop severe medical illness during their period of coverage. 9 With TRICARE coverage, patients must seek medical care at military treatment facilities (MTFs) and only seek care through civilian facilities if unavailable at their duty station.…”

Section: Introductionmentioning

confidence: 99%

“… 9 The Affordable Care Act requires TRICARE to cover patients irrespective of preexisting medical conditions or if they develop severe medical illness during their period of coverage. 9 With TRICARE coverage, patients must seek medical care at military treatment facilities (MTFs) and only seek care through civilian facilities if unavailable at their duty station.…”

Section: Introductionmentioning

confidence: 99%

Military healthcare system mitigates racial disparities for severe maternal morbidity from preeclampsia

Lundeberg

Tindal

Grob

et al. 2023

AJOG Global Reports

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“…It has been previously established that the Military Health System (MHS) provides a distinctive opportunity for the analysis of racial disparities in health care (Koehlmoos et al, 2021; Pierre-Louis et al, 2015). The MHS provides health services to 9.6 million beneficiaries, including 2.3 million children (Tanielian & Farmer, 2019).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Racial Disparities in Suspected Child Abuse among Insured Children with Head Injury

et al. 2022

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Previous studies demonstrate racial disparities in child abuse evaluations even after controlling for health insurance coverage. We conducted a cross-sectional study using the Military Health System Data Repository (MDR) of Military Health System (MHS) beneficiaries born between fiscal years 2016 and 2018 to evaluate racial disparities and other factors in the suspicion of child abuse. We observed beneficiaries for 2.5 years after birth and assessed the incidence of head injury using diagnostic codes. Among children with head injury codes, we performed a multivariable logistic regression analysis to measure the association between race and the concurrent use of the diagnostic code for suspected child abuse (SCA) or for the performance of a skeletal survey. There were 195,893 infants included and 45,269 (23.1%) underwent evaluations for head injury. Less than one percent ( n = 424) concurrently had the diagnostic code for SCA or a skeletal survey performed within 2 weeks of the head injury evaluation. When controlling for other factors, race was not associated with SCA. Higher military rank was independently associated with decreased odds of SCA. Racial disparities in SCA may be mitigated in the MHS, and further evaluation is needed. Military rank could be a factor in SCA disparities and warrants further study.

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The Military Health Care System May Have the Potential to Prevent Health Care Disparities

Abstract: In a health equity system of care such as the military health care system, active duty soldiers and their family members did not experience disparities in access to care or in important health outcomes of patient satisfaction, physical health status, or mental health status.

Cited by 18 publications

References 33 publications

Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives

Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives

Military healthcare system mitigates racial disparities for severe maternal morbidity from preeclampsia

Evaluation of Racial Disparities in Suspected Child Abuse among Insured Children with Head Injury

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