Racial and Ethnic Disparities in Reproductive Health Care and Outcomes Among Female Veterans: A Scoping Review

被引：0

作者：

Nietsch, Katrina S. ^{[1
]}

Estevez, Samantha L. ^{[2
]}

Goodsmith, Nichole ^{[3
,4
,5
]}

Haeger, Kristin O. ^{[6
]}

Inderstrodt, Jill ^{[7
]}

Inslicht, Sabra S. ^{[8
,9
]}

Kosman, Katherine A. ^{[10
]}

Mu, Qiyan ^{[11
]}

Nillni, Yael I. ^{[12
,13
]}

Quinn, Deirdre ^{[14
,15
]}

Rodriguez, Adriana ^{[3
]}

Siff, Lauren ^{[16
]}

Stryczek, Krysttel C. ^{[17
,18
]}

Tartaglione, Erica V. ^{[17
]}

Katon, Jodie G. ^{[3
]}

机构：

[1] Icahn Sch Med Mt Sinai, New York, NY USA

[2] Univ Pittsburgh, Med Ctr, Dept Obstet Gynecol & Reprod Sci, Pittsburgh, PA USA

[3] VA Greater Los Angeles Hlth Care Syst, Ctr Study Hlth Care Innovat Implementat & Policy, 16111 Plummer St, Los Angeles, CA 91343 USA

[4] VA Greater Los Angeles Healthcare Syst, VA Desert Pacific Mental Illness Res Educ & Clin C, Los Angeles, CA 91343 USA

[5] David Geffen Sch Med UCLA, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA

[6] US Dept Vet Affairs, VA Off Womens Hlth, Washington, DC USA

[7] Indiana Univ, Fairbanks Sch Publ Hlth, Indianapolis, IN USA

[8] San Francisco VA Hlth Care Syst, San Francisco, CA USA

[9] Univ Calif San Francisco, San Francisco, CA USA

[10] VA Boston Hlth Care Syst, Boston, MA USA

[11] Clement J Zablocki VA Med Ctr, Res & Simulat Div, Nursing Educ, Milwaukee, WI USA

[12] VA Boston Healthcare Syst, Natl Ctr PTSD, Womens Hlth Sci Div, Boston, MA USA

[13] Boston Univ, Chobanian & Avedisian Sch Med, Dept Psychiat, Boston, MA USA

[14] VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot CHERP, Pittsburgh, PA USA

[15] Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA

[16] Virginia Commonwealth Univ, Sch Med, Richmond, VA USA

[17] VA Puget Sound Hlth Care Syst, Ctr Innovat Study Vet Centr & Value Driven Care, Seattle, WA USA

[18] VA Eastern Colorado Healthcare Syst, Aurora, CO USA

来源：

HEALTH EQUITY | 2025年 / 9卷 / 01期

关键词：

reproductive health; women veterans; racial disparities; health equity; female veterans; WOMEN VETERANS; UTERINE FIBROIDS; PUBLIC-HEALTH; PREGNANCY; PREDICTORS; SYSTEM; INFERTILITY; DELIVERY; QUALITY;

D O I：

10.1089/heq.2024.0168

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Introduction: Female veterans are the fastest growing group of new Veterans Health Administration (VA) users, and 40% identify as belonging to a racialized group. It is unclear if racial/ethnic disparities in reproductive health care and outcomes observed among nonveterans are present among veterans. The purpose of this scoping review was to characterize patterns of racial/ethnic disparities in reproductive health care and outcomes among female veterans.Methods: A structured PubMed search was performed to extend a prior systematic review (from 2008-2017 to 2018-2023). We included original research on reproductive health care and outcomes in female veterans that also included a measure of association to race or ethnicity. Four hundred thirty-eight articles were identified for potential inclusion. Following PRISMA guidelines, titles and abstracts were screened in duplicate, and full articles were reviewed using a standardized abstraction form. Articles were sorted into six categories by topic (contraception, infertility, pregnancy, reproductive health screenings, gynecology, and menopause) and outcomes characterized as structural (e.g., organization of care), process (e.g., access to services), or clinical/behavioral (e.g., low birthweight) measures per Donabedian's model.Results: After title and abstract screening, 53 articles were reviewed in full. Four additional articles were excluded for a final sample of 49 articles. All articles described results from observational studies, which were almost exclusively focused on veterans using VA care (94%, n = 46). Topics with the greatest number of articles included pregnancy (43%, n = 21) and contraception (24%, n = 12). Racial/ethnic disparities were detected more frequently for clinical and behavioral outcome measures than for process measures.Conclusion: Consistent with literature regarding other types of VA care, racial/ethnic disparities were more prevalent for clinical and behavioral outcome measures versus process measures, highlighting that access is necessary but not sufficient for reaching health equity. Understanding the racial/ethnic health disparities and their relationships with different measures of health care quality is essential for achieving health equity for female veterans.

引用

页码：203 / 228

页数：26

共 107 条

[1] Racial and Ethnic Disparities in the Incidence of Severe Maternal Morbidity in the United States, 2012-2015 [J].