What Does the Term 'Military Family' Mean? - A Comparison Across Four Countries
Abstract: Defining a family is particularly important for military family health research and for the provision of services and benefits. Studies repeatedly stress the importance of family in supporting military personnel throughout their service. However, much of this research adheres to traditional ideals of family structure despite changing social attitudes and potential nuances between the definition and function of ‘family’. In order to ensure military family research is applicable to modern military families, we need a greater understanding of who a modern military family is. The first step in this process is considering how the family as an institution is implicitly and explicitly constructed through the definitions contained within policies relating to military families and the military charity sector. Publicly available definitions of military families described in health, education, and social welfare policies and the charitable sectors of the United Kingdom, United States, Australia and Canada were reviewed.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.