Military Sexual Assault (MSA) Among Veterans in Southern California: Associations With Physical Health, Psychological Health, and Risk Behaviors
Abstract: This study describes the relationship between military sexual assault (MSA) and various health and behavioral outcomes among a community-based sample of male (n 2,208) and female (n This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 327) veterans. Logistic regression analyses were conducted to assess the relationship of MSA with physical health symptoms (PHQ-15), probable posttraumatic stress disorder (PTSD; PCL) and depression (PHQ9), risk-taking behaviors, and alcohol use (AUDIT-C) among men and women. Among the sample, 4.8% of male and 40.6% of female veterans reported experiencing MSA. Men who experienced MSA had approximately 4 times the odds of physical health symptoms, and probable PTSD and depression, compared with those without MSA (p .001 for all). Male veterans also had significantly increased odds of taking unnecessary health risks (p .001), risking a sexually transmitted disease (STD; p driving while intoxicated (p .022), taking unnecessary life risks (p .005), .001), and using tobacco (p .012) in the last year if they had experienced MSA. Women who experienced MSA had approximately double the odds of physical health symptoms (p .002), 3 times the odds of depressive symptoms (p .001), and almost 7 times the odds of probable PTSD (p .001). Female veterans with MSA also had significantly greater odds of taking unnecessary health risks (p .003), taking unnecessary life risks (p .001), and using tobacco (p .003) in the last year than those without MSA. These findings highlight the unique treatment needs of male and female victims of MSA, the potential long-term impact of MSA, and the need for timely assessment of MSA to help mitigate negative health outcomes among veterans.
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.