Examining physical health conditions and associations of pain, obesity, and function of UK Veterans diagnosed with PTSD and other mental health conditions
Abstract: Introduction: Little is known about the physical health conditions experienced by United Kingdom (UK) military Veterans with posttraumatic stress disorder (PTSD) or other mental health diagnoses. We aimed to explore the prevalence of self-reported physical health complaints and health behaviours in a patient sample of UK Veterans who had engaged with mental health services. Methods: This study used questionnaire data from a cross-sectional study that sampled Veterans engaged in a UK national Veteran’s mental health charity (N = 403). Prevalence rates of reported physical health complaints were ranked, and health behaviours were described. Adjusted multivariate logistic regression models were fitted to examine associations between the top five physical health complaints and socio-demographic factors, mental health outcomes, and health-related behaviours. Results: We observed that chronic pain (41.2%, n = 166) and poor mobility (34.2%, n = 138) were the most prevalent conditions reported. Participants with PTSD were more than twice as likely to report chronic pain (AOR = 2.25, 95% CI, 1.16–4.37, P ≤ 0.05). Of 384 Veterans in the sample, the majority had a calculated body mass index (BMI) deemed overweight or obese (76.5%, n = 294). Obese participants were 2–4 times more likely to report prevalent physical health complaints. Discussion: Veterans with complex mental health problems experience a high burden of physical health complaints. Of most concern are the associations between PTSD, obesity, pain, impairment, and the potential difficulties in recovery and treatment. These findings are important for the way health services assess and treat individuals presenting with complex mental health problems.
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.