Experiences of ethnic minority personnel in the armed forces: A systematic review
Abstract: Ethnic minority personnel experience greater levels of harassment and discrimination than their nonminority counterparts. This review demonstrates the impact of these experiences on ethnic minority personnel in the armed forces. A literature search was conducted in PubMed, PsycInfo, PsycArticles, EBSCO, and Web of Science. Sixteen articles that discussed Black, Asian, and ethnic minority armed forces personnel were analyzed. Much of what is known about ethnic minority experiences of serving in the armed forces is based on ethnic minorities in the U.S. Armed Forces. The available literature shows that ethnic minority serving personnel and Veterans experience greater disadvantage than their native counterparts, both during and after service. Ethnic minority personnel reported poorer health than white personnel and fear of criticism from their ethnic minority community on disclosure of traumatic experiences. Ethnic minority personnel were also more likely to access formal mental health services yet less likely to engage in treatment, particularly women. Three themes were identified: cultural identity, health status and health utilization, and trauma and discrimination. Research reports often do not highlight individual ethnic minority groups, thus making it difficult to draw conclusions about them. Future research should consider evaluating the psychosocial context influencing functioning among different ethnic minority groups and should also explore the benefits of serving in the armed forces.
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.