Disease prevalence and use of preventive services: comparison of female veterans in general and those with spinal cord injuries and disorders.

Lavela SL, Weaver FM, Smith B, Chen K. Disease prevalence and use of preventive services: comparison of female veterans in general and those with spinal cord injuries and disorders. Journal of women's health. 2006 Apr 1; 15(3):301-11.

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• RCS 98-354 – Research Career Scientist Award

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Abstract:

BACKGROUND: Disease prevalence and use of preventive services may differ between women veterans in general and those with spinal cord injuries and disorders (SCIandD). Prevention is particularly important in SCIandD, and disparities may exist in receipt of this care, particularly when special equipment and body adjustments are needed, among women with SCIandD. METHODS: To compare disease prevalence and preventive service use among female veterans in general and those with SCIandD, we conducted a cross-sectional survey among female veterans in general (n = 478) and those with SCIandD (n = 115). Behavioral Risk Factor Surveillance System (BRFSS) survey questions were administered to veterans with SCIandD and compared with 2003 CDC BRFSS data. RESULTS: Female veterans with SCIandD were similar in age and race but were better educated and less likely to be employed than female veterans in general. Coronary heart disease (CHD) prevalence was higher in those with SCIandD (17% vs. 8%, p < 0.0001). Health status was lower in SCIandD (27%) than in general female veterans (41%), p = 0.002. Fewer women with SCIandD, than female veterans in general reported having received recommended dental care (56% vs. 69%, p = 0.004), colon screening in prior 5 years (59% vs. 72%, p = 0.023) or prior 10 years (67% vs. 92%, p < 0.0001), mammogram (84% vs. 91%, p = 0.019), and Pap smear (88% vs. 98%, p < 0.0001). There were no differences in receipt of respiratory vaccinations or cholesterol screening. CONCLUSIONS: Receipt of services that require the use of equipment, body adjustments, and potential discomfort due to disability was lower in women with SCIandD. Veterans Affairs (VA) is doing well in most areas, but there are gaps in receipt of some preventive services. Efforts to increase preventive care in women with SCIandD should address equipment and access barriers and patient and provider education.