Health Disparities in Veterans: A Map of the Evidence

Karli Kondo, Allison Low, Teresa Everson, Christine D. Gordon, Stephanie Veazie, Crystal C. Lozier, Michele Freeman, Makalapua Motu'apuaka, Aaron Mendelson, Mark Friesen, Robin Paynter, Caroline Friesen, Johanna Anderson, Erin Boundy, Somnath (Som) Saha, Ana Quinones, Devan Kansagara

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

BACKGROUND: Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood.

OBJECTIVES: To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence.

RESEARCH DESIGN: We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health.

MEASURES: We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence.

RESULTS: We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome.

CONCLUSIONS: Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations.

Original languageEnglish (US)
Pages (from-to)S9-S15
JournalMedical Care
Volume55
DOIs
StatePublished - Sep 1 2017

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Veterans
Veterans Health
Quality of Health Care
Homeless Persons
United States Department of Veterans Affairs
Health
Population
Healthcare Disparities
Transgender Persons
Information Storage and Retrieval
Population Characteristics
Research
Social Class
MEDLINE
Mental Health
Demography
Sexual Minorities

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Kondo, K., Low, A., Everson, T., Gordon, C. D., Veazie, S., Lozier, C. C., ... Kansagara, D. (2017). Health Disparities in Veterans: A Map of the Evidence. Medical Care, 55, S9-S15. https://doi.org/10.1097/MLR.0000000000000756

Health Disparities in Veterans : A Map of the Evidence. / Kondo, Karli; Low, Allison; Everson, Teresa; Gordon, Christine D.; Veazie, Stephanie; Lozier, Crystal C.; Freeman, Michele; Motu'apuaka, Makalapua; Mendelson, Aaron; Friesen, Mark; Paynter, Robin; Friesen, Caroline; Anderson, Johanna; Boundy, Erin; Saha, Somnath (Som); Quinones, Ana; Kansagara, Devan.

In: Medical Care, Vol. 55, 01.09.2017, p. S9-S15.

Research output: Contribution to journalArticle

Kondo, K, Low, A, Everson, T, Gordon, CD, Veazie, S, Lozier, CC, Freeman, M, Motu'apuaka, M, Mendelson, A, Friesen, M, Paynter, R, Friesen, C, Anderson, J, Boundy, E, Saha, SS, Quinones, A & Kansagara, D 2017, 'Health Disparities in Veterans: A Map of the Evidence', Medical Care, vol. 55, pp. S9-S15. https://doi.org/10.1097/MLR.0000000000000756
Kondo K, Low A, Everson T, Gordon CD, Veazie S, Lozier CC et al. Health Disparities in Veterans: A Map of the Evidence. Medical Care. 2017 Sep 1;55:S9-S15. https://doi.org/10.1097/MLR.0000000000000756
Kondo, Karli ; Low, Allison ; Everson, Teresa ; Gordon, Christine D. ; Veazie, Stephanie ; Lozier, Crystal C. ; Freeman, Michele ; Motu'apuaka, Makalapua ; Mendelson, Aaron ; Friesen, Mark ; Paynter, Robin ; Friesen, Caroline ; Anderson, Johanna ; Boundy, Erin ; Saha, Somnath (Som) ; Quinones, Ana ; Kansagara, Devan. / Health Disparities in Veterans : A Map of the Evidence. In: Medical Care. 2017 ; Vol. 55. pp. S9-S15.
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AU - Freeman, Michele

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N2 - BACKGROUND: Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood.OBJECTIVES: To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence.RESEARCH DESIGN: We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources. We included studies of Veteran populations that examined disparities in 3 outcome categories: utilization, quality of health care, and patient health.MEASURES: We abstracted data on study design, setting, population, clinical area, outcomes, mediators, and presence of disparity for each outcome category. We grouped the data by population characteristics including race, disability status, mental illness, demographics (age, era of service, rural location, and distance from care), sex identity, socioeconomic status, and homelessness, and created maps illustrating the evidence.RESULTS: We reviewed 4249 citations and abstracted data from 351 studies which met inclusion criteria. Studies examining disparities by race/ethnicity comprised by far the vast majority of the literature, followed by studies examining disparities by sex, and mental health condition. Very few studies examined disparities related to lesbian, gay, bisexual, or transgender identity or homelessness. Disparities findings vary widely by population and outcome.CONCLUSIONS: Our evidence maps provide a "lay of the land" and identify important gaps in knowledge about health disparities experienced by different Veteran populations.

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