Journal of women's health
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Journal of women's health · Jun 2020
Prevalence and Patterns of Symptoms Among Female Veterans of the 1991 Gulf War Era: 25 Years Later.
Background: A new national cohort of Gulf War (GW) veterans of 1,318 participants was created from the Veterans Affairs Cooperative Studies Program 585 Gulf War Era Cohort and Biorepository (GWECB) pilot study. However, female veteran health outcomes have not been reported separately for those deployed versus nondeployed to the 1990-1991 GW. Methods: Using data from the cooperative studies program (CSP) #585 GWECB, this study examined whether excess prevalence and patterns of Gulf War Illness (GWI) symptoms were present among female veterans who served during the GW compared with female veterans who did not deploy to the GW (GW-Era). Results: A total of 301 women veterans participated in the survey (203 GW, 98 GW-era). Mean ages in 2016 were 53 years among GW women veterans and 54 years among GW-era women. ⋯ Results showed deployed GW veterans to have a nearly twofold risk of reporting more symptoms than GW-era women, with younger, nonwhite, army-enlisted GW women significantly more likely to report more total symptoms. Discussion: Twenty-five years after the war, GWECB women GW veterans continued to report a wide variety of symptoms at a significantly higher excess frequency prevalence than GW-era women. Our results showed at least a 14% excess frequency prevalence in all seven significantly different symptoms encompassing two out of the six Kansas GWI criteria, including neurological/mood/cognition, and respiratory domains. These results suggest that further study of these symptom domains is warranted in GW women veterans.
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Objective: In the United States, there have been very few improvements in adverse birth outcomes, such as infant mortality, low birthweight, and preterm birth in recent years. Health promotion before pregnancy (e.g., preconception care) has been increasingly recognized as an important strategy by which to improve these reproductive outcomes. As of yet, no research has examined sexual orientation disparities in preconception health which has important implications for birth outcomes in the United States, since sexual minority women (SMW) are more likely to report stillbirths, low birthweight, and preterm infants than heterosexual women. ⋯ Results: Our findings suggest that, even after controlling for maternal characteristics, SMW are more likely to report adverse health conditions and behaviors before pregnancy relative to heterosexual women 1 year before the survey, including higher odds of binge drinking, other substance use, having a sexually transmitted infection diagnosis, and depression. Conclusions: Despite new public health policies aimed at improved preconception health, our findings suggest that SMW are even more vulnerable to poor preconception health than their heterosexual counterparts, which has important implications for maternal and child health. This study provides important evidence for the need to invest in the reproductive health of SMW, particularly in the context of pregnancy.
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Journal of women's health · Jun 2020
Economic and Humanistic Burden of Cervical Cancer in the United States: Results from a Nationally Representative Survey.
Objective: To measure the economic and humanistic burden of cervical cancer in the United States. Materials and Methods: This was a retrospective analysis of Medical Expenditure Panel Survey data (2006-2015). Cervical cancer cases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification code "180" or clinical classification software code "26". The control group included women without any cancer diagnosis. ⋯ Multivariate analyses suggested that compared to controls, cancer cases had significantly higher costs: institutional outpatient ($1,610 vs. $502), physician visit ($2,422 vs. $1,321), and total health care ($10,031 vs. $4,913). Cases were 1.99 (odds ratio [OR]: 1.991; 95% confidence interval [CI]: 1.23-3.22) and 2.56 (OR: 2.562; 95% CI: 1.78-3.68) times as likely to report activity limitations and poor general health versus controls. Cervical cancer patients had significantly lower SF-12 physical and MCS score, health utility, and higher depression severity. Conclusions: Cervical cancer is associated with significant economic burden, activity limitations, and quality of life impairment among ambulatory women in the United States.
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Journal of women's health · Jun 2020
Sex as a Biological Variable: A 5-Year Progress Report and Call to Action.
A little over 5 years ago, the U. S. National Institutes of Health (NIH) announced the intention to develop policies to require applicants to report plans to balance male and female cells and animals in preclinical investigations. ⋯ We call on NIH's various stakeholders to redouble their efforts to integrate SABV throughout the biomedical research enterprise. Sex- and gender-aware investigations are critical to the conduct of rigorous and transparent science and the advancement of personalized medicine. This kind of research achieves its greatest potential when sex and gender considerations are integrated into the biomedical research enterprise in an end-to-end manner, from basic and preclinical investigations, through translational and clinical research, to improved health care delivery.