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Racial and Ethnic Disparities in Reproductive Health Care and Outcomes Among Female Veterans: A Scoping Review
Katrina S Nietsch1, Samantha L Estevez2, Nichole Goodsmith3,4,5
1Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
Racial and ethnic disparities exist in reproductive health care for female veterans, particularly in clinical outcomes. Addressing these disparities is crucial for achieving health equity within the Veterans Health Administration.
Area of Science:
- Reproductive Health
- Health Services Research
- Health Equity
Background:
- Female veterans are the fastest-growing group of Veterans Health Administration (VA) users, with 40% identifying with a racialized group.
- Existing research shows racial/ethnic disparities in reproductive health among non-veterans, but patterns among veterans are unclear.
Purpose of the Study:
- To characterize patterns of racial/ethnic disparities in reproductive health care and outcomes among female veterans.
- To identify specific areas within reproductive health where disparities are most prevalent.
Main Methods:
- A structured PubMed search extended a prior systematic review (2018-2023) for original research on female veterans' reproductive health and race/ethnicity.
- Included studies measured association with race/ethnicity and were categorized by topic (contraception, infertility, pregnancy, etc.) and outcome type (structural, process, clinical/behavioral).
- Followed PRISMA guidelines for screening and abstraction, analyzing 49 articles.
Main Results:
- Racial/ethnic disparities were detected more frequently for clinical and behavioral outcome measures compared to process measures.
- The majority of included studies (94%) focused on veterans utilizing VA care.
- Pregnancy and contraception were the most frequently studied topics.
Conclusions:
- Racial/ethnic disparities in female veterans' reproductive health are more evident in clinical/behavioral outcomes than in access to care (process measures).
- Access to care is essential but not sufficient for achieving health equity.
- Understanding these disparities is vital for improving health equity for female veterans.
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