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Abstract
Background: Routine healthcare access is critical to reduce drinking and its effects, yet little is known about Veteran and gender differences in routine healthcare access among unhealthy drinkers. The current study examined differences in routine healthcare access, stratified by Veteran status and gender, among a national sample of adults endorsing unhealthy drinking. Method: Using data from the Centers for Disease Control and Prevention’s 2019 Behavioral Risk Factor Surveillance System National Survey, we identified adults who endorsed unhealthy drinking over the past month (N = 58,816; 41.4% female; 2.7% female Veterans). Bivariate and multivariable analyses modeled associations between gender, Veteran status, and their interaction in predicting routine healthcare access. All multivariable models adjusted for sociodemographic characteristics. Results: Veterans with unhealthy alcohol use reported high rates of routine healthcare access (e.g., >86% sought care in the past 2 years) and were less likely to experience a cost barrier to care (aOR = 0.75, 95% CI = 0.62–0.92). Females were more likely than males to report better access to care but also to experience a cost barrier (aOR = 1.2, 95% CI = 1.10–1.37). The interaction between Veteran status and gender was non-significant. Conclusions: Overall, healthcare access was better for Veterans and females with unhealthy alcohol use compared to civilians and males with unhealthy alcohol use. However, given that females were more likely to report a cost barrier, future implementation research aiming to improve equity in care may want to explore reasons for cost barriers and develop strategies to help reduce these barriers in order to eliminate gender disparities in primary care-based alcohol-related care.
Acknowledgments
The authors gratefully acknowledge John Blosnich, PhD for helpful review of data analysis and syntax. Results from this study were presented at the annual meeting of the VA Pittsburgh Healthcare System Research Week (May 17, 2021) and at the annual meeting of the Addiction Health Services Research Conference (October 2021).
Disclosure of interest
The authors do not have any conflicts of interest to declare. The opinions expressed in this work are those of the authors and do not necessarily reflect those of the funders, institutions, the Department of Veterans Affairs, or the United States Government.
Notes
1 Throughout this manuscript we use the terms ‘women’ and ‘men’ when citing data specific to cisgender individuals; we use the terms ‘male’ and ‘female’ when referring specifically to findings from BRFSS surveys that use these terms. We use gender-inclusive language where possible.