Women’s Health and the Military

Occupational and Environmental Challenges for Women

ABSTRACT

The prevalence of women in the global workforce is increasing. Women increasingly participate in nontraditional employment settings in previously male-dominated industries and manually intensive professions, such as military service, emergency response, health care, aviation, space, agriculture, and technical trades. Limited occupational and environmental hazard data specific to women exist for these work environments. Physiologic and biomechanical differences between sexes create unique workplace challenges specific to women. This article will summarize challenges confronting women working in nontraditional employment and identify strategies to mitigate risk within these populations.

A Scoping Review of Unintended Pregnancy in Active Duty United States Military Women

INTRODUCTION

The purpose of this scoping review was to apply the Social Ecological Model for Military Women's Health to literature on unintended pregnancy (UIP) to answer the question: In United States active duty military women (population) with the potential for UIP (context), what is known about risk factors, prevention, and pregnancy outcomes (concepts)?

METHODS

We conducted this review based on a PRISMA-ScR protocol registered a priori in Open Science Framework. Following a literature search of six databases and the grey literature, we used DistillerSR to manage data screening and data charting. The Social Ecological Model for Military Women's Health served as the theoretical framework to chart findings regarding UIP at the individual, microsystem, mesosystem, exosystem, and macrosystem levels.

RESULTS

A total of 74 research, review, and grey literature articles met the inclusion criteria. Risk factors included specific demographics, military service, and recent deployment. Prevention included contraceptive practices, access, and education that should take place early in servicewomen's careers and before deployment. Outcomes included early return from deployment, personal career challenges, and seeking alternative health services outside the military health system.

CONCLUSIONS

Research and policy initiatives should focus on decreasing risk factors in the military working environment, with particular attention to the deployed environment. These initiatives should include input from military leaders, health care providers, servicewomen, and servicemen with the goal of decreasing the incidence of unintended pregnancies. Pregnancy intentionality among military women should be considered as a concept to shape intervention research to reduce unintended pregnancies.

A National Survey of Prosthesis Use in Veterans with Major Upper Limb Amputation: Comparisons by Gender

BACKGROUND

A better understanding of women veterans with upper limb amputation is needed.

OBJECTIVE

To compare prosthetic use and outcomes of female and male veterans with upper limb amputation.

DESIGN

Cross-sectional survey: Amputation characteristics, prosthesis use, and quality of life outcomes were compared by gender. Separate logistic regression models examined association of gender with prosthesis use and receipt of training to use a prosthesis. Separate linear regression models examined the relationship between gender and health-related quality of life (HRQoL) outcomes.

PARTICIPANTS

Participants were veterans with major upper limb amputation who received care at the Department of Veterans Affairs (VA) in 2010-2015, identified from VA data sources. A total of 808 individuals (755 men, 21 women) were surveyed by telephone.

MAIN OUTCOME MEASURES

Disabilities of the Arm, Shoulder and Hand (QuickDASH), VR-12 Physical Component Summary (PCS) and VR-12 Mental Component Summary (MCS), Trinity Amputation and Prosthetic Experience Scale satisfaction scale, Orthotics and Prosthetic User's Survey client satisfaction with devices scale.

SETTING

Telephone survey of community dwelling participants.

INTERVENTIONS

Not applicable.

RESULTS

Survey response rate was 47.3% for men and 62.8% for women. Women were less likely to have ever used a prosthesis (adjusted odds ratio [aOR] = 0.26; confidence interval [CI] 0.08-0.88), have received training for an initial prosthesis (aOR: 0.24; CI 0.08-0.70), be current users (aOR = 0.34; CI 0.12-1.01), and have received training for a current prosthesis (aOR: 0.15; 0.03-0.87). A greater proportion of women used cosmetic and a smaller proportion used body-powered devices compared to men (P < .05). Device heaviness or fatigue was the most common reason for abandonment. There were no significant differences in outcome measures by gender.

CONCLUSIONS

Women were less likely than men to have ever used and currently use prostheses or to have received prosthetic training, more likely to use cosmetic devices, and less likely to use body-powered devices. Efforts to develop prostheses that are cosmetically acceptable, yet lightweight and functional, are needed.