title: Disease prevalence and use of preventive services: comparison of female veterans in general and those with spinal cord injuries and disorders.
abstract: BACKGROUND
  Disease prevalence and use of preventive services may differ between women veterans in general and those with spinal cord injuries and disorders (SCI&D). Prevention is particularly important in SCI&D, and disparities may exist in receipt of this care, particularly when special equipment and body adjustments are needed, among women with SCI&D.
  
  
  METHODS
  To compare disease prevalence and preventive service use among female veterans in general and those with SCI&D, we conducted a cross-sectional survey among female veterans in general (n = 478) and those with SCI&D (n = 115). Behavioral Risk Factor Surveillance System (BRFSS) survey questions were administered to veterans with SCI&D and compared with 2003 CDC BRFSS data.
  
  
  RESULTS
  Female veterans with SCI&D were similar in age and race but were better educated and less likely to be employed than female veterans in general. Coronary heart disease (CHD) prevalence was higher in those with SCI&D (17% vs. 8%, p < 0.0001). Health status was lower in SCI&D (27%) than in general female veterans (41%), p = 0.002. Fewer women with SCI&D, than female veterans in general reported having received recommended dental care (56% vs. 69%, p = 0.004), colon screening in prior 5 years (59% vs. 72%, p = 0.023) or prior 10 years (67% vs. 92%, p< 0.0001), mammogram (84% vs. 91%, p = 0.019), and Pap smear (88% vs. 98%, p < 0.0001). There were no differences in receipt of respiratory vaccinations or cholesterol screening.
  
  
  CONCLUSIONS
  Receipt of services that require the use of equipment, body adjustments, and potential discomfort due to disability was lower in women with SCI&D. Veterans Affairs (VA) is doing well in most areas, but there are gaps in receipt of some preventive services. Efforts to increase preventive care in women with SCI&D should address equipment and access barriers and patient and provider education.
authors.affiliation: Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Midwest Center for Health Services and Policy Research (MCHSPR), Hines, IL 60141, USA. sherri.lavela@va.gov
authors.forename: Sherri L
authors.initials: SL
authors.lastname: Lavela
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Bridget
authors.initials: B
authors.lastname: Smith
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011314:Preventive Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D016387:Women's Health; D014932:Women's Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution