title: Gender differences in substance use treatment utilization in the year prior to deployment in Army service members.
abstract: Although military men have heavier drinking patterns, military women experience equal or higher rates of dependence symptoms and similar rates of alcohol-related problems as men at lower levels of consumption. Thus, gender may be important for understanding substance use treatment (SUT) utilization before deployment. Military health system data were analyzed to examine gender differences in both substance use diagnosis (SUDX) and SUT in 152,447 Army service members returning from deployments in FY2010. Propensity score analysis of probability of SUDX indicated that women had lower odds (AOR: 0.91, 95% CI: 0.86-0.96) of military lifetime SUDX. After adjusting for lifetime SUDX using propensity score analysis, multivariate regression found women had substantially lower odds (AOR: 0.61; 95% CI: 0.54-0.70) of using SUT the year prior to deployment. Findings suggest gender disparities in military-provided SUT and a need to consider whether military substance use assessment protocols are sensitive to gender differences.
authors.affiliation: University of South Carolina, College of Social Work, Columbia, SC 29208, USA. nwooten@sc.edu
authors.forename: Nikki R
authors.initials: NR
authors.lastname: Wooten
authors.forename: Beth A
authors.initials: BA
authors.lastname: Mohr
authors.forename: Lena M
authors.initials: LM
authors.lastname: Lundgren
authors.forename: Rachel Sayko
authors.initials: RS
authors.lastname: Adams
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Merrick
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Williams
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Larson
mesh_terms: D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D057216:Propensity Score; D012044:Regression Analysis; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*
keywords: Army; Combat veterans; Gelberg-Andersen behavioral model for vulnerable populations; Gender disparities; Military deployment; Propensity score model; Substance use diagnosis; Substance use treatment utilization