title: Racial and Ethnic Health Care Disparities Among Women in the Veterans Affairs Healthcare System: A Systematic Review.
abstract: Women are a rapidly growing segment of patients who seek care in the Veterans Affairs (VA) Healthcare System, yet many questions regarding their health care experiences and outcomes remain unanswered. Racial and ethnic disparities have been well-documented in the general population and among veterans; however, prior disparities research conducted in the VA focused primarily on male veterans. We sought to characterize the findings and gaps in the literature on racial and ethnic disparities among women using the VA.
  
  
  
  We systematically reviewed the literature on racial and ethnic health care disparities exclusively among women using the VA Healthcare System. We included studies that examined health care use, satisfaction, and/or quality, and stratified data by race or ethnicity.
  
  
  
  Nine studies of the 2,591 searched met our inclusion criteria. The included studies examined contraception provision/access (n = 3), treatment of low bone mass (n = 1), hormone therapy (n = 1), use of mental health or substance abuse-related services (n = 2), trauma exposure and use of various services (n = 1), and satisfaction with primary care (n = 1). Five of nine studies showed evidence of a significant racial or ethnic difference.
  
  
  
  In contrast with the wealth of literature examining disparities both among the male veterans and women in non-VA settings, only nine studies examine racial and ethnic disparities specifically among women in the VA Healthcare System. These results demonstrate that there is an unmet need to further assess health care disparities among female VA users.
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Andrea
authors.initials: A
authors.lastname: Carter
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Health Equity, Research, and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Electronic address: borrerosp@upmc.edu.
authors.forename: Sonya
authors.initials: S
authors.lastname: Borrero
authors.affiliation: Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Charles
authors.initials: C
authors.lastname: Wessel
authors.affiliation: Veterans Affairs Health Service Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Washington
authors.affiliation: Veterans Affairs Health Service Research and Development Center for the Study of Healthcare Innovation, Implementation, and Policy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
authors.forename: Bevanne
authors.initials: B
authors.lastname: Bean-Mayberry
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Corbelli
mesh_terms: D000328:Adult; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*