Research: health checks for vets

Epub: Lavela et al. Preventive healthcare use among males with multiple sclerosis. Public Health. 2012 Jul.


OBJECTIVES: To understand preventive healthcare use by males MSers.


METHODS: Primary survey data were collected from male veterans with MS (n = 1142) and compared with national surveillance data for a general veteran population (n = 31,500) and a general population (n = 68,357). Analyses compared use by group and identified variables associated with service use by male veterans with MS.


RESULTS: More veterans with MS had a cholesterol check (93%) than the general veteran population (89%, P < 0.001) and the general population (78%, P < 0.001). More veterans with MS had received annual influenza vaccination (69%) than the general veteran population (58%, P < 0.001) and the general population (42%, P < 0.001). More veterans with MS (81%) had ever received pneumonia vaccination than the general veteran population (67%) and the general population (51%) (P < 0.001). Colon screening was received by 55% of veterans with MS, 49% of the general veteran population (P < 0.001), and 39% of the general population (P < 0.0001). Fewer veterans with MS (34%) had received a prostate-specific antigen (PSA) test and digital rectal examination than the general veteran population (46%, P < 0.001) and the general population (36%, not significant). In males with MS, variables independently associated with cholesterol checks were: white race [odds ratio (OR) = 3.75] and living in the south (OR = 1.95); variables independently associated with influenza vaccination were increased age (OR = 1.03) and being a non-smoker (OR = 0.55); increased age was independently associated with colon screening (OR = 1.02); variables independently associated with PSA testing were increased age (OR = 1.08) and being employed (OR = 3.31), and being unemployed was independently associated with pneumonia vaccination (OR = 0.16).


CONCLUSIONS: More males with MS received several recommended preventive health services (e.g. cholesterol and colon screening, influenza and pneumonia vaccination) than males without MS. The Veterans Health Administration is meeting many prevention needs in males with MS, but there is room for improvement in areas such as reducing disparities in PSA screening and increasing respiratory vaccinations to meet national targets.




"This study is telling us that male MSers are more likely to take-up preventative healthcare initiatives that the control population. I assume this would be the same for female MSers. Why? Any ideas?"


"Could it be that by having more contact with healthcare professionals and the healthcare system, MSers are more exposed to education around preventative healthcare? Are MSers tired of being 'ill' and don't want any other additional problems? As MSers are more likely to be unemployed they may have more time to engage in preventative healthcare programmes? Is it because MSers are more likely to read about health, and therefore become experts, that they seek out preventative healthcare? Do MSers gravitate towards doctors, and healthcare professionals, who look after chronic diseases and therefore have a focus on preventing disease?"


"I would appreciate your thoughts on this work. You may consider  this soft science, but there is something interesting happening here. If we can find out what is happening with MSers we could use the knowledge to help nudge the general population to adopt preventative healthcare initiatives. Prevention is better than cure; a lesson I learnt in medical school and one that  will continue to espouse in  the field of MS."


"I believe strongly that MS is preventable; or at least a substantial chunk of the disease is."

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