Does Military Service Modify the Relationship between Race/Ethnicity and Diabetes and Hypertension Prevalence and Control? National Health and Nutrition Examination Survey (NHANES) 2007–2014

Abstract

Abstract Does Military Service Modify the Relationship between Race/Ethnicity and Diabetes and Hypertension Prevalence and Control? National Health and Nutrition Examination Survey (NHANES) 2007–2014 BACKGROUND: Studies on the effects of military service on the long-term health of veterans have produced mixed results. One factor explaining these differences in the health outcomes among veterans is race and ethnicity. Like racial and ethnic minorities in the general population, minority veterans experience worse health outcomes than do White veterans. However, unlike their civilian counterparts, minority service members receive a number of positive benefits from serving in the U.S. Armed Forces that disadvantaged racial and ethnic minorities do not experience. These include equal access to health care, economic, educational benefits and a culture of meritocracy. No detailed study has examined whether minority veterans have better health outcomes than do minorities in the general public. PURPOSE: This study has two objectives. One is to determine if having served in the U.S. Armed Services affects the prevalence and control of hypertension and diabetes. The second objective will be to determine if military service modifies the relationship between race and ethnicity and hypertension and diabetes. METHODS: Data from the 2007–2014 National Health and Nutrition Examination Surveys enabled identification of 2,386 veterans and 9,586 non-veterans for this study. Differences in hypertension and diabetes prevalence and control between veterans and non-veterans were compared using adjusted logistical analysis. Multivariate logistic regression and models were used to adjust for age and then selected socio-demographic factors to assess whether military health service was associated with lower levels of diabetes and hypertension. RESULTS: Veteran men were older than non-veteran men (59.6 years vs 40.4 years) and were more likely to be non-Hispanic White. Adjustments for age, and then age and socio-demographic factors, revealed no difference in the prevalence of diabetes or hypertension between veterans and non-veterans. African American veterans and non-veterans had a statistically significant higher likelihood of both diabetes and hypertension than did their White counterparts. Using logistical regression models to determine if there was an interaction between veteran status and race/ethnicity on the outcomes of interest, we found no evidence that military service modifies the effects of race/ethnicity on either hypertension or diabetes prevalence or control. CONCLUSION: This study found that military service does not modify the effects of race/ethnicity on either hypertension or diabetes. It also found that African American males had a higher prevalence of hypertension than do White males, and that African American, Hispanic, and the other/multiracial group non-veteran males had a higher prevalence of diabetes than do White non-veteran males.