Research: health checks for vets

R
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.”

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

9 comments

  • I suspect it is for a combination of all the reasons you postulate primarily being that they don't want to add to their health troubles.
    On a slightly different subject – its wildly known that men compared to women generally seek medical advice for symptoms (especially if they are ones that cause a degree of embarrassment). Is this why men generally present/ get diagnosed later than women? Or is it more due to a feature of the disease process?

  • Re: "Is this why men generally present/ get diagnosed later than women? Or is it more due to a feature of the disease process?"

    I think the latter; men tend to have their first symptoms ~2 years later than woman. Why? I don't know, but may have to do with hormonal status or vD levels. If vD is an important risk factor most countries have a slight gender difference in that woman have lower levels than men. This is probably due to social factors, more indoor activity and the use of cosmetics with sun block.

  • Yes, yearly checks has become my doctor routine after I had spent a decade prior to MS refusing to see a doctor except if absolutely necessary (I'm female). Now I go and also I take herbal medicine when I see first signs of a cold/bladder problems etc. in order to prevent disease development & preventing a relapse. Healthy diet is another matter but also something I have adhered to more consistently after my diagnosis.

  • I think it's because we are ill. I was a fit / healthy 35 year old with fit / healthy parents in their in-60s. Why did i need to bother going for regular check-ups – I never smoked and rans 10ks. I thought I'd covered myself with regard to lung cancer and heart disease. Out of the blue comes RRMS and the contact with the health service goes through the roof – GP/neuro/MRI/MS nurse/ blood tests / DMT/ physio (after relapse)/counselling. You become much more conscious of your health / mortality. My interest in my health is to try and keep disability as low as possible for as long as possible – not sure if any of the following will help, but I'm giving it a try: weight loss, Vit D supplementation, exercise, regular dentist visits, regular optician visits.

    Not sure how you can et the 'healthy' population to take their health seriously. This is all a numbers game – you are lucky or not lucky. I've got an uncle of 83 who smoked until 75 and he's fine. I was the opposite and got MS! Best advice I can give to healthy peopel is 'don't get MS'. I still can't believe that I'll be ill until the day I die and that there was no chance of me beconing well again i.e. rid of MS.

    By the way, if prevention is possible, why isn't someone doing something about it?

  • Totally agree with your previous poster – I've always tried to keep fit and healthy, the more so since diagnosis. If that includes preventative, then so be it. Women are subject to more routine screening than men, so this might be a factor too.

  • Re: "By the way, if prevention is possible, why isn't someone doing something about it?"

    There is a lot on this blog about prevention. The most obvious one is vD supplementation! Another one is smoking and EBV. We are trying to get science done to support the studies.

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