Health effects associated with minority status among U.S. Navy officers.

Abstract

The Navy is a dynamic organization that has changed over the decade from an almost exclusively male Caucasian population to an cmrised of increasing numbers of minorities. Each minority group brings to the Navy a unique set of health problems and health care needs that should be recognized and met by the Navy's medical department. Objective The objectives of this study were (1) to identify the health risks unique to various minority groups in the Navy Officer Corps and (2) to determine whether or not being a member of a minority group had an impact on the individual's health, as reflected by an elevated hospitalization rate, especially for stress-related disorders. Physical Evaluation Board incidence and disability rates as well as attrition rates and death data also were examined across subpcpulations. Using the officer career history file and the medical inpatient file, five subpopulations of Navy officers who served for any time period from July 196l7 through December 1979 were identified: male Caucasians (n-133,818), male blacks (n-1,486), unrestricted line officers (n = 46,189 men; n = 3,149 women), Nurse C s(n-1,156 men; n = 7,410 women), and other officers of the Staff Corps (n = 45,409 men; n = 1,132 women). The numbers of hospital admissions for each specific diagnosis were tallied for the five subpopulations, and hospitalization rates per 10,000 strength were computed for total hospitalizations, major diagnostic categories, and several selected diagnoses. Similarly, rates per 10,000 were derived for Physical Evaluation Board actions; percentages of losses for various reasons also were computed. The X 2 technique was used to ascertain the statistical significance of differences between officer groups for hospitalizations and Physical Evaluation Board actions. Results Results of this study identified several specific healtH problems unique to each of the selected minority grous in the Navy Officer Corps. One of the most significant health problems differentiating black officers from Caucasians was the subcategory of hereditary hemolytic anemias which clearly implicated genetic predisposition as the contributing factor. Blacks also had significantly higher hospitalization rates than Caucasians for diabetes mellitus, hypertension, and psychoses; the incidence of these disorders has been shown to be associated with genetic predisposition and job-related stress. Hospitalization rates for redundant prepuce and phimoasis and strains, sprains, and dislocations also were significantly higher for black officers than their Caucasian counterparts. Results of the occupational comarisons of hospitalization rates by sex identified male nurses as having the highest overall rate of all groups. Woman in each of the three occupational groups had significantly higher hospitalization rates than men for genitourinary diseases, supplementary classifications, and neoplams; also noted was the sizable proportion of women's total rate for pregnancy-related conditions. The large observed differences in rates, therefore, were attrib...

A Longitudinal Study of Ethnicity and Disease Incidence

“…Although Table 3 provides a clear indication of highest and lowest rates within each disease category, cross-comparison among all of the ethnic groups is a complex process yielding limited information because of the small number of cases in many disease categories. Therefore, it was decided to compare the rates of each minority ethnic group with those of the Euro-American group in order to obtain estimates of relative risk, enabling us to test the hypothesis that certain ethnic groups are at risk for morbidity by virtue of their minority status in a pop ulation (Hoiberg 1983;Silberman 1964). Significance of this estimate was determined by means of the confidence intervals from Table 3.…”