Sex, Race, and Ethnic Disparities in Cardiovascular Disease Risk Factors among Service Members and Veterans

Background: Health disparities in cardiovascular disease (CVD) risk factors persist among racially, ethnically, and sex diverse civilian populations. Little is known about whether these disparities persist in US military populations. The aim of this study was to examine and describe differences in CVD risk factors by sex, race, and ethnicity among US service members and veterans of Operation Enduring Freedom/Operation Iraqi Freedom conflicts. Method: Sex, racial, and ethnic differences in CVD risk factors (self-reported diagnoses of hypertension, high cholesterol, and diabetes, obese body mass index, and current smoking) were examined in 2014-2016 among 103,245 service members and veterans (age [years], M=40, SD=11; 70.3% men; 75.7% non-Hispanic White adults) enrolled in the Millennium Cohort Study. A series of ordinal regressions were conducted sequentially adjusting for sociodemographic, military, behavioral, and psychosocial factors. Results: Overall, 59% of participants reported at least 1 CVD risk factor. Men had greater odds of screening positive for CVD risk factors than did women. Non-Hispanic Asian or Pacific Islander adults had lower odds of screening positive for CVD risk factors than did non-Hispanic White adults. Although unadjusted models showed non-Hispanic Black, Hispanic/Latino, and non-Hispanic American Indian/Alaska Native individuals had greater odds of screening positive for CVD risk factors, these associations were attenuated or reversed after adjusting for sociodemographic, military, behavioral, and/or psychosocial factors. Conclusion: Due to differences in CVD risk by sex, race, and ethnicity among service members and veterans, studies are needed to understand the potential mechanisms that explain persistent disparities. Implementation of CVD prevention interventions should be considered.