Gender Differences in Use of Complementary and Integrative Health by U.S. Military Veterans with Chronic Musculoskeletal Pain

Abstract

AIMS: The Veterans Health Administration (VA) promotes evidence-based complementary and integrative health (CIH) therapies as non-pharmacological approaches for chronic pain. We aimed to examine CIH use by gender among veterans with chronic musculoskeletal pain, and variations in gender differences by race/ethnicity and age. METHODS: We conducted secondary analysis of electronic health records provided by all women (n=79,537) and men (n=389,269) veterans age 18–54 with chronic musculoskeletal pain who received VA-provided care between 2010–2013. Using gender-stratified multivariate binary logistic regression, we examined predictors of CIH use, tested a race/ethnicity-by-age interaction term, and conducted pairwise comparisons of predicted probabilities. RESULTS: Among veterans with chronic musculoskeletal pain, more women than men use CIH (36% vs. 26%), with rates ranging from 25%−42% among women and 15%−29% among men, depending on race/ethnicity and age. Among women, patients under age 44 or Hispanic, White, or patients of other race/ethnicities are similarly likely to use CIH; in contrast, Black women, regardless of age, are least likely to use CIH. Among men, White and Black patients, and especially Black men under age 44, are less likely to use CIH than men of Hispanic or other racial/ethnic identities. CONCLUSIONS: Women veteran patients with chronic musculoskeletal pain are more likely than men to use CIH therapies, with variation in CIH use rates by race/ethnicity and age. Tailoring CIH therapy engagement efforts to be sensitive to gender, race/ethnicity, and age could reduce differential CIH use and thereby help to diminish existing health disparities among veterans.