Disparities in health services utilization during basic combat training (BCT)

Objectives. To examine disparities in health services utilization among Soldiers during BCT at a single United States Army Training Center (ATC). Methods. We prospectively collected visits and subsequent dispositions of Soldiers who sought medical care at battalion aid stations. We analyzed 15,704 visits representing 9441 female and male Soldiers. The disposition was recorded by trained healthcare professionals and indicated if Soldiers received additional care at the troop medical clinic, returned to duty, or were given limited duty status. Results. Non-Hispanic whites (NHW) were more likely to receive additional medical care at the troop medical clinic than Non-Hispanic blacks (NHB) (relative risk [RR] = 1.07; 95% confidence interval [CI] = 1.04, 1.11). We further stratified the analyses by sex because females accounted for 54% of the visits to the battalion aid station despite only accounting for 39% of the Soldiers in training during the study period. When stratified, NHW males were 23% more likely to receive additional care at the troop medical clinic than NHB males (RR = 1.23; 95% CI = 1.15, 1.31). No significant differences were found among female or Hispanic Soldiers. Conclusions. Similar to civilian society, health care services are underutilized by black males during BCT, despite equal access to health insurance and health care providers. Future research should explore reasons for these disparities and if these differences affect BCT graduation rates.