Journal of women's health (2002)最新文献

{"title":"Low-Dose Chest CT-Participating in the Rise of Breast Density Awareness.","authors":"Lauren J Lentini, Sydney T Woode, Laurie Margolies, Rowena Yip, Claudia I Henschke, David F Yankelevitz","doi":"10.1177/15409996251372349","DOIUrl":"https://doi.org/10.1177/15409996251372349","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> There is a strong correlation between CT and mammographic assessment of breast density. The purpose of this study was to assess whether women enrolled in the low-dose CT (LDCT) scan lung cancer screening program and had dense breasts on their CT scan were aware of their breast density, to confirm the correlation of CT and mammographic breast density, and to determine the utilization rates of supplemental screening. <b><i>Methods:</i></b> Participants were English-speaking women with dense breasts identified on LDCT done through the International Early Lung Cancer Action Program (I-ELCAP). All signed consent. Participants completed the I-ELCAP Dense Breast Questionnaire addressing patients' awareness and knowledge of breast density. Mammogram reports in the electronic medical record were analyzed for breast density category. Discrepant cases, i.e., where mammogram and LDCT dense breast density categories differed, were reviewed by an expert radiologist. <b><i>Results:</i></b> Most patients, 78/88 (89%), knew they had dense breasts. More than half of the participants, 56/88 (64%), did not receive additional testing. The CT and mammogram reported density was concordant in 52/60 (87%) of cases. All the discordant cases differed by one category-the mammograms were reported as having \"scattered fibroglandular elements.\" Re-review of mammograms confirmed they were not dense in 5/8, and images were not available for 3/8. <b><i>Conclusion:</i></b> The lack of additional testing in those with documented dense breasts suggests weak adherence to recommendations and the potential for enhanced education about the potential benefits of supplemental screening. Additional education concerning breast density determination on CT relative to mammography may be useful.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Impacting Endometrial Thickness Visibility and Information Availability in Black Patients.","authors":"Minerva A Orellana, Mindy Pike, Ronit Katz, Whitney Robinson, Kemi M Doll","doi":"10.1177/15409996251371097","DOIUrl":"https://doi.org/10.1177/15409996251371097","url":null,"abstract":"<p><p><b><i>Background:</i></b> Black patients experience worse endometrial cancer outcomes compared to white patients. Endometrial thickness (ET) measures from transvaginal ultrasound (TVUS) are used in diagnostic triage to determine if further endometrial tissue sampling is needed. However, recent work suggests that TVUS may disproportionately underdiagnose Black patients and those over 60 years old, contributing to Black patients' lower survival. Our study aimed to identify risk factors that impact ET measurement quality [visibility, missing data] from TVUS and result in nondiagnostic TVUS results. <b><i>Methods:</i></b> A retrospective analysis was conducted in a cohort of Black patients undergoing hysterectomy from 2014 to 2020. ET visibility documentation was categorized as visible or \"compromised\" (partially visible or nonvisible). The presence or absence of endometrial information was also assessed. <b><i>Results:</i></b> Of 2,705 patients with ultrasound information, 78% (<i>N</i> = 1,838) had documented ET visibility. Of those with visibility, 1,301 (71%) had complete ET visibility. Among those with compromised visibility (<i>n</i> = 537), 271 (50.5%) had partially visible ET, while 266 (49.5%) had nonvisible ET. Significant risk factors associated with compromised visibility included an enlarged uterus (OR: 2.89, 95% CI: 2.32-3.61) and fibroids (OR: 3.78, 95% CI: 1.94-7.39). Of 2,032 patients with ultrasound reports, 9.5% (<i>N</i> = 194) lacked endometrial information. Fibroids (OR: 1.81, 95% CI: 1.19-2.76) and enlarged uterus (OR: 2.61, 95% CI: 1.53-4.45) were also significantly associated with missing endometrial information. <b><i>Conclusion:</i></b> These findings suggest that a substantial proportion of TVUS examinations may not yield definitive data for diagnostic triage in Black women, potentially contributing to diagnostic delays and worse survival. Improved diagnostic approaches are needed in this population.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Disparities in Perinatal Substance Use Emergency Department Visits Before and During COVID-19.","authors":"Ana Daniela González-Alvarez, Sidath Kapukotuwa, Larry Hurst, Abena Gyawu Owusu-Ansah, Ying Guo, Jennifer Vaderlaan, Jay J Shen","doi":"10.1177/15409996251370887","DOIUrl":"https://doi.org/10.1177/15409996251370887","url":null,"abstract":"<p><p><b><i>Background:</i></b> Substance use during pregnancy threatens maternal and fetal health, and the COVID-19 pandemic may have altered patterns of use and disparities. <b><i>Methods:</i></b> We analyzed 2019-2021 Nationwide Emergency Department Sample data to examine emergency department visits among pregnant individuals with documented substance use (opioids, cannabis, alcohol, or nicotine). A difference-in-differences approach assessed pandemic-related changes and disparities by race/ethnicity and insurance status. <b><i>Results:</i></b> During the pandemic, odds of emergency department visits involving alcohol use increased by 16% (adjusted odds ratio [aOR] = 1.16, 95% confidence interval [CI] = 1.05-1.27) and cannabis use by 10% (aOR = 1.10, 95% CI = 1.01-1.20). Prepandemic, Native American individuals had markedly higher odds of opioid use, while African American individuals had higher odds of cannabis and nicotine use. Disparities in cannabis use narrowed for Hispanic and Native American individuals compared to White individuals. Uninsured and Medicaid-insured patients showed consistently elevated odds for opioid, cannabis, and nicotine use. <b><i>Conclusions:</i></b> The pandemic was associated with increased alcohol and cannabis use in pregnancy and shifting disparities across racial and insurance groups. Targeted public health strategies are needed to address substance use among pregnant individuals, especially during societal disruptions.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U.S. Maternal Mortality: An Unrelenting National Crisis.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1177/15409996251371492","DOIUrl":"https://doi.org/10.1177/15409996251371492","url":null,"abstract":"","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Menopause Care: A Pilot Survey Study of Providers from Primary Care, Endocrinology, and Obstetrics and Gynecology.","authors":"Athavi Jeevananthan, Anastasia-Stefania Alexopoulos, Karen M Goldstein, Anna C Moreno","doi":"10.1177/15409996251370925","DOIUrl":"https://doi.org/10.1177/15409996251370925","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To describe and compare current attitudes, practices, and needs in the provision of menopause care across multiple specialties. <b><i>Materials and Methods:</i></b> An anonymous survey was emailed to providers in primary care, endocrinology, and obstetrics and gynecology (OB/GYN) at Duke University and the University of Utah between January 4 and February 14, 2024. <b><i>Results:</i></b> The response rate was 18% (238/1326). Data analysis was performed on the 201 fully licensed providers who completed the survey. Most primary care physicians (PCPs) (92%, 94/102) and OB/GYNs (95%, 54/57) reported providing care for symptomatic menopause, whereas only 38% (16/42) of endocrinologists reported the same. The respondents indicated the following specialties as being responsible for the provision of menopause care at the following frequencies: 83% (166/201) primary care, 96% (193/201) OB/GYN, and 40% (81/201) endocrinology. OB/GYN providers endorsed the highest rates of confidence and understanding with menopausal hormone therapy, whereas endocrinologists endorsed the lowest rates. Most frequently reported barrier to provision of menopause care was lack of training (62%, 124/201). Most frequently reported way to improve provision of menopause care was training for providers (92%, 184/201). For primary ovarian insufficiency, only 45% (46/102) of PCPs always found it appropriate to treat with hormone therapy as compared with 82% (47/57) of OB/GYNs and 86% (36/42) of endocrinologists. <b><i>Conclusions:</i></b> Our pilot study highlights the need for enhanced provider education and the existing variations in menopause care across specialties. However, due to the study's limited generalizability, a nationally representative study is necessary to better understand the provider-related factors influencing menopause care delivery.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 Positivity, Indicators of COVID-19 Severity, COVID-19 Hospitalization, and Diabetes Risk in the Women's Health Initiative.","authors":"Hind A Beydoun, JoAnn E Manson, May A Beydoun, Jack Tsai, Aladdin H Shadyab, Su Yon Jung, Simin Liu, Matthew Allison, Farha Ikramuddin, Charles P Mouton, Tomas Nuño, Alan B Zonderman, Lesley F Tinker","doi":"10.1177/15409996251369820","DOIUrl":"https://doi.org/10.1177/15409996251369820","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To examine prospective associations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test positivity, coronavirus disease 2019 (COVID-2019) symptom severity, and COVID-2019 hospitalization with incident clinical diabetes among aging women. <b><i>Methods:</i></b> A cohort study was conducted using data from 34,405 eligible Women's Health Initiative participants who completed ≥1 COVID-2019 surveys (Survey 1: June-December 2020; Survey 2: June 2021-February 2022) and were followed up for an average of 1.86 (±0.49) years, yielding 399 incident diabetes cases. <b><i>Results:</i></b> SARS-CoV-2 test positivity was associated with diabetes risk in the age-adjusted Cox regression model (hazard ratio [HR] = 1.76, 95% confidence interval [CI]: 1.10, 2.82), but not when fully adjusted (HR = 1.43, 95% CI: 0.88, 2.31). Diabetes risk was higher among those with 1-2 COVID-19 symptoms (HR = 1.39, 95% CI: 1.09, 1.77) and those with 3± COVID-2019 symptoms (HR = 1.53, 95% CI: 1.06, 2.22) compared with those without COVID-2019 symptoms in fully-adjusted models, irrespective of self-reported SARS-CoV-2 testing. COVID-2019 hospitalization was associated with 2-3 times the risk of clinical diabetes in age-adjusted (HR = 2.95, 95% CI: 1.52, 5.72) and fully-adjusted (HR = 1.90, 95% CI: 0.97, 3.72) models. <b><i>Conclusions:</i></b> Age-adjusted self-reported SARS-CoV-2 test positivity was associated with a higher incidence of diabetes. Reporting of COVID-2019 symptoms and being hospitalized for COVID-2019 were each associated with higher incidence of diabetes in aging women, after controlling for demographic, socioeconomic, lifestyle, and health characteristics.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Self-Classified Race/Ethnicity, Insurance Status, and Hospital Type in Benign Hysterectomy.","authors":"Maya A Wright, Alan C Kinlaw, Asha B McClurg, Erin Carey, Kemi M Doll, Anissa I Vines, Andrew F Olshan, Whitney R Robinson","doi":"10.1177/15409996251370641","DOIUrl":"10.1177/15409996251370641","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To explore the associations of self-classified race/ethnicity, insurance status, and hospital type with updated appropriateness ratings of hysterectomy among premenopausal patients. <b><i>Study Design:</i></b> The study population consisted of patients 18-44 years of age who received a hysterectomy for benign and non-obstetric gynecological conditions between October 2014 and December 2017. Structured and unstructured data were abstracted from electronic medical records (EMR). We estimated weighted prevalence differences (PD_w), ratios (PR_w), and 95% confidence intervals (CIs) between self-classified race/ethnicity (Hispanic, Non-Hispanic Black, and Non-Hispanic White), insurance status at time of surgery (uninsured, Medicaid, and private insurance), and hospital type (non-academic and academic) and the Wright appropriateness rating (inappropriate, ambiguous, and appropriate). To assess potential missing data bias, we conducted sensitivity analyses with stratification of prevalence estimates by a proxy for EMR completeness (1, ≥2 preoperative notes from the primary surgeon). <b><i>Results:</i></b> Among the 1,613 hysterectomies analyzed, 26.5% received an inappropriate rating, 15.8% an ambiguous rating, and 57.7% an appropriate rating. Patients with Medicaid had 17.2% (95% CI = -22.3%, -12.1%) lower prevalence of inappropriate ratings compared with patients with private insurance. Surgeries at non-academic medical centers had 20.4% (95% CI = 17.0%, 23.8%) higher prevalence of inappropriate ratings compared with surgeries at academic medical centers. In sensitivity analyses, among surgeries with ≥2 preoperative notes from the primary surgeon, the prevalence of an inappropriate rating was similar between non-academic and academic medical centers (PD_w = -2.1%, 95% CI = -6.8%). <b><i>Conclusions:</i></b> Associations between insurance status, hospital type, and inappropriate rating may be partially explained by EMR completeness. EMR completeness, provider documentation, and data management are important determinants of equitable clinical care. Additional research to improve assessment of appropriate hysterectomy care and efforts to improve EMR completeness are important next steps in gynecological research.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging Peer Mentors for Opportunity, Well-Being, and Equity Realization-A Leadership Intervention for Women in Academic Medicine.","authors":"Christina M Cutter, Rochelle D Jones, Nancy D Spector, Kanakadurga Singer, Kelly C Paradis, Dana A Telem, Eve A Kerr, Eva L Feldman, Abigail J Stewart, Isis H Settles, Peter A Ubel, Susan M Pollart, Harriet W Hopf, Kent A Griffith, Nina A Bickell, Ann Brown, Linda A DiMeglio, Colleen T Fogarty, Nisha Garg, Sheryl L Heron, Richelle J Koopman, Martha McGrew, Karin Muraszko, Elizabeth M Petty, Aina Puce, Anne L Taylor, Lisa Tedesco, Sharon Turner, Pamela M Williams, Reshma Jagsi","doi":"10.1177/15409996251369457","DOIUrl":"10.1177/15409996251369457","url":null,"abstract":"<p><p><b><i>Background:</i></b> The underrepresentation of women in senior positions persists in academic medicine. Data-driven strategies are needed to catalyze advancement. <b><i>Methods:</i></b> We designed a novel, National Institutes of Health-funded intervention-Engaging Peer Mentors for Opportunity, Well-Being, and Equity Realization (EMPOWER) to be evaluated in a randomized study. This educational innovation was modeled on the Leadership Learning Model Framework developed for the Executive Leadership in Academic Medicine (ELAM)® program and integrated existing research and multidisciplinary content expertise. EMPOWER strives to support the career advancement of women faculty by cultivating fundamental leadership competencies implemented within a peer mentorship framework. Early outcomes surrounding perceptions, feasibility, as well as engagement are described. <b><i>Results:</i></b> We share the EMPOWER curriculum implemented among a national cohort of women clinician-scientists within a broader randomized trial design; 94 consenting participants were assigned to the intervention. Many participants (68%; <i>n</i> = 54) found EMPOWER valuable or very valuable for their personal or career development. It was easy or very easy for 79% (<i>n</i> = 63) of participants to access the online educational materials, and 61% (<i>n</i> = 49) attended all or almost all of the peer circle meetings. <b><i>Conclusions:</i></b> We describe EMPOWER, a novel, potentially scalable, virtual intervention, to address the unmet needs of women faculty in academic medicine at the pivotal transition to leadership. The EMPOWER intervention was feasible, and we report early lessons learned from its development. Future evaluation will include qualitative analyses and comparison of outcomes between program participants and control subjects.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Opioid-Related Mortality Trends in the United States, 1999-2020: By Age, Race/Ethnicity, Region, and Opioid Type.","authors":"Rafi Khandaker, Annika Eyth, Greta Muriel Eikermann, Megan Carroll, Maira Rudolph, Aline M Grimm, Felix Borngaesser, Tina Ramishvili, Sherif Elsayed Ali, Adela Aguirre-Alarcon, Ismaeel Yunusa, Matthias Eikermann, Ibraheem M Karaye","doi":"10.1177/15409996251369454","DOIUrl":"10.1177/15409996251369454","url":null,"abstract":"<p><p><b><i>Background:</i></b> Previous studies on opioid-related mortality in the United States have largely focused on burden estimation by sex, with limited analysis of temporal trends in sex-based differences in opioid-related overdose deaths. This study examines opioid overdose mortality trends by sex in the United States from 1999 through 2020. <b><i>Methods:</i></b> We retrospectively analyzed mortality data from the National Center for Health Statistics' Multiple Cause of Death Files, from 1999 to 2020. Using International Classification of Diseases (ICD)-10 codes (X40-X44, X60-X64, X85, and Y10-Y14 in underlying causes; T40.0-T40.4 and T40.6 in multiple causes), we identified opioid-related overdose deaths. Sex-based mortality trends were analyzed across age, race/ethnicity, region, and opioid type using piecewise linear regression. Annual percentage changes (APCs) and average annual percentage changes were calculated, with model selection based on weighted Bayesian information criteria, and confidence intervals (CIs) estimated <i>via</i> the empirical quantile method. <b><i>Results:</i></b> From 1999 to 2020, 564,418 opioid-related overdose deaths were recorded in the United States. Men experienced a significantly higher mortality burden than women (mortality rate ratio = 2.11; 95% CI: 2.09, 2.12). Mortality rates in men also increased at a higher rate (APC = 14.9; 95% CI: 11.4, 21.0) than in women (APC = 8.0; 95% CI: 7.0, 8.8) across most age, race/ethnicity, region, and opioid-type categories. However, among women under 45 years, women in the Northeastern region, and women who died from synthetic opioid overdoses, mortality trends are higher compared with men. <b><i>Conclusions:</i></b> Although men exhibit higher opioid-related mortality trends overall, certain subgroups of women, under 45 years, those in the Northeast, and those affected by synthetic opioids, are experiencing worsening trends than men in recent years. Targeted interventions are needed to address the broader impact on men and the emerging risks among vulnerable groups of women.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postdeployment At-Risk Drinking Among Active Duty Women: Health Care Utilization and Military Readiness Outcomes.","authors":"Rachel Sayko Adams, Mary Jo Larson, Natalie Moresco, David Ogan, Michael Setzer, Grant A Ritter, Steven Dufour, Noel Vest, Charles S Milliken, Joshua C Gray","doi":"10.1177/15409996251365144","DOIUrl":"https://doi.org/10.1177/15409996251365144","url":null,"abstract":"<p><p><b><i>Background:</i></b> Studies have found increasing rates of excessive drinking among women and high levels of psychiatric comorbidity. This follow-up study replicated our predominantly male study to identify multimorbidity clusters among the subsample of military women with postdeployment at-risk drinking and to examine the association of cluster membership with health care utilization and military readiness. <b><i>Methods:</i></b> Participants consisted of Army women who screened positive for postdeployment at-risk alcohol use (<i>n</i> = 12,066). Latent class analysis (LCA) categorized participants into classes using 31 indicators of mental and physical health, alcohol, and tobacco use. Cox proportional hazard models estimated the relative hazards of classes with health care utilization and military readiness outcomes. <b><i>Results:</i></b> LCA identified a 5-class model as optimal: Class 1-relatively healthy/pain (50.6%), Class 2-pain/tobacco (16.7%), Class 3-mental health (MH)/pain/sleep (16.7%); Class 4-heavy drinking/MH/pain/tobacco/sleep (8.9%); and Class 5-heavy drinking/pain/tobacco (7.2%). Pain diagnoses (i.e., musculoskeletal, headache/migraine, and visceral/pelvis) and tobacco use were particularly elevated in certain classes and differed in nuanced ways from the full-sample study. Compared to Class 1, women in Classes 2-5 had increased risk for health care utilization and adverse military readiness outcomes. Class 4 had the highest odds of adverse readiness outcomes, including a higher hazard for self-harm/suicide attempt compared to the comparable class from the full-sample study. <b><i>Conclusions:</i></b> This study of women soldiers with at-risk postdeployment alcohol use found similarities with the predominantly male full-sample study, with some important differences, including a higher prevalence of pelvic pain and migraines and a greater hazard for self-harm/suicide attempt. Findings inform the need for targeted, integrated treatment for women soldiers at the highest risk for negative outcomes.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}