Unmet Healthcare Needs and Associated Factors Among Korean Enlisted Soldiers

ABSTRACT Introduction The purpose of this study was to explore the rate of unmet healthcare needs among Korean enlisted soldiers and to examine the factors associated with unmet healthcare needs, based on Andersen’s Health Service Behavior Model. Method This study employed secondary data analysis using the dataset of the military health survey for two years, 2014 and 2015, conducted by the Republic of Korea School of Military Medicine. Of all military health survey participants, 3,636 enlisted soldiers who answered the question “In the last year, have you ever been unable to go to a hospital or a clinic when you wanted to go to a hospital or a clinic?”—the dependent variable in this study—were included in this study. Result The rate of unmet healthcare needs among Korean enlisted soldiers was 23.7% (n = 860) in the current study. Among the individual characteristics, on-duty stress (Odds ratio (OR) = 1.59, 95% Confidence Interval (95% CI): 1.25-2.03) and need for treatment by a mental health specialist (OR = 1.40, 95% Confidence Interval (CI): 1.00-1.95) were associated with unmet healthcare needs. Among the contextual characteristics, perception of injury-prevention effort (OR = 0.61, 95% CI: 0.52-0.71), support from superiors (OR = 0.81, 95% CI: 0.71-0.93), and possibility of accident or injury of military unit (OR = 0.73, 95% CI: 0.64-0.82) were significant factors associated with unmet healthcare needs. The subjective health condition which was a proxy of the health outcome was significantly associated with unmet healthcare needs (OR = 1.58, 95% CI: 1.13-2.22). The results indicate that the safety awareness of troops and social support of superiors were the contextual military characteristics associated with unmet healthcare needs of enlisted soldiers. Conclusions The strengthening of aspect of organizational culture, such as injury-prevention efforts at the military level, or support from superior officers, will contribute to a reduction of the unmet healthcare needs of Korean enlisted soldiers.

The “Racial (and Sexual) Maelstrom” in Hawaii, 1909–1940

This chapter examines U.S. Army deployments to Hawaii from 1909-1940. In Hawaii the army was particularly invested in maintaining the privileges of commissioned officers and their families, which it sought to do in cases where enlisted soldiers invaded the privacy of officers’ and their families. This occurred with greater frequency at Hawaiian army bases than at other army posts, likely due to the relative remoteness of Hawaiian army bases from civilian communities. Hawaii, described as a racial and ethnic “maelstrom,” is also useful for illuminating the complexities that differences in race and ethnicity brought to cases involving sexuality. The chapter also analyzes the army’s growing post-war belief that acts of sodomy were symptomatic of mental pathology, and hence completely incompatible with continued service in the army, which resulted in disproportionately large numbers of sodomy-related courts-martial after the First World War.