Disability prevalence has increased as our population has aged (Iezzoni et al., 2000; Stripling, 2000). Several researchers have written about health outcomes and their individual determinants, as we describe in the following discussion, but there are almost no studies that look within the disability community to compare adults with disabilities who have and have not served in the military. Furthermore, even fewer researchers have addressed the combined effects of multiple determinants on health outcomes for adults with disabilities within these two subpopulations, as we propose to do. Because of this information deficit, health care providers and policy developers who are charged with addressing the health care needs of adults with disabilities who have and have not served in the military may not possess an accurate picture of existing disparities and gaps in the health care service delivery system that can contribute to negative health outcomes for adults with disabilities who have and have not served in the armed forces.

Our long-term goal of this project is to prevent further functional loss among adults with disabilities. We will accomplish this goal by meeting the following short-term goals in the course of our investigation.

•  To determine and compare the prevalence and type of disability and nationally prioritized chronic conditions among adults with disabilities who have and have not served in the armed forces;

•  To compare health outcomes (self-reported health status), health-related factors affecting health status, such as access to health care (usual source of care, unmet need for care, and reasons for not getting needed care, health insurance status, average income and out-of-pocket medical expenses), and health care utilization (office visits, hospitalizations, out-patient department visits, emergency room visits, dental visits, receipt of preventive services and prescription medications purchased) between adults with disabilities who have and have not served in the armed forces.

•  To identify barriers to receipt of health care (such as inability to get medical appointments, lack of transportation, and lack of affordable health care) for adults with disabilities who did and did not serve in the armed forces; and

•  To examine the relationship of health care access and health care utilization to health outcomes among adults with disabilities who have and have not served in the armed forces.

Research Questions: Using data from the combined 1996-2000 Medical Expenditure Panel Survey (MEPS), we will address the following questions:

•  Are there significant differences in type and prevalence of disability and chronic conditions between adults with disabilities who have and have not served in the armed forces?

•  Are there significant differences in health outcomes, health care access, and health care utilization between adults with disabilities who have and those who have not served in the armed forces?

•  Do adults with disabilities who have served in the armed forces report more barriers to receipt of health care services than adults with disabilities who have no military service?

•  To what extent are health care access and health care utilization associated with health outcomes among adults with disabilities, and are the significant differences between adults with disabilities who have and have not served in the armed forces?