Refractive Errors, Amblyopia Risk, and Prenatal Factors in Children with Autism Spectrum Disorder: A Cross-Sectional Study.

Women veterans are a fast-growing sub-population within the Veterans Healthcare Administration (VHA), projected to represent 16.3% (up from 9.4% in 2015) of veterans by 2042 (). Women veterans have unique healthcare needs, including growing concerns about unhealthy alcohol use. Unhealthy alcohol use includes a spectrum of alcohol use, ranging from risky drinking, or drinking above recommended limits, to a diagnosis of Alcohol Use Disorder (AUD) (). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines risky drinking for women as more than three drinks per occasion or more than seven drinks per week (). Among women veterans enrolled in VHA, 33% screen positive for unhealthy alcohol use and about 4% meet criteria for an AUD (; ). Unhealthy alcohol use is associated with a range of health and psychosocial consequences, and women are more susceptible to and experience more severe consequences than men, even at lower levels of consumption. A review by indicated women have a significant increase in mortality risk at 2–2.9 drinks per day compared to 4 drinks per day among men () and are more susceptible to the neurotoxic and neurobehavioral effects of alcohol than men (e.g., greater impairment from alcohol, greater subjective intoxication; ; ). Additionally, research shows that women veterans who died from alcohol-attributable causes lost significantly more years of life (33.1) compared to their male counterparts (18.8 years; ). Unhealthy alcohol use is negatively correlated with occupational and family functioning and relationship satisfaction among women veterans (). Women with unhealthy alcohol use also report more comorbid psychiatric symptoms and diagnoses than men (e.g., anxiety disorders, PTSD, and mood disorders) and are more likely to report using alcohol in response to negative emotion than men (; ). While women tend to report better long-term alcohol treatment outcomes than men (), they are less likely to receive alcohol treatment in their lifetime (), and visits with their provider are less likely to include discussions about alcohol use (). However, women veterans have indicated receptivity to alcohol treatment, with increased receptivity for treatment that is tailored to women, and when their provider encourages patient autonomy, presents multiple treatment options, and is nonjudgmental (; ). While these findings show treatment receptivity and facilitators among women veterans, more work is needed identifying potential barriers for alcohol treatment interest to understand the gap in care received among women veterans.