Army Wives: Exploring the Social Determinants of Health in a Population With Universal Health Care in the United States

Guided by the World Health Organization’s (WHO) Social Determinants of Health (SDH) conceptual framework the purpose of this study was to explore the SDH among military spouses, who have universal access to health care. Two research questions guided this study: (1) What SDH factors are significantly associated with Army wives’ self-reported health, and (2) What SDH level of factors best explains Army wives’ self-rated health. The present study is a secondary analysis of survey data collected in 2012 from 327 U.S. Army wives. Bivariate pairwise correlations and hierarchical linear regressions (HLR) were used to examine determinant categories outlined in the SDH framework. Results suggest significant bivariate associations in most determinant categories. The best-fitting HLR models were those with all determinant categories. These preliminary findings suggest that although universal health care can improve mental and physical health equity, other SDH factors within and across multiple determinant categories can contribute to persistent inequities.