Women, Alcohol, and the Military: Changes in Drinking Environment and Later Alcohol Problems among Female Veterans

Background: Women working in traditionally male-dominated environments are at higher risk for alcohol use disorders (AUDs). The male-dominated U.S. military environment has additional risk factors associated with problem drinking including isolation from family and exposure to life-threatening stressors. In the 1980s, the military conformed to all U.S. states' 21-year minimum legal drinking age and established prevention and intervention policies for abusive drinking. We explored longitudinal trends in AUDs measured by treatment rates among female veterans versus civilians in the changing military environment. Methods: From the Department of Health's Treatment Episode Data Set, we extracted alcohol-related admissions from years 1992-2003 for female veterans and civilians in four age cohorts. Using age-specific population figures, we calculated alcohol treatment rates and odds ratios for female veterans versus civilians. Results: In 1992, odds ratios of alcohol treatment episodes for female veterans compared to civilians ranged from 1.9 for 25-29 year-olds to 4.2 for 40-44 year-olds (all p<0.01). Female veterans' alcohol treatment rates dropped substantially from 1992-2003, while rates for female civilians ages 25-34 dropped only marginally and those for civilians ages 35-44 increased. By 2003, odds ratios of alcohol treatment for female veterans compared to civilians fell to between 0.73 and 0.90 in all age groups (all p<0.01). Discussion: Prior to the military's efforts to reduce problem drinking, female veterans' alcohol treatment rates exceeded those of same-age civilians. However, with increasing exposure to a military environment which discourages abusive drinking, female veterans have reduced their rates of alcohol treatment to below same-age civilians' rates.