Life-course cohort evaluation of long-term consequences of military service

There are 23.4 million living US veterans in the United States, consisting of 39.4% sixty-five or older. Relatively little is known about the long-term effects of war cohort membership on physical health outcomes across a life-course. This research uses a nationally representative survey of veterans to analyze four era cohorts of US veterans examining measures of health and well-being, disability, prevalence and treatment of significant health issues. The research question was: Drawing on life-course theory, among US veterans, does physical health differ among war era cohorts and between combat and non-combat era veterans? Multivariate models controlled for age, gender, race/ethnicity, occupational status, marital status, environmental exposures, and mental health. Analysis was weighted for national representation. Adjusted odds of self-reported good health for Korean War veterans (OR 1.27); Vietnam War Veterans (1.07); and Gulf War Veterans (0.84) compared to veterans of WWII. Intra-cohort differences were noted. Combat veterans of Korea (OR 1.28); Vietnam (OR 1.09); and WWII (OR 1.16) all had higher odds of self-reported good health compared to non-combat veterans; Gulf War veterans were notably less likely (OR 0.83) (all p<.0001). Korea combat era veterans had significantly higher odds of being treated for rheumatism and lung issues; Gulf War Era veterans were more likely to have high blood pressure, lung, heart, stroke, and rheumatism issues compared to the older WWII cohort. As veterans age they will need substantial physical health services, often from the VA. Policymakers and practitioners alike need to plan for and address these needs.