Original articleGender Differences in the Impact of Warfare Exposure on Self-Rated Health
Section snippets
Sample
The 2010 National Survey of Veterans is the sixth in a series of surveys commissioned by the VA to assess needs for veteran programs and services, as well as beneficiaries' awareness of these services (Westat, 2010). The 2010 National Survey of Veterans was mandated by Congress as part of the Veterans Benefits Improvement Act (2004). Veterans were recruited using an address-based sampling approach, which matched U.S. Postal Service residential addresses with VA health care and beneficiary data
Measures
The key independent variable was a veteran's level of warfare exposure. This was assessed by two dichotomous items: 1) “Did you ever serve in a combat or war zone? [NOTE: Persons serving in a combat or war zone usually receive combat zone tax exclusion, imminent danger pay, or hostile fire pay.]” and 2) “During your military service, were you ever exposed to dead, dying, or wounded people?” The two variables were multiplied to yield an overall warfare exposure term with four categories: Neither
Results
Male and female veterans differed across most study variables (Table 1). Women were younger [t (7711) = 17.3, p < .001], better educated [t (7702) = −7.54, p < .001], and more likely to be of minority status [χ2(1) = 84.7, p < .001] compared with men. Median income did not differ between men and women [t (7270) = 1.0, p = .32]. Regarding warfare exposure, men and women endorsed significantly different categories of exposure [χ2(3) = 59.0, p < .001]. The majority of veterans experienced neither
Discussion
Overall, we found that warfare exposure was associated with worse health status in both men and women, and greater functional impairment in men. Findings suggest the relative importance of exposure to casualties compared with deployment to a war zone when predicting self-reported health status and functional impairment, especially for men. Deployment to a war zone only did not have a significant impact on health. Contrary to our hypothesis, we did not find stronger associations between warfare
Joyce M. Wang is affiliated with the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System and the Department of Epidemiology, Boston University School of Public Health.
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Cited by (0)
Joyce M. Wang is affiliated with the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System and the Department of Epidemiology, Boston University School of Public Health.
Lewina O. Lee, PhD, is affiliated with the National Center for PTSD, VA Boston Healthcare System, the Department of Epidemiology, Boston University School of Public Health, and the Department of Psychiatry, Boston University School of Medicine.
Avron Spiro III, PhD, is affiliated with the Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, and with the Department of Epidemiology, Boston University School of Public Health, the Department of Psychiatry, Boston University School of Medicine, and the Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine.
This research was supported by a VA Clinical Science Research and Development Service Senior Research Career Scientist Award and National Institutes of Health grant R24-AG039343. The views expressed in this paper are those of the authors and do not necessarily represent the views of the U.S. Department of Veterans Affairs.