The effect of race and birth cohort on the veteran mortality differential

Age differences in long-term mortality among male nonveterans, noncombat veterans, and combat veterans

Research documenting differences in mortality risk across the life course between veterans and nonveterans has not accounted for combat status. To address this gap in the literature, the current study examined differences in long-term mortality among midlife and older-adult male nonveterans, noncombat veterans, and combat veterans. Data were drawn from Wave 2 (2004/2005) of the Midlife Development in the United States survey and linked to 2020 mortality data (N = 2,024). Based on interpretation of a veteran-combat status by age interaction term, compared to nonveterans, noncombat veterans experienced a mortality advantage at younger ages, ORmain effect = 0.12, 95% CI [0.03, 0.54], p = .006, and a mortality disadvantage at older ages, ORinteraction term = 1.06, 95% CI [1.01, 1.05], p = .004, with the crossover occurring at 73.4 years. A similar pattern was present among combat veterans, with the mortality advantage at younger ages not reaching significance, ORmain effect = 0.16; 95% CI [0.02, 1.18], p = .072; a mortality advantage at older ages, ORinteraction term = 1.03, 95% CI [1.00, 1.05], p = .040; and the crossover occurring 4.2 years earlier at 69.2 years. The findings suggest that combat status may accelerate the age-related mortality disadvantage among veterans. Studies of health and mortality outcomes among veterans should, therefore, account for combat status. When data allow, future studies should confirm whether this pattern is present in nationally representative samples.

Age differences in allostatic load among veterans: The importance of combat exposure

The current study examinedage differences in allostatic load among nonveterans, noncombat veterans, and combat veterans. Participants included 280 individuals from the Midlife Development in the United States (MIDUS) survey, including 164 veterans (n = 48 combat veterans; n = 116 noncombat veterans) and 116 nonveterans. Age differences in allostatic load were similar among nonveterans and noncombat veterans, B = 0.002, SE = .011, p = .878, with older adults showing higher levels of allostatic load than their comparatively younger counterparts. Among combat veterans, however, a different pattern emerged. In this group, levels of allostatic load were similar across age, seemingly due to higher levels of allostatic load among younger combat veterans, B = -0.029, SE = .014, p = .031, ƞ_p ²  =  .022. Results reveal the importance of considering combat exposure when examining health outcomes of military veterans, particularly in the context of age.

Accelerated DNA Methylation Aging in U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study

OBJECTIVE

The aim of this study was to identify how a broad range of sociodemographic, military, health, and psychosocial factors relate to accelerated DNA methylation aging (Δ_age) in a large, contemporary, nationally representative sample of male U.S. veterans.

METHODS

Data were analyzed from a sample of U.S. male European-American veterans who participated in the National Health and Resilience in Veterans Study (N = 1,135).

RESULTS

Psychosocial factors of lifetime trauma burden, child sexual trauma, and negative beliefs about aging were independently associated with Δ_age. Three health variables-diabetes, hypertension, and body mass index-emerged as additional correlates of Δ_age.

CONCLUSION

Results of the study build on prior work demonstrating associations between accelerated DNA methylation aging and traumatic stress, highlighting a role for child sexual abuse in particular. They further underscore the importance of targeting negative beliefs about aging, which are modifiable, in prevention efforts designed to forestall accelerated DNA methylation aging.

Black/white differences in mortality among veteran and non-veteran males

U.S. military veterans are a large and racially heterogeneous population. There are reasons to expect that racial disparities in mortality among veterans are smaller than those for non-veterans. For example, blacks are favorably selected into the military, receive relatively equitable treatment within the military, and after service accrue higher socioeconomic status and receive health and other benefits after service. Using the 1997-2009 National Health Interview Survey (N = 99,063) with Linked Mortality Files through the end of 2011 (13,691 deaths), we fit Cox proportional hazard models to estimate whether racial disparities in the risk of death are smaller for veterans than for non-veterans. We find that black/white disparities in mortality are smaller for veterans than for non-veterans, and that this is explained by the elevated socioeconomic resources of black veterans relative to black non-veterans. Leveraging birth cohort differences in military periods, we document that the smaller disparities are concentrated among All-Volunteer era veterans.