Gender Differences in the Impact of Warfare Exposure of Self-Rated Health

Authors
Wang, J. M. Lee, L. O. Spiro, A.
Publication year
2015
Citation Title
Gender differences in the impact of warfare exposure of self-rated health.
Journal Name
Women’s Health Issues
Journal Volume
25
Issue Number
1
Page Numbers
35-41
DOI
10.1016/j.whi.2014.09.003
Summary
Veterans completed questionnaires to examine gender differences relationships among warfare exposure (combat deployment and exposure to casualties), health status, and functional impairment. Both male and female Veterans who were exposed to casualties reported worse health status than those not exposed to casualties.
Key Findings
Combat-deployed male and female Veterans who were exposed to casualties reported worse health status than combat-deployed personnel who were not exposed to casualties.
Male Veterans who were exposed to casualties were more likely to report functional impairment (e.g., needing assistance with daily activities) than combat-deployed men who were not exposed to casualties and non-deployed men.
Warfare exposure was not associated with increased risk of functional impairment among women.
Implications for Program Leaders
Provide courses for family members of Service members about the impact of combat deployment on physical health, and how families can promote well-being in a holistic manner
Offer classes for Service members exposed to casualties, teaching effective means of coping with stress and reminders of the distressing events
Collaborate with other service providers to provide resources and support for Service members needing assistance with daily living activities, such as eating, dressing, and walking
Implications for Policy Makers
Support programs and services specifically for Service members exposed to combat and casualties and their families
Recommend that facilities supporting Service members who were exposed to casualities include programming for children and families
Encourage routine assessment of both physical and mental health among Service members and Veterans who experienced combat deployment and were exposed to casualities
Methods
Data were from the 2010 National Survey of Veterans; Veterans from all wars starting from WWII through September 2001 and later were included.
Veterans were recruited via mailed letter using an address-based sampling approach, and included Veterans from all 50 states and the District of Columbia.
Participants completed scales of warfare and casualty exposure, health status, and functional impairment.
Participants
Seven thousand seven hundred seventy-nine Veterans completed the online questionnaire (94% male).
The average age for males was 66 years (SD = 12) and 52 years (SD = 17) for females.
Twelve percent minority for males, 26% minority for females.
No data regarding service branch were provided.
Limitations
The data were cross-sectional, and causality cannot be inferred.
Relatively few females were included in comparison to males, which may have limited the significant findings for females.
Other variables beside warfare exposure likely contribute to health status and functional impairment (e.g., chronic health conditions, mental health diagnoses prior to deployment).
Avenues for Future Research
Examine multiple aspects of combat deployment (e.g., duration and number of deployments, degree of exposure to casualties, work and living conditions)
Explore additional stressors related to post-deployment health and functioning, such as social support and exposure to prior trauma
Employ longitudinal research designs to examine associations between warfare exposure and health status over time
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Background: This study examined gender differences in the impact of warfare exposure on self-reported physical health. Methods: Data are from the 2010 National Survey of Veterans, a nationally representative survey of veterans from multiple eras of service. Regression analyses assessed gender differences in the association between warfare exposure (deployment to a war zone, exposure to casualties) and health status and functional impairment, adjusting for sociodemographics. Findings: Women reported better health status but greater functional impairment than men. Among men, those who experienced casualties only or both casualties and deployment to a war zone had worse health compared with those who experienced neither stressor or deployment to a war zone only. Among women, those who experienced casualties only or both stressors reported worse health than those who experienced war zone only, who did not differ from the unexposed. No association was found between warfare exposure and functional impairment in women; in men, however, those who experienced exposure to casualties or both stressors had greater odds of functional impairment compared with those who experienced war zone only or neither stressor. Conclusions: Exposure to casualties may be more predictive of health than deployment to a war zone, especially for men. We did not find a stronger association between warfare exposure and health for women than men. Given that the expansion of women’s military roles has allowed them to serve in direct combat, their degree and scope of warfare exposure is likely to increase in the future.
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