Service-Connected Disability and the Veteran Mortality Disadvantage

Abstract

Research consistently reports a veteran mortality disadvantage relative to nonveterans, but has not considered the contribution of service-connected disability to this differential. We use data from the 1986 and 1989 National Health Interview Survey-2011 Linked Mortality Files ( N = 124,122) to estimate multivariate Cox regression models of the association between veteran status and mortality, taking service-connected disability status into account. Bivariate analyses demonstrate higher mortality risk, lower socioeconomic status, and poorer health and functioning among veterans with a service-connected disability than among nonveterans and veterans without a service-connected disability. Multivariate models confirm a mortality disadvantage for all veteran service-connected disability subgroups, which is reduced by the inclusion of exogenous sociodemographic variables and substantially mediated by the health/functional limitation status measures. Results indicate that service-connected disability status accounts for some variation in, and may have a cumulative effect on, the veteran mortality disadvantage. When possible, future research should account for service-connected disability status when studying veteran–nonveteran mortality differentials.

Consistent Honor, Persistent Disadvantage: American Indian and Alaska Native Veteran Health in the National Survey of Veterans

“…This finding stands in spite of the fact that the health of all veterans is relatively comparable across race/ethnic groups as individuals enter the military and minorities generally smoke less than whites ( Teachman, 2011 ; Chisick et al, 1998 ). The implications of this finding are stark as recent research has documented that veterans with a disability are at significantly higher risk of mortality ( Landes et al, 2019 ). Future research should further explore the age of onset of ADLs among racial and ethnic minority veterans and the military and social factors that may increase their risk of experiencing an ADL.…”

How do veterans view gun policies? Evidence from the Guns in American Life Survey

“…Our goals in this study have been twofold: (a) to augment the significant literature on public opinion regarding guns and gun policy attitudes by identifying a potentially important, and hitherto neglected, factor and (b) to contribute to the modest but growing literature that links military background-and combat experience in particular-with distinctive social and political behaviors and attitudes. To date, contemporary social scientists have tended to pay greater attention to the role of military service in shaping subsequent life-course transitions (Landes, London, and Wilmoth 2021;MacLean and Elder 2007;Werum et al 2020) than to the potential influence of military background on various facets of civic engagement and public opinion. This imbalance is unfortunate because the latter works have shown important links between military service and (a) civic and political participation and (b) political attitudes, particularly regarding those issues that have particular relevance with respect to the military (Ellison 1992;Endicott 2020;Wilson and Ruger 2021).…”

“…In one major line of investigation, social scientists have examined the influence of military background on a broad array of subsequent life course transitions (MacLean and Elder 2007). Examples of such research have focused on (a) the formation and duration of marital and intimate unions (Heerwig and Conley 2013;Karney and Crown 2011;Routon 2017); (b) trajectories of health, morbidity, and mortality (Landes, London, and Wilmoth 2021;Teachman 2011;Wilmoth, London, and Parker 2010); (c) desistance from delinquent and criminal behavior (Johnson and Giordano 2021); and (d) stratification outcomes, including skills acquisition and occupational attainment, earnings, and other socioeconomic attainments (Brown and Routon 2016;Martorelli et al 2013;Werum et al 2020).…”

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

“…The veteran health and mortality advantage that is present in early-to midlife, however, does not appear to be as strong, or present at all, among those who served longer, were exposed to combat or environmental hazards, acquired a service-connected disability, or served during a particular war era (Landes et al, 2017(Landes et al, , 2018(Landes et al, , 2019Porter et al, 2019;Sheehan et al, 2015;Taylor et al, 2015;Wilmoth et al, 2010Wilmoth et al, , 2018. In addition, the early life health advantage some veterans experience does not appear to persist into later life (e.g., Wilmoth et al, 2010).…”

“…Moreover, interpersonal trauma, such as sexual harassment or assault, which are experienced disproportionately by female service members, may have long‐term effects on health (O'Brien & Sher, 2013; Suris & Lind, 2008). The cumulative effect of illness, injury, or trauma exposure during one's time in service, combined with the continuation of adverse health behaviors, can result in poorer health outcomes and increased mortality risk for veterans later in life (Landes et al., 2019; Wilmoth et al., 2019).…”