Erosion of the healthy soldier effect in veterans of US military service in Iraq and Afghanistan

Population Health Metrics
Mary J BollingerMary Jo Pugh

Abstract

This research explores the healthy soldier effect (HSE) - a lower mortality risk among veterans relative to the general population-in United States (US) veterans deployed in support of operations in Iraq and Afghanistan (OEF/OIF/OND). While a HSE has been affirmed in other OEF/OIF/OND populations, US veterans of OEF/OIF/OND have not been systematically studied. Using US Department of Veterans Affairs (VA) administrative data, we identified veterans who (1) had been deployed in support of OEF/OIF/OND between 2002 and 2011 and (2) were enrolled in the VA health care system. We divided the VA population into VA health care utilizers and non-utilizers. We obtained Department of Defense (DOD) administrative data on the OEF/OIF/OND population and obtained VA and DOD mortality data excluding combat deaths from the analyses. Indirect standardization was used to compare VA and DOD cohorts to the US population using total population at risk to compute the Standardized Mortality Ratio (SMR). A directly standardized relative risk (DSRR) was calculated to enable comparisons between cohorts. To compare VA enrollee mortality on military specific characteristics, we used a DOD population standard. The overall VA SMR of 2.8 (95% Confidence Inte...Continue Reading

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Citations

Nov 23, 2016·Health Promotion Practice·Anna Torrens Armstrong
Dec 30, 2017·BMC Psychiatry·Candice OsterSharon Lawn
Jul 2, 2016·Medical Care·Laurel A CopelandMary Jo V Pugh
Jun 4, 2019·Journal of Palliative Medicine·Deborah WayChristopher A Jones
Apr 6, 2017·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Huang HuangYawei Zhang

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