Long-term Disability Associated With War-related Experience Among Vietnam Veterans

Retrospective Cohort Study

Bibliographic Data

ID9099774
AuthorsPhilip M Clarke, Philip Clarke (0000-0002-7555-5348, The University of Melbourne, corresponding author), Robert Gregory (0000-0002-5034-8895, Australian National University), Joshua A Salomon (0000-0003-3929-5515, Harvard Global Health Institute)
Year2015
Volume53
Issue5
Pages401-408
Publication date2015-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000336
PMID25768060
PMCIDPMC4396733
OpenAlexW2049495380
LanguageEN
Citations received1
References cited22

BACKGROUND: Recent combat operations have involved large numbers of personnel. Long-term health effects of military deployment remain largely unknown. OBJECTIVES: To examine patterns and trends in long-term disability among combat veterans and to relate disability to aspects of wartime experience. PARTICIPANTS: A total of 60,228 Australian military personnel deployed between 1962 and 1975 during the Vietnam War, and 82,877 military personnel who were not deployed overseas. OUTCOME MEASURES: Accepted physician-assessed disability claims were evaluated over follow-up periods up to 50 years after deployment, and compared with age-matched controls. Multivariable analysis was used to examine differences by service branch, rank, age, and deployment duration. RESULTS: The steepest rise in disability incidence was observed among Vietnam veterans starting in the 1990s, around 20-30 years after deployment for most veterans. After 1994, when Statements of Principles were introduced to guide evaluation of disability claims, the hazard ratio for disability incidence was 1.53 (95% confidence interval, 1.32-1.77) compared with the prior period. By January 2011, after an average follow-up of 42.5 years, 69.7% (95% confidence interval, 69.4%-70.1%) of veterans had at least 1 war-related disability. Many veterans had multiple disabilities, with leading causes being eye and ear disorders (48.0%), mental health conditions (47.9%), and musculoskeletal disorders (18.4%). For specific categories of disability, relative risks for accepted claims among veterans compared with controls were highest for mental health disorders, at 22.9 (21.9-24.0) and lowest for injuries, at 1.5 (1.4-1.6) with a relative risk for any disability of 3.7 (3.7-3.8). Veterans with service of >1 year were 2.5 (2.2-2.7) times more likely to have a mental health disability than those who served <100 days, and 2.3 (2.1-2.5) times more likely to have other disabilities. CONCLUSIONS: Long-term effects of deployment into military conflicts are substantial, and likelihood of war-related disability is associated with service history. If similar patterns follow from more recent conflicts, significant additional resources will be needed to prevent and treat long-term health conditions among veterans

Confidence interval · Hazard ratio · Incidence (geometry) · Mental health · Military deployment · Military personnel · Military service · Occupational safety and health · Psychiatry · Software deployment · Veterans Affairs · Vietnam War · Demography · Fibromyalgia and Chronic Fatigue Syndrome Research · Medicine · Occupational Health and Performance · Posttraumatic Stress Disorder Research · Gerontology

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