Vietnam-era veteran health: a life-course perspective at the end of middle-adulthood




Willrodt, Pamela S.

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The Vietnam War interrupted the lives of the men and women who served and affected the direction of their lives in a multitude of ways. This study examines disparities in health, cognition, and health literacy among Vietnam-era military Veterans during their late middle-adulthood years, ages 50 to 64, guided by the paradigms of life-course theory. The study attempts to remove selection bias inherent in analyzing Veteran populations by limiting the sample to Veterans. The sample was limited to those who completed high school or its equivalency, generally a requirement for military induction. Little literature exists that examines this age period in general, let alone for Veterans. The data used to help fill this gap are from the 2003 National Assessment of Adult Literacy, Health Literacy Component, and the RAND harmonized Health and Retirement Study, version N, and the individual HRS longitudinal files from 1996 through 2010. The main conclusion is that education is essential in these each three analyses in that health literacy levels, early cognitive dysfunction (CD), and self-report of health/access to health are all associated with educational attainment, e.g., education increases health literacy, reduces the odds of early CD, and increases odds of reporting good SRH. Other conclusions are: (1) Veterans in the 50 to 64-year age group have lower Mean Health Literacy Scores than Non-Veterans, (2) Veterans and civilians 65 and older have inadequate health literacy unless health is self-reported as very good or excellent, (3) CD can be detected prior to age 65 using the four questions in the HRS survey, (4) Vietnam Veterans do not have higher odds of transitioning into early CD when compared to those who did not serve, (5) Good/very good/excellent self-report of health is associated with decreased odds of transitioning into early CD, (6) No association was found between Veteran status and self-report of health (SRH) when controlling for the various indicators of socio-economic position (wealth, income, or health insurance), (7) Race was not significantly associated with good SRH in the Veteran population, and (8) Income was significantly associated with increased odds of reporting good health for Blacks, while wealth did the same for Whites. These results suggest that practitioners should be aware of potential issues relating the low health literacy levels, cognitive dysfunction, and the effects of socio-economic position and racial disparities in treating Vietnam Veterans.


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Early cognitive dysfunction, Health literacy, Importance of education, Self-report of health, Socio-economic position (SEP), Vietnam Veterans