Article
Health Status of Female and Male Gulf War and Gulf Era Veterans: A Population-Based Study

https://doi.org/10.1016/j.whi.2019.04.003Get rights and content

Abstract

Background

The health of women Gulf War (deployed) and Gulf Era (nondeployed) veterans is understudied; although most studies examining the health effects of deployment to the Gulf War adjust for gender in multivariate analyses, gender-specific prevalence and effect measures are not routinely reported. The National Academy of Medicine recommended that the Department of Veterans Affairs assess gender-specific health conditions in large cohort studies of Gulf War veterans.

Methods

Data from this study come from the follow-up study of a national cohort of Gulf War and Gulf Era veterans. This study was conducted between 2012 and 2014, and was the second follow-up of a population-based cohort of Gulf War and Gulf Era veterans that began in 1995. Measures included self-reported medical conditions and frequency of doctor visits as well as validated screening instruments for mental health conditions.

Results

Overall, female veterans (both Gulf War and Era) reported poorer health than their male counterparts as measured by the prevalence of self-reported disease. The top five prevalent conditions in both Gulf War and Gulf Era veterans were migraine, hypertension, major depressive disorder, arthritis, and dermatitis. Female Gulf War veterans were found to have a higher prevalence of disease than male Gulf Era veterans.

Conclusions

Women veterans, particularly deployed veterans, from this era have significant medical needs that may justify increased outreach from the Department of Veterans Affairs. Our findings highlight the importance of asking about military service, particularly for women veterans, in the clinical setting, both in the Department of Veterans Affairs and in the private sector.

Section snippets

Methods

Data from this study come from the follow-up study of a national cohort of Gulf War and Gulf Era veterans. This study was conducted between 2012 and 2014, and was the second follow-up of a population-based cohort of Gulf War and Gulf Era veterans that began in 1995 (Kang et al., 2000). The sample consisted of a population-based permanent panel of 30,000 veterans (15,000 Gulf War veterans and 15,000 Gulf Era veterans), stratified by gender and unit component. The 15,000 Gulf War veterans were

Results

Military and demographic characteristics of the study population, stratified by gender, are reported in Table 1. In this study, we calculated response rate according to the American Association for Public Opinion Research standards, which is the number of completed interviews by sample members divided by the total number of eligible sample members. The non-eligible category for this study was narrowly defined and included veterans who were correctly identified but who were incarcerated or

Discussion

In this article, we presented population prevalence estimates and relative odds of disease in female and male Gulf War veterans almost 25 years after the Gulf War to fill a well-recognized gap in the literature (Danan et al., 2017, National Academy of Medicine (NAM), 2016). To our knowledge, this is the first article to report gender-specific disease prevalence estimates in the Gulf War and Gulf Era population. The 10 most prevalent chronic medical conditions in women veterans, both Gulf War

Implications for Policy and/or Practice

This article is the first to report gender-specific prevalence of health conditions in the Gulf War and Gulf War Era veteran population. Our analyses demonstrated that, overall, female veterans report poorer health than male veterans, with a significantly increased burden of mental health conditions as well as symptom-based conditions. Women veterans, particularly deployed veterans, from this era have significant medical needs that may justify increased outreach from the VA. The proportion of

Conclusions

These findings demonstrate the importance of asking about military service in the clinical setting, both within VA and the private sector; providers should always ask veterans about potential exposures and health concerns related to their service. It is especially relevant for clinicians providing care to women veterans to be attentive to gender-specific health concerns that may be associated with service.

Erin K. Dursa, PhD, MPH, is a senior epidemiologist in the Post Deployment Health Services. Her work focuses on the health effects of military deployments, specifically medically unexplained illness among veterans of the 1990-1991 Gulf War.

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    Erin K. Dursa, PhD, MPH, is a senior epidemiologist in the Post Deployment Health Services. Her work focuses on the health effects of military deployments, specifically medically unexplained illness among veterans of the 1990-1991 Gulf War.

    Aaron I. Schneiderman, PhD, MPH, RN, is Director of the Post Deployment Health Services Epidemiology Program, U.S. Department of Veterans Affairs. His research focuses on the effects of military-related occupational and environmental exposures on the health and well-being of veterans.

    Shannon K. Barth, MPH, is a PhD student in Epidemiology at West Virginia University. Additionally, she is a Graduate Research Assistant at the West Virginia University Injury Control Research Center and a Program Analyst at the Department of Veterans Affairs VISN 2 Center of Excellence for Suicide Prevention.

    Ben W. Porter, PhD, held a WOC (without compensation) appointment with Research Services, Veterans Affairs San Diego Healthcare System. He is employed as a Biostatistician for Leidos, Inc., working on the Department of Defense's Millennium Cohort Study.

    This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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