Hardy Melissa A, Reyes Adriana M
Department of Sociology, The Pennsylvania State University, University Park.
Gerontologist. 2016 Feb;56(1):104-14. doi: 10.1093/geront/gnv041. Epub 2015 Jul 28.
We examine hypotheses involving the potential health advantages of selection into military service and the potential health disadvantages associated with the experience of military service by comparing later-life mortality rates for veterans and nonveterans as well as among veterans based on their cohort of reentry into civilian life.
We use data on 3,453 men, including 1,496 veterans from the older men cohort of the National Longitudinal Surveys to estimate Cox proportional hazard mortality models. We distinguish between veterans and nonveterans and further classify veterans by age at exit while incorporating measures associated with military selection, health behaviors, and socioeconomic status.
Veterans who were discharged from the military at older ages have a mortality advantage relative to veterans discharged at younger ages. For the 1914-1921 birth cohorts, the mortality advantage for veterans who exited around age 30 is apparent for deaths before age 65, but rates equalize across all groups when deaths at older ages are included. These findings are robust to the inclusion of background characteristics, education, occupation, body mass index, smoking, marital status, and proxies for service deferments.
Rather than focusing on a general health effect of military service, per se, future research should distinguish among individual traits; the nature, timing, and duration of exposures relative to life course stage; and the sociohistorical context of military service to expand our understanding of the differential health consequences of military service.
我们通过比较退伍军人和非退伍军人的晚年死亡率,以及根据他们重新进入平民生活的队列对退伍军人进行比较,来检验有关入伍潜在健康优势和与服役经历相关的潜在健康劣势的假设。
我们使用了3453名男性的数据,其中包括来自全国纵向调查老年男性队列的1496名退伍军人,以估计Cox比例风险死亡率模型。我们区分退伍军人和非退伍军人,并根据退伍时的年龄对退伍军人进行进一步分类,同时纳入与军事选拔、健康行为和社会经济地位相关的指标。
老年退伍军人相对于年轻退伍军人具有死亡率优势。对于1914 - 1921年出生队列,30岁左右退伍的退伍军人在65岁之前的死亡中具有明显的死亡率优势,但纳入老年死亡后,所有组的死亡率趋于相等。这些发现对于纳入背景特征、教育程度、职业、体重指数、吸烟、婚姻状况以及服役延期代理指标具有稳健性。
未来的研究不应仅仅关注服役本身对健康的总体影响,而应区分个体特征;相对于生命历程阶段的暴露性质、时间和持续时间;以及服役的社会历史背景,以扩大我们对服役不同健康后果的理解。