Tyler C. Hein, Evaluation Scientist, Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), Office of Mental Health and Suicide Prevention (10NC5), Department of Veterans Affairs, Ann Arbor, MI;, Email:
Benjamin Muz, Research Analyst, Westat, Rockville, MD.
Am J Health Behav. 2020 Nov 1;44(6):876-892. doi: 10.5993/AJHB.44.6.11.
Despite substantial research linking adverse childhood experiences (ACEs) and health, it is unclear how associations differ by veteran status and military service era (draft, volunteer era). The current study evaluated differences in ACEs and health by veteran status and era, increasing understanding important for service provision as the volunteer era veteran population increases. Behavioral Risk Factor Surveillance System 2012 data were used in univariate and weighted multivariable logistic regression models to assess associations among veteran status, service era, ACEs, and health. Volunteer era veterans experienced the most ACEs (M = 2.42); draft era veterans experienced the fewest (M = 1.04). Individuals reporting 3 or more ACEs were 3.67 times (95% CI = 3.22-4.19) more likely to endorse depression, 1.32 times (95% CI = 1.17-1.48) more likely to report poorer general health, and 1.77 times (95% CI = 1.58-1.97) more likely to endorse poorer physical health, compared to those reporting none. Volunteer era veterans were 2.43 times more likely to report poorer physical health (95% CI = 1.49-3.97) than draft era veterans, adjusting for ACEs. ACEs were associated with poorer health independent of veteran status and service era. Volunteer era veterans experienced more ACEs; need for trauma-informed services supporting whole health may increase.
尽管有大量研究表明童年逆境经历（ACEs）与健康之间存在关联，但目前尚不清楚这种关联在退伍军人身份和兵役时代（征兵、志愿兵役时代）上有何不同。本研究评估了退伍军人身份和兵役时代对 ACEs 和健康的影响差异，增加了对服务提供的理解，因为志愿兵役时代的退伍军人人数增加。 使用行为风险因素监测系统 2012 年的数据，在单变量和加权多变量逻辑回归模型中评估了退伍军人身份、兵役时代、ACEs 和健康之间的关联。志愿兵役时代的退伍军人经历的 ACEs 最多（M = 2.42）；征兵时代的退伍军人经历的 ACEs 最少（M = 1.04）。报告有 3 个或更多 ACEs 的个体，其抑郁的可能性是报告无 ACEs 的个体的 3.67 倍（95%置信区间=3.22-4.19），报告一般健康状况较差的可能性是报告无 ACEs 的个体的 1.32 倍（95%置信区间=1.17-1.48），报告身体状况较差的可能性是报告无 ACEs 的个体的 1.77 倍（95%置信区间=1.58-1.97）。与征兵时代的退伍军人相比，调整 ACEs 后，志愿兵役时代的退伍军人报告身体状况较差的可能性高出 2.43 倍（95%置信区间=1.49-3.97）。 ACEs 与健康状况较差独立于退伍军人身份和兵役时代有关。志愿兵役时代的退伍军人经历的 ACEs 更多；可能需要提供以创伤为中心的服务，以支持整体健康。
