Health Mechanisms and Outcomes in an Epidemiological Cohort of Vietnam Era Women Veterans

Boston University Medical Campus, Boston MA

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Abstract

? DESCRIPTION (provided by applicant): Trauma exposure and its mental health correlates - particularly posttraumatic stress disorder (PTSD) - can have negative implications for health-related outcomes, particularly in high-risk populations, such as military and veteran groups. Specific risk mechanisms, however, are understudied in older adults. While there is growing evidence for the association between traumatic stress and physical health, less is known about the role of modifiable psychosocial factors and risk behaviors in the relationships among trauma exposure, stress reactions, and physical health outcomes, including how these risk factors operate over the long term. Examinations of traumatic stress-associated health risk in older, high-risk populations are needed to elucidate potentially modifiable mechanisms by which traumatic stress undermines health-related quality of life and functioning over the long term. Further, to date, the vast majority of research on older veterans has been conducted on men, yet women veterans are the fastest growing group among the veteran population, and they have poorer mental and physical health as compared to their civilian and male veteran counterparts. The proposed research will overcome existing gaps in the literature related to representing women and examining potentially modifiable risk mechanisms in the wake of stress, and will also set the stage for further longitudinal study of risk associations, an important direction in tis research. The focus of the proposed study is to examine the impact of early life traumatic stress exposure and mental health sequelae on later life health in an epidemiological cohort of older women veterans (N=4219) using data from The Health of Vietnam Women's Study (HealthVieWS), which is the most comprehensive study of women Vietnam Era veterans to date. The roles of PTSD and depression will be examined explicitly, as will several potentially modifiable psychosocial factors including salient health-risk behaviors (tobacco use, alcohol abuse, lack of exercise) and perceived social support. The primary health outcomes examined are indicators of health-related quality of life and functional status, obesity, and health conditions. Results will provide valuable pilot data for a larger-scale follow-up with this cohort o investigate hypothesized longitudinal associations linking early life traumatic stress exposure (including military exposure) with health outcomes in later-life, to better understand the long-term impact of military service and early life stress on healthy aging among women veterans.