Long-Term Outcomes of Military Service The Health and Well-Being of Aging Veterans

Using data compiled from longitudinal studies of World War II, Korean War, and Vietnam War veterans, contributors to this groundbreaking book examine the effects of military service across the lifespan.

The US spends over 100 billion dollars annually on healthcare for more than 30 million active military and veterans. The prevalence of negative trauma and post-traumatic stress disorder (PTSD) among military veterans is well-known. But other more subtle effects of military service—particularly on health and well-being in later life—are less well-understood, among researchers as well as medical and mental health professionals who care for veterans.

Chapters in this book give us crucial insights into the impact of military service, including the surprising finding that service can serve as a protective factor in some contexts, throughout the aging process. Topic areas include the effects of combat and stress on longevity and brain functioning; the use of memory, cognition, and ego development at various points in life; the relationship between experiences of discrimination and the later development of PTSD; marriage longevity; employment; and the way notions of patriotism and nationalism among service personnel and their families may change over time.

Avron (Ron) Spiro III is research professor of epidemiology and psychiatry at Boston University Schools of Public Health and Medicine. He is the director of Psychosocial Research at the VA Normative Aging Study at the VA Boston Healthcare System and is also affiliated with the Massachusetts Veterans Epidemiology Research and Information Center, the National Center for PTSD, and the Center for Healthcare Organization and Implementation Research. He is a recipient of a Senior Research Career Scientist award from the Clinical Science R&D Service of the U.S. Department of Veterans Affairs (VA) and is a fellow of Divisions 5 (Quantitative and Qualitative Methods) and 20 (Adult Development and Aging) of the American Psychological Association and of the Behavior and Social Sciences Section of the Gerontological Society of America. Dr. Spiro has been funded by the National Institutes of Health (NIH ) and the VA, and is the author or coauthor of over 250 publications. He was coprincipal investigator (with Carolyn Aldwin) of an NIH grant to establish a research network on Lifespan Outcomes of Military Service and coinvestigator on several projects funded by NIH or the VA studying health, personality, cognition, and aging. His current work involves (a) examining the effects of health and disease on cognitive aging, (b) modeling longitudinal changes in personality in relation to health, (c) developing a lifespan approach to health and aging in veterans, and (d) studying mental disorders and their impact on health and functioning.

Richard A. Settersten Jr. is endowed director of the Hallie Ford Center for Healthy Children and Families, and professor of social and behavioral health sciences at Oregon State University. A fellow of the Gerontological Society of America (GSA), he has held leadership roles in the GSA and the American Sociological Association (ASA). His coedited book (with Jacqueline L. Angel), Handbook of Sociology of Aging, won the 2012 Outstanding Publication Award of the ASA’s Section on Aging and the Life Course, and an earlier book, Lives in Time and Place, won the Kalish Award of the GSA. He coedited (with Vern L. Bengtson) the third edition of the Handbook of Theories of Aging and is coeditor (with Megan McClelland) of the journal Research in Human Development. The MacArthur Foundation and NIH have supported his research. He has also participated in National Academy of Sciences/Institute of Medicine panel discussions on the health and wellbeing of young adults and on new directions in social demography, social epidemiology, and sociology of aging. He collaborated with Ron Spiro and Carolyn Aldwin on a grant from the National Institutes of Health to establish a research network on Lifespan Outcomes of Military Service.

Carolyn M. Aldwin is the Jo Anne Leonard endowed director for the Center for Healthy Aging Research and professor of human development and family sciences, Oregon State University. She received her doctorate in adult development and aging from the University of California, San Francisco. She is a fellow of the Gerontological Society of America, as well as both Divisions 20 (Adult Development and Aging) and 38 (Health Psychology) of the American Psychological Association. Dr. Aldwin received the 2011 Developmental Health Psychology Award from these divisions and is a former president of Division 20. She has authored or edited eight books and over 125 other publications on stress, stress-related growth, coping, health, and the long-term effects of military service on health in later life. Her work has been funded by the National Institute on Aging, the National Science Foundation, and the Templeton Foundation. She was coprincipal investigator (with Avron Spiro) on a grant from the National Institutes of Health to establish a research network on Lifespan Outcomes of Military Service.

Contributors
Preface
Introduction: Understanding the Long-Term Outcomes of Military Service
Avron Spiro III, Richard A. Settersten Jr., and Carolyn M. Aldwin

Part I. Psychosocial Dynamics
Chapter 1. Two Faces of Wartime Experience: Collective Memories and Veterans’ Appraisals in Later Life
Richard A. Settersten Jr., Claudia Recksiedler, Bethany Godlewski, and Glen H. Elder Jr.
Chapter 2. Midlife Ego Development of World War II Veterans: Contributions of Personality Traits and Combat Exposure in Young Adulthood
Johanna C. Malone, Laura M. L. Distel, and Robert J. Waldinger
Chapter 3. Perceived Racial, Ethnic, and Gender Discrimination Among Male and Female Vietnam-Era Veterans and PTSD Symptoms Later in Life
Daniel H. Kabat, Steven D. Stellman, and Jeanne Mager Stellman
Chapter 4. Using a Life Course Perspective to Examine the Prevalence of Marriage in Military Families
Shelley MacDermid Wadsworth, Sarah Mustillo, Anthony J. Faber, and Abigail Tolhurst Christiansen
Chapter 5. Labor Force Participation Among Older Veterans
Alair MacLean, Meredith A. Kleykamp, and John Robert Warren
Chapter 6. Nationalism and Patriotism Among World War II Veterans and Their Baby-Boom Children
Merril Silverstein, Andrew S. London, and Janet M. Wilmoth
Part II. Health Dynamics
Chapter 7. Military Service Experiences and Older Men’s Trajectories of Self-Rated Health
Janet M. Wilmoth, Andrew S. London, and William J. Oliver
Chapter 8. Studying Longitudinal Links From Early Adult Adversity to Later-Life Well-Being: American Repatriated Prisoners of the Vietnam War
Lewina O. Lee, Avron Spiro III, Anna L. Tyzik, Daniel W. King, and Lynda A. King
Chapter 9. The Impact of Military Service on Stress, Health, and Well-Being in Later Life
Carolyn M. Aldwin, Crystal L. Park, Soyoung Choun, and Hyunyup Lee
Chapter 10. Exploring the Veteran Mortality Differential: The Influence of War Era and Smoking Behavior
Scott D. Landes, Monika Ardelt, and Ann T. Landes
Chapter 11. Military Service and Changes in Memory Performance During Later Life
Robert S. Stawski, Meghann L. Fenn, Chenkai Wu, and Gwenith G. Fisher
Chapter 12. Long-Term Influences of Combat Exposure and Posttraumatic Stress Symptoms on Brain Structure, Health, and Functioning: The Vietnam Era Twin Study of Aging
Carol E. Franz, Michael J. Lyons, and William S. Kremen
Chapter 13. The Effect of Combat and Posttraumatic Stress Disorder on Longevity
George E. Vaillant and Diane Highum Vaillant
Part III. Implications for Practice and Policy
Chapter 14. Mental Health Considerations and Service Utilization in Older Adult Nonveterans and Veterans
Anica Pless Kaiser, Joan M. Cook, Joyce Wang, Eve Davison, and Paula P. Schnurr
Chapter 15. Aging Veterans and Long-Term Outcomes of Military Service: Implications for Practice and Policy
Richard A. Settersten Jr., Carolyn M. Aldwin, and Avron Spiro III

Index
About the Editors