# Long-Term Health Impact of Vietnam Era Service: Examining Gender Differences in Risk of Mortality and Chronic Disease

> **NIH VA I01** · VA BOSTON HEALTH CARE SYSTEM · 2021 · —

## Abstract

Background: Despite increasing evidence of the health impact of exposure to traumatic stress during wartime
for veterans, less is known about gender differences in long-term health risks, including risks for chronic
disease and early mortality. Given that veteran status can be an important influence on later health, it is
important to advance understanding of what are likely to be gender-specific effects, as much of what is
currently known about veterans’ long-term health is based on male veteran samples. To better tailor clinical
services for veterans, more information is needed on gender differences in the implications of military service—
including the effects of warfare-related exposures, as well as experiences disproportionately facing deployed
women, such as military sexual trauma (MST), and their mental health sequelae—for long-term health
outcomes, especially chronic disease morbidity and all-cause and cause-specific mortality, including suicide.
Study Design: The proposed retrospective research will overcome existing gaps in the literature related to
representing older women veterans and examining long-term health risk by leveraging data from two national
cohorts of Vietnam Era (VNE) veterans: HealthViEWS (CSP 579; N=4,219), a study of VNE women veterans,
and the Veteran Health Study (CSP 569; N=5,598), a study of male VNE veterans. Leveraging and building
directly on these two VA CSP studies, the objective of this project is to examine gender differences in the
impact of military service, including warfare-related exposures and MST, and mental health sequelae—
posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD),
and substance use disorder (SUD)—on later-life health outcomes, with a focus on cardiovascular disease
(CVD), cancer, and other chronic conditions and early mortality risk. Both CSP studies used a mail survey to
collect data on demographics, military experiences, health outcomes, and psychosocial factors, and a
telephone interview to diagnose psychiatric disorders. In addition to leveraging these important VA data, vital
status records on CSP participants will be obtained via the National Death Index (NDI). This study will also
account for salient military service characteristics and later-life psychosocial factors, such as health behaviors,
social support, and suicidal ideation. Gender comparisons in the weighted prevalence of health outcomes will
be conducted, and associations will be tested using regression-based models, including gender-stratified
structural equation modeling (SEM) to examine gender differences in risk for long-term health outcomes.
Clinical Implications: As the number of veterans age 65 and older accessing VA healthcare is expected to
rapidly increase over the next 10-20 years, it is crucial to advance understanding of aging veterans’ health and
clinical care needs in the context of their military experiences. In addition to directly targeting the VA Wom...

## Key facts

- **NIH application ID:** 10249645
- **Project number:** 1I01CX002164-01A2
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Brian N Smith
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-10-01 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10249645

## Citation

> US National Institutes of Health, RePORTER application 10249645, Long-Term Health Impact of Vietnam Era Service: Examining Gender Differences in Risk of Mortality and Chronic Disease (1I01CX002164-01A2). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10249645. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*