The Effect of Veteran Status on Mortality among Older Americans and its Pathways |
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Authors: | Email author" target="_blank">Xian?LiuEmail author Jr" target="_blank">Charles?C?EngelJr Han?Kang David?Cowan |
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Institution: | (1) Deployment Health Clinical Center, Walter Reed Army Medical Center, Washington, DC 20307, USA;(2) Department of Psychiatry, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA;(3) Department of Veterans Affairs, Environmental Epidemiology Service, Washington, DC 20420, USA;(4) Deployment Health Clinical Center, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA |
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Abstract: | This research examines excess mortality among American veterans age 70 years or older during a two-to-three year interval
from 1993/94 to the end of 1995. Using a structural hazard rate model, we analyzed data on a sample of respondents age 70
or over from the Survey of Asset and Health Dynamics among the Oldest Old (AHEAD). We found that at age 70, older veterans
have a slightly higher death rate than their nonveteran counterparts, implying a mortality crossover right before this age.
Such excess mortality among veterans increases considerably with age, when other factors are held equal. The direct and indirect
effects of veteran status on mortality by means of physical and mental health mostly perform in opposite directions, and such
effects vary greatly in magnitude and direction as a function of age. The intervening effects of physical and mental health
status decrease substantially with increasing age. Many of the mechanisms inherent in the excess mortality among older veterans
are not captured by variations in their health status, especially among the oldest-old. A more extensive study on this topic
is urgently needed. |
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Keywords: | Differential mortality Older veterans Structural equation models Survival analysis |
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