A retrospective cohort study of U.S. service members returning from Afghanistan and Iraq: is physical health worsening over time?

BMC Public Health. 2012 Dec 28:12:1124. doi: 10.1186/1471-2458-12-1124.

Abstract

Background: High rates of mental health disorders have been reported in veterans returning from deployment to Afghanistan (Operation Enduring Freedom: OEF) and Iraq (Operation Iraqi Freedom: OIF); however, less is known about physical health functioning and its temporal course post-deployment. Therefore, our goal is to study physical health functioning in OEF/OIF veterans after deployment.

Methods: We analyzed self-reported physical health functioning as physical component summary (PCS) scores on the Veterans version of the Short Form 36 health survey in 679 OEF/OIF veterans clinically evaluated at a post-deployment health clinic. Veterans were stratified into four groups based on time post-deployment: (1Yr) 0 - 365 days; (2Yr) 366 - 730 days; (3Yr) 731 - 1095 days; and (4Yr+) > 1095 days. To assess the possibility that our effect was specific to a treatment-seeking sample, we also analyzed PCS scores from a separate military community sample of 768 OEF/OIF veterans evaluated pre-deployment and up to one-year post-deployment.

Results: In veterans evaluated at our clinic, we observed significantly lower PCS scores as time post-deployment increased (p = 0.018) after adjusting for probable post-traumatic stress disorder (PTSD). We similarly observed in our community sample that PCS scores were lower both immediately after and one year after return from deployment (p < 0.001) relative to pre-deployment PCS. Further, PCS scores obtained 1-year post-deployment were significantly lower than scores obtained immediately post-deployment (p = 0.02).

Conclusion: In our clinical sample, the longer the duration between return from deployment and their visit to our clinic, the worse the Veteran's physical health even after adjusting for PTSD. Additionally, a decline is also present in a military community sample of OEF/OIF veterans. These data suggest that, as time since deployment length increases, physical health may deteriorate for some veterans.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Afghan Campaign 2001-*
  • Afghanistan
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Iraq War, 2003-2011*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • New Jersey / epidemiology
  • Personnel Delegation
  • Quality of Life*
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology
  • Time Factors
  • Veterans / psychology*
  • Veterans / statistics & numerical data