How Does War Influence Assessments of Health? An Analysis of Older Adult Self-Rated Health and Health Pessimism in the Vietnam Health and Aging Study.

Kim Korinek , University of Utah
Robert Tennyson, University of Utah
Sahlil Ahmed, University of Utah

The toll of war on populations is far more devastating when we account not only direct casualties on the battlefield, but also mortality and morbidity that occurs year later. Accordingly, we ask: ‘How does the long arm of war and its associated violence and deprivation extend from early adulthood to affect the health of war survivors in older adulthood?’ Using a life course logic, we examine both direct and indirect pathways between early life war exposure and late life self-rated health, and consider physical, functional, and mental health pathways of influence. We analyze survey and biomarker data from the Vietnam Health and Aging Study, conducted in 2018 among 2,447 men and women age 60 and older in four northern Vietnamese districts that experienced widely variant exposure to the American War in Vietnam. Our focal dependent variables are self-rated health (ordinal) and health pessimism (continuous), our focal independent variables are indices of exposure to violence and malevolent environmental conditions during the American War, and mediating variables include counts of current physical health problems and ADLs, and an index of psychological distress (SRQ-10). Generalized structural equation models are used to estimate ordered logistic regression analyses of SRH and Poisson regression analyses of health pessimism. Preliminary results suggest that the effects of wartime exposure to violence and malevolent environments on late life SRH are mediated through their effects on physical health conditions, SRQ-10 scores, and ADLs (all p’s<0.01). The direct effects of the war exposure indices are not significant in preliminary model estimates.

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 Presented in Session 102. The Impact of Violence on Health, Wellbeing and Morbidity