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Combat exposure and mental health: the long‐term effects among US Vietnam and Gulf war veterans

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  • Daniel M. Gade
  • Jeffrey B. Wenger

Abstract

Using a random sample of more than 4000 veterans, we test the effects of combat exposure on mental health. We focus on two cohorts of veterans: those who served in Vietnam (1964–1975) and the Gulf War (1990–1991). Combat exposure differed between these groups in intensity, duration and elapsed time since exposure. We find that combat exposure generally, and exposure to dead, dying, or wounded people, specifically, is a significant predictor of mental health declines as measured by an individual's Mental Component Summary score. Under our general specifications, the negative effects of combat on mental health were larger for Gulf war veterans than for Vietnam veterans as of 2001. These effects persist after controlling for demographic characteristics, insurance coverage, income and assets. Using discrete factor, nonparametric maximum likelihood (DFML) estimation we controlled for unobserved heterogeneity as well as the factors above. In the DFML specifications we find a negative impact of exposure to dead, wounded or dying people for both Gulf and Vietnam veterans, but find no statistically significant effect for combat exposure overall for Vietnam veterans as of 2001. Based on our Gulf war parameters, we estimate that the costs of mental health declines to be between $87 and $318 per year for each soldier with combat service and exposure to dead, dying and wounded people. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Daniel M. Gade & Jeffrey B. Wenger, 2011. "Combat exposure and mental health: the long‐term effects among US Vietnam and Gulf war veterans," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 401-416, April.
  • Handle: RePEc:wly:hlthec:v:20:y:2011:i:4:p:401-416
    DOI: 10.1002/hec.1594
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    References listed on IDEAS

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    1. Mroz, Thomas A., 1999. "Discrete factor approximations in simultaneous equation models: Estimating the impact of a dummy endogenous variable on a continuous outcome," Journal of Econometrics, Elsevier, vol. 92(2), pages 233-274, October.
    2. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March.
    3. Sophia Rabe-Hesketh & Anders Skrondal & Andrew Pickles, 2004. "Generalized multilevel structural equation modeling," Psychometrika, Springer;The Psychometric Society, vol. 69(2), pages 167-190, June.
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    1. Nobuaki Yamashita & Trong‐Anh Trinh, 2022. "Long‐Term Effects of Vietnam War: Agent Orange and the Health of Vietnamese People After 30 Years," Asian Economic Journal, East Asian Economic Association, vol. 36(2), pages 180-202, June.
    2. Bratti, Massimiliano & Mendola, Mariapia & Miranda, Alfonso, 2015. "Hard to Forget: The Long-Lasting Impact of War on Mental Health," IZA Discussion Papers 9269, Institute of Labor Economics (IZA).
    3. Johanna Catherine Maclean & Douglas A. Webber & Michael T. French & Susan L. Ettner, 2015. "The Health Consequences of Adverse Labor Market Events: Evidence from Panel Data," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 54(3), pages 478-498, July.
    4. Gilad Ritov & Zion Barnetz, 2014. "The interrelationships between moral attitudes, posttraumatic stress disorder symptoms and mixed lateral preference in Israeli reserve combat troops," International Journal of Social Psychiatry, , vol. 60(6), pages 606-612, September.
    5. Jiyuan Wang & Rob Alessie & Viola Angelini, 2023. "Exposure in utero to adverse events and health late‐in‐life: Evidence from China," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 541-557, March.
    6. Lyk-Jensen, Stéphanie Vincent & Weatherall, Cecilie Dohlmann & Jepsen, Peter Winning, 2016. "The effect of military deployment on mental health," Economics & Human Biology, Elsevier, vol. 23(C), pages 193-208.

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