Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts.
Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined.
The sample included 781 women veterans. Compared with the oldest age group (≥65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77–6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25–7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32–9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64.
Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care.
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Carolyn J. Gibson, PhD, MPH, is an Advanced Fellow in Women's Health at the San Francisco VA Medical Center. Her research focuses on women's mental health, the menopausal transition, and healthy aging.
Kristen E. Gray, PhD, is a Post-doctoral Fellow in Health Services Research & Development at the VA Puget Sound Health Care System. Her research focuses on chronic disease and health disparities among women veterans.
Jodie G. Katon, PhD, is a Health Science Research Specialist at VA Puget Sound Health Care System and Senior Epidemiology Consultant for VA Office of Women's Health Services. Her research focuses on reproductive health of women veterans.
Tracy L. Simpson, PhD, is a Clinician Investigator, VA Puget Sound Health Care System, and Associate Professor, University of Washington Department of Psychiatry and Behavioral Sciences. Her work focuses on PTSD and substance use comorbidity and randomized clinical trials.
Keren Lehavot, PhD, is Core Investigator at the Health Services Research & Development, Center of Innovation, VA Puget Sound, and Assistant Professor, University of Washington Department of Psychiatry and Behavioral Sciences. Her research focuses on women veterans' mental health and health disparities.
Published online: November 26, 2015
Accepted: September 23, 2015
Received in revised form: September 22, 2015
Received: June 11, 2015
Published by Elsevier Inc.