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The 2018 Health of Those Who Have Served Report features an expanded set of 15 health outcome measures. New to this year’s edition are a range of mental health measures, including anxiety, any mental illness in the past year, suicidal thoughts, and suicide attempts. Also new is a measure of pain, defined as the percentage who reported having neck pain or lower back pain in the past three months.
How Have Self-Reported Health Status Rates Changed Since 2011-2012 for Those Who Have Served? Encouraging Improvements: - Health status rates have generally held steady for those who have served, overall and for most subpopulation groups. - Among college graduates who have served, health status rates improved by 6% from 64.1% to 68.1%.
Overall, men and women who have served are more likely to say they are in excellent or very good health than men and women who have not served. Despite this positive outlook, those who have served have a significantly higher burden of many physical health, mental health, and chronic disease challenges. Findings on health outcomes in this section are organized by overall health status, mental health, and chronic conditions.
Overall Health Status
Those who have served report significantly higher rates of high health status than those who have not served (56.3% vs. 51.1%). Detailed findings show that:
- Both men (56.6% vs. 51.0%) and women (55.7% vs. 51.0%) who have served have significantly higher self-reported rates of high health status than men and women who have not served.
- Many minorities who have served report significantly higher rates of high health status than minorities who have not served.
- Self-reported health status varies between those who have and have not served by age. Those who have served who are 18-25 years (74.1% vs. 61.3%), 26-34 years (62.8% vs. 57.4%), and 35-49 years (58.7% vs. 51.6%) have significantly higher rates of self-reported high health status than those who have not served. This difference disappears at higher age levels. No difference, for instance, occurred in perception of high health status between those 50 years and older who have served and those who have not.
Mental Health
The 2018 Health of Those Who Have Served Report features six mental health measures, including percentage with any mental illness, anxiety, depression, frequent mental distress, suicidal thoughts, and suicide attempts. Rates of suicidal thoughts are significantly higher among those who have served than those who have not (5.1% vs. 4.1%). On other mental health measures, overall rates are similar for those who have and have not served. However, significant differences were found by gender, age, race/ethnicity, and other factors.
How Have Mental Health Rates Changed Since 2011-2012 for Those Who Have Served? Remaining Challenges: - Since 2011-2012, depression rates significantly increased by 9% among those who have served. - Since 2011-2012, anxiety rates doubled, and suicidal thoughts tripled, among women who have served.
First, both men and women who have served report significantly higher rates of anxiety, depression, and frequent mental distress than men and women who have not served. Second, women who have served continue to have significantly higher rates of most mental health concerns than both women who have not served and men who have served. Of note:
- About one in three (30.6%) women who have served have had a diagnosed mental illness in the past year, compared to 22.1% of women who have not served and 16.2% of men who have served.
- About one in four (24.4%) women who have served have depression, compared to 21.2% of women who have not served and 15.1% of men who have served.
- About one in six (15.2%) women who have served report frequent mental distress, compared to 13.5% of women who have not served and 10.7% of men who have served.
- Women who have served have almost twice the rate of suicidal thoughts (7.0%) as compared to women who have not served (4.3%) and men who have served (4.7%).
In addition, findings reveal that the mental health burden among those who have served varies by race/ethnicity:
- Whites who have served have significantly lower rates of anxiety (10.4% vs. 13.5%), any mental illness (18.8% vs. 21.2%), depression (16.5% vs. 20.0%), and frequent mental distress (10.7% vs. 12.2%) than whites who have not served.
- Minorities who have served—including blacks (16.0% vs. 13.9%), Hispanics (16.5% vs. 13.6%), and Asians (10.2% vs. 6.5%)—report significantly higher rates of depression than their counterparts who have not served.
Chronic Conditions
Eight self-reported measures of chronic disease are included in this report: arthritis, cancer, cardiovascular disease, COPD, diabetes, functional impairment, pain, and teeth extractions. Those who have served, overwhelmingly, report significantly higher rates of chronic disease than those who have not served. This is the case for seven of the eight measures, with the only exception being teeth extractions for which both those who have and have not served have similar rates. Several important differences in the burden of chronic disease exist among subpopulations.
First, both men and women who have served consistently report significantly higher rates of chronic disease, such as arthritis, cancer, COPD, functional impairment, and pain than men and women who have not served.
How Have Chronic Disease Rates Changed Since 2011-2012 for Those Who Have Served? Remaining Challenges: - Rates of chronic disease have generally held steady over time, with those who have served persistently facing a significantly higher burden than those who have not served.
Second, despite the higher burden of disease generally among those with service, women who have served have significantly higher rates than even men who have served and women who have not. For example:
- Women who have served have an arthritis rate of 30.4% as compared to 25.3% among women who have not served and 23.9% among men who have served.
- Whereas 7.8% of women who have served have COPD, 6.4% of women who have not served, and 6.0% of men who have served have the condition.
- Functional impairment is also significantly more common among women who have served (29.0%) than both women who have not served and men who have (21.6% and 25.3%, respectively).
- Women who have served are also significantly more likely to report pain (28.4%) than women who have not served and men who have (24.2% and 20.6%, respectively).
Third, chronic disease rates vary between those who have and have not served by age. Of note, two age cohorts who have served, in particular, experience higher rates of chronic disease than their counterparts who have not served—26-34 year olds and 50 years and older.
- For those 50 years and older, rates of cancer (24.1% vs. 20.5%), cardiovascular disease (21.7% vs. 15.0%), diabetes (21.1% vs. 18.1%), and functional impairment (36.1% vs. 32.2%) are significantly higher among those who have served than those who have not.
- Those 26-34 years old who have served have significantly higher rates of many chronic conditions than those who have not served, including: arthritis (11.6% vs. 6.7%), depression (19.5% vs. 16.9%), frequent mental distress (15.3% vs. 12.2%), functional impairment (20.4% vs. 12.1%), and pain (25.5% vs. 11.1%).
In addition, some minorities who have served have significantly higher rates of chronic disease than minorities who have not served. For example:
- Asians who have served report twice the rate of pain (18.1% vs. 8.3%) and functional impairment (19.7% vs. 10.5%) than Asians who have not served.
- American Indians/Alaska Natives who have served have significantly higher rates of arthritis (35.2% vs. 29.9%), cancer (12.6% vs. 9.0%), cardiovascular disease (17.6% vs. 11.3%), and pain (54.9% vs. 28.0%) than those who have not served.
- Hispanics who have served also have significantly higher rates of arthritis (21.8% vs. 18.2%), COPD (5.2% vs. 3.7%), cancer (6.7% vs. 4.5%), and cardiovascular disease (9.6% vs. 6.9%) than Hispanics who have not served.