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Associations among ACEs, Health Behavior, and Veteran Health by Service Era

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Objectives: Despite substantial research linking adverse childhood experiences (ACEs) and health, it is unclear how associations differ by veteran status and military service era (draft, volunteer era). The current study evaluated differences in ACEs and health by veteran status and era, increasing understanding important for service provision as the volunteer era veteran population increases. Methods: Behavioral Risk Factor Surveillance System 2012 data were used in univariate and weighted multivariable logistic regression models to assess associations among veteran status, service era, ACEs, and health. Results: Volunteer era veterans experienced the most ACEs (M = 2.42); draft era veterans experienced the fewest (M = 1.04). Individuals reporting 3 or more ACEs were 3.67 times (95% CI = 3.22-4.19) more likely to endorse depression, 1.32 times (95% CI = 1.17-1.48) more likely to report poorer general health, and 1.77 times (95% CI = 1.58-1.97) more likely to endorse poorer physical health, compared to those reporting none. Volunteer era veterans were 2.43 times more likely to report poorer physical health (95% CI = 1.49-3.97) than draft era veterans, adjusting for ACEs. Conclusions: ACEs were associated with poorer health independent of veteran status and service era. Volunteer era veterans experienced more ACEs; need for trauma-informed services supporting whole health may increase.
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Keywords: ADVERSE CHILDHOOD EXPERIENCES (ACEs); BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS); DRAFT ERA VETERANS; MENTAL HEALTH; MILITARY VETERANS; VOLUNTEER ERA VETERANS

Document Type: Research Article

Affiliations: 1: Tyler C. Hein, Evaluation Scientist, Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC), Office of Mental Health and Suicide Prevention (10NC5), Department of Veterans Affairs, Ann Arbor, MI;, Email: [email protected] 2: Benjamin Muz, Research Analyst, Westat, Rockville, MD 3: Halima Ahmadi-Montecalvo, Director of Research and Evaluation, Sigma Health Consulting LLC, McLean, VA 4: Tyler Smith, Professor of Epidemiology and Biostatistics, Department of Community Health, School of Health and Human Services, National University, San Diego, CA

Publication date: November 1, 2020

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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