Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function: Korean War Era Military Service Associated with Smaller Disparities

Anusha M. Vable, Mathew V. Kiang, Sanjay Basu, Kara E. Rudolph, Ichiro Kawachi, S. V. Subramanian, M. Maria Glymour

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Military service is associated with smoking initiation, but U.S. veterans are also eligible for special social, financial, and healthcare benefits, which are associated with smoking cessation. A key public health question is how these offsetting pathways affect health disparities; we assessed the net effects of military service on later life pulmonary function among Korean War era veterans by childhood socio-economic status (cSES). METHODS: Data came from U.S.-born male Korean War era veteran (service: 1950-1954) and non-veteran participants in the observational U.S. Health and Retirement Study who were alive in 2010 (average age = 78). Veterans (N = 203) and non-veterans (N = 195) were exactly matched using coarsened exact matching on birth year, race, coarsened height, birthplace, childhood health, and parental and childhood smoking. Results were evaluated by cSES (defined as maternal education <8 yr/unknown or ≥8 yr), in predicting lung function, as assessed by peak expiratory flow (PEF), measured in 2008 or 2010. FINDINGS: While there was little overall association between veterans and PEF [β = 12.8 L/min; 95% confidence interval (CI): (-12.1, 37.7); p = 0.314; average non-veteran PEF = 379 L/min], low-cSES veterans had higher PEF than similar non-veterans [β = 81.9 L/min; 95% CI: (25.2, 138.5); p = 0.005], resulting in smaller socio-economic disparities among veterans compared to non-veterans [difference in disparities: β = -85.0 L/min; 95% CI: (-147.9, -22.2); p = 0.008]. DISCUSSION: Korean War era military service appears to disproportionately benefit low-cSES veteran lung functioning, resulting in smaller socio-economic disparities among veterans compared with non-veterans.

Original languageEnglish (US)
Pages (from-to)e576-e582
JournalMilitary medicine
Volume183
Issue number9-10
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

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Korean War
Veterans
Economics
Lung
Confidence Intervals
Health
Smoking
Retirement
Smoking Cessation
Public Health

Keywords

  • health disparities
  • lung function
  • matching
  • pulmonary function
  • veterans

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function : Korean War Era Military Service Associated with Smaller Disparities. / Vable, Anusha M.; Kiang, Mathew V.; Basu, Sanjay; Rudolph, Kara E.; Kawachi, Ichiro; Subramanian, S. V.; Glymour, M. Maria.

In: Military medicine, Vol. 183, No. 9-10, 01.09.2018, p. e576-e582.

Research output: Contribution to journalArticle

Vable, Anusha M. ; Kiang, Mathew V. ; Basu, Sanjay ; Rudolph, Kara E. ; Kawachi, Ichiro ; Subramanian, S. V. ; Glymour, M. Maria. / Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function : Korean War Era Military Service Associated with Smaller Disparities. In: Military medicine. 2018 ; Vol. 183, No. 9-10. pp. e576-e582.
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abstract = "BACKGROUND: Military service is associated with smoking initiation, but U.S. veterans are also eligible for special social, financial, and healthcare benefits, which are associated with smoking cessation. A key public health question is how these offsetting pathways affect health disparities; we assessed the net effects of military service on later life pulmonary function among Korean War era veterans by childhood socio-economic status (cSES). METHODS: Data came from U.S.-born male Korean War era veteran (service: 1950-1954) and non-veteran participants in the observational U.S. Health and Retirement Study who were alive in 2010 (average age = 78). Veterans (N = 203) and non-veterans (N = 195) were exactly matched using coarsened exact matching on birth year, race, coarsened height, birthplace, childhood health, and parental and childhood smoking. Results were evaluated by cSES (defined as maternal education <8 yr/unknown or ≥8 yr), in predicting lung function, as assessed by peak expiratory flow (PEF), measured in 2008 or 2010. FINDINGS: While there was little overall association between veterans and PEF [β = 12.8 L/min; 95{\%} confidence interval (CI): (-12.1, 37.7); p = 0.314; average non-veteran PEF = 379 L/min], low-cSES veterans had higher PEF than similar non-veterans [β = 81.9 L/min; 95{\%} CI: (25.2, 138.5); p = 0.005], resulting in smaller socio-economic disparities among veterans compared to non-veterans [difference in disparities: β = -85.0 L/min; 95{\%} CI: (-147.9, -22.2); p = 0.008]. DISCUSSION: Korean War era military service appears to disproportionately benefit low-cSES veteran lung functioning, resulting in smaller socio-economic disparities among veterans compared with non-veterans.",
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AU - Kiang, Mathew V.

AU - Basu, Sanjay

AU - Rudolph, Kara E.

AU - Kawachi, Ichiro

AU - Subramanian, S. V.

AU - Glymour, M. Maria

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N2 - BACKGROUND: Military service is associated with smoking initiation, but U.S. veterans are also eligible for special social, financial, and healthcare benefits, which are associated with smoking cessation. A key public health question is how these offsetting pathways affect health disparities; we assessed the net effects of military service on later life pulmonary function among Korean War era veterans by childhood socio-economic status (cSES). METHODS: Data came from U.S.-born male Korean War era veteran (service: 1950-1954) and non-veteran participants in the observational U.S. Health and Retirement Study who were alive in 2010 (average age = 78). Veterans (N = 203) and non-veterans (N = 195) were exactly matched using coarsened exact matching on birth year, race, coarsened height, birthplace, childhood health, and parental and childhood smoking. Results were evaluated by cSES (defined as maternal education <8 yr/unknown or ≥8 yr), in predicting lung function, as assessed by peak expiratory flow (PEF), measured in 2008 or 2010. FINDINGS: While there was little overall association between veterans and PEF [β = 12.8 L/min; 95% confidence interval (CI): (-12.1, 37.7); p = 0.314; average non-veteran PEF = 379 L/min], low-cSES veterans had higher PEF than similar non-veterans [β = 81.9 L/min; 95% CI: (25.2, 138.5); p = 0.005], resulting in smaller socio-economic disparities among veterans compared to non-veterans [difference in disparities: β = -85.0 L/min; 95% CI: (-147.9, -22.2); p = 0.008]. DISCUSSION: Korean War era military service appears to disproportionately benefit low-cSES veteran lung functioning, resulting in smaller socio-economic disparities among veterans compared with non-veterans.

AB - BACKGROUND: Military service is associated with smoking initiation, but U.S. veterans are also eligible for special social, financial, and healthcare benefits, which are associated with smoking cessation. A key public health question is how these offsetting pathways affect health disparities; we assessed the net effects of military service on later life pulmonary function among Korean War era veterans by childhood socio-economic status (cSES). METHODS: Data came from U.S.-born male Korean War era veteran (service: 1950-1954) and non-veteran participants in the observational U.S. Health and Retirement Study who were alive in 2010 (average age = 78). Veterans (N = 203) and non-veterans (N = 195) were exactly matched using coarsened exact matching on birth year, race, coarsened height, birthplace, childhood health, and parental and childhood smoking. Results were evaluated by cSES (defined as maternal education <8 yr/unknown or ≥8 yr), in predicting lung function, as assessed by peak expiratory flow (PEF), measured in 2008 or 2010. FINDINGS: While there was little overall association between veterans and PEF [β = 12.8 L/min; 95% confidence interval (CI): (-12.1, 37.7); p = 0.314; average non-veteran PEF = 379 L/min], low-cSES veterans had higher PEF than similar non-veterans [β = 81.9 L/min; 95% CI: (25.2, 138.5); p = 0.005], resulting in smaller socio-economic disparities among veterans compared to non-veterans [difference in disparities: β = -85.0 L/min; 95% CI: (-147.9, -22.2); p = 0.008]. DISCUSSION: Korean War era military service appears to disproportionately benefit low-cSES veteran lung functioning, resulting in smaller socio-economic disparities among veterans compared with non-veterans.

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