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 language | English (US) |
|---|---|
| Pages (from-to) | e576-e582 |
| Journal | Military medicine |
| Volume | 183 |
| Issue number | 9-10 |
| DOIs | |
| State | Published - Sep 1 2018 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Military Service, Childhood Socio-Economic Status, and Late-Life Lung Function
T2 - Korean War Era Military Service Associated with Smaller Disparities
AU - Vable, Anusha M.
AU - Kiang, Mathew V.
AU - Basu, Sanjay
AU - Rudolph, Kara E.
AU - Kawachi, Ichiro
AU - Subramanian, S. V.
AU - Glymour, M. Maria
PY - 2018/9/1
Y1 - 2018/9/1
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.
KW - health disparities
KW - lung function
KW - matching
KW - pulmonary function
KW - veterans
UR - http://www.scopus.com/inward/record.url?scp=85054462329&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054462329&partnerID=8YFLogxK
U2 - 10.1093/milmed/usx196
DO - 10.1093/milmed/usx196
M3 - Article
C2 - 29509934
AN - SCOPUS:85054462329
VL - 183
SP - e576-e582
JO - Military Medicine
JF - Military Medicine
SN - 0026-4075
IS - 9-10
ER -