Executive BriefForewordIntroductionDesignKey FindingsOverviewMental HealthPhysical HealthHigh Health StatusAccess to Health Care and Preventive ServicesSubstance UseSeniorsConclusionsAppendixTable 1. MeasuresMethodology2022 Health of Those Who Have Served Advisory Committee
Spotlight on the Health of Seniors Who Have Served
There are over 8.9 million adults ages 65 and over who have served in the U.S. military.20 It is important to consider how to safeguard and improve the health of all older adults, and in particular those who have served. We considered 11 measures in the clinical care, health behaviors and health outcomes categories to identify where significant differences exist between senior adults (ages 65 years and older) who have served in the U.S. military and those who have not served. Measures included: able-bodied, arthritis, chronic obstructive pulmonary disease (COPD), dedicated health care provider, depression, excessive drinking, flu vaccination, frequent mental distress, physical inactivity, smokeless tobacco and smoking.
Overall, seniors who have served are less likely to be living free of disabilities and report higher rates of substance use and physical inactivity than their counterparts who have not served. On the positive side, they report slightly lower rates of having been diagnosed with a depressive disorder, although gender-based disparities exist and mental health issues are becoming increasingly prevalent in the senior population, irrespective of military service. Finally, rates of annual flu vaccination have increased in both groups since 2011-2012.
Similar to the findings for the general population, the likelihood of being able-bodied was lower in 2019 for older adults who have served (59.8%) than for those who have not served (66.4%). Notably, the likelihood of those ages 65 and older who have served being able-bodied has decreased since 2011, while it has increased for the civilian population since 2011.
Unlike the findings for the general population, those 65 and older who have served are 1.2 times more likely to be physically inactive than those who have not (15.4% vs. 12.7%). In addition, they engage in higher levels of substance use than non-serving seniors. Almost 1 in 10 (8.9%) seniors with military experience drinks excessively, compared with 6.8% of non-serving seniors. Seniors who have served also smoke cigarettes and use smokeless tobacco at higher rates than those with no military background (11.0% vs. 7.9% and 3.1% vs. 1.5%, respectively). And while smoking rates have stagnated in the senior civilian population since 2011-2012, they have increased 18% in seniors who served in the military from 9.3% to 11.0%. On the other hand, the likelihood of excessive drinking has increased in the civilian senior population since 2011-2012 while it has remained essentially unchanged for those with a military background.
On the positive side, rates of diagnosed depressive disorders are lower in those 65 and older who have served (12.2%) than in their non-serving counterparts (14.6%). However, the prevalence of depression has increased in both groups since 2011-2012, and at a higher rate in the serving population. The likelihood of experiencing poor mental health 14 or more days out of the past 30 is similar for both groups, but it has increased 24% in seniors who served in the military since 2011-2012 while it has remained stable for those who did not serve in the military. In addition, there are gender disparities in mental health. Specifically, the rates of frequent mental distress are 1.2 and 1.3 times higher for older males (7.5%) and females (11.8%) who have served compared with those who have not (6.4% and 9.0%, respectively). In addition, female seniors who served have 1.7 times higher rates of depression (19.5% vs. 11.7%) and 1.6 times greater likelihood of reporting frequent mental distress (11.8% vs. 7.5%) than their male counterparts.
Finally, the rate of annual flu vaccination is rising in both groups, increasing 8% among those 65 and older who have served and 10% in the non-serving senior population since 2011-2012. The likelihood of flu vaccination is slightly higher for seniors with military backgrounds (67.4%) than those without (65.5%). However, Hawaiian/Pacific Islander seniors who have served have 1.3 times higher rates of flu vaccination (71.0%) than their non-serving counterparts (53.2%).
20. U.S. Census Bureau. “Sex by Age by Veterans Status for the Civilian Population 18 Years and Over, 2016-2020.” Retrieved from https://data.census.gov/cedsci/table?q=Table%20B21001&tid=ACSDT5Y2020.B21001