title: Gender differences in the impact of warfare exposure on self-rated health.
abstract: BACKGROUND
  This study examined gender differences in the impact of warfare exposure on self-reported physical health.
  
  
  METHODS
  Data are from the 2010 National Survey of Veterans, a nationally representative survey of veterans from multiple eras of service. Regression analyses assessed gender differences in the association between warfare exposure (deployment to a war zone, exposure to casualties) and health status and functional impairment, adjusting for sociodemographics.
  
  
  RESULTS
  Women reported better health status but greater functional impairment than men. Among men, those who experienced casualties only or both casualties and deployment to a war zone had worse health compared with those who experienced neither stressor or deployment to a war zone only. Among women, those who experienced casualties only or both stressors reported worse health than those who experienced war zone only, who did not differ from the unexposed. No association was found between warfare exposure and functional impairment in women; in men, however, those who experienced exposure to casualties or both stressors had greater odds of functional impairment compared with those who experienced war zone only or neither stressor.
  
  
  CONCLUSIONS
  Exposure to casualties may be more predictive of health than deployment to a war zone, especially for men. We did not find a stronger association between warfare exposure and health for women than men. Given that the expansion of women's military roles has allowed them to serve in direct combat, their degree and scope of warfare exposure is likely to increase in the future.
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts; Boston University School of Public Health, Boston, Massachusetts. Electronic address: joycemw@bu.edu.
authors.forename: Joyce M
authors.initials: JM
authors.lastname: Wang
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts; Boston University School of Public Health, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Lewina O
authors.initials: LO
authors.lastname: Lee
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts; Boston University School of Public Health, Boston, Massachusetts; Boston University School of Medicine, Boston, Massachusetts; Boston University School of Dental Medicine, Boston, Massachusetts.
authors.forename: Avron
authors.initials: A
authors.lastname: Spiro
mesh_terms: D000223:Adaptation, Psychological; D055826:Afghan Campaign 2001-; D003130:Combat Disorders / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D016273:Occupational Exposure / Q000706:statistics & numerical data; D012044:Regression Analysis; D017678:Sex Distribution; D012737:Sex Factors; D013315:Stress, Psychological; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data