Vietnam Vets' Death Rates Higher Just After Discharge

But since then the rates have been similar to non-Vietnam veterans

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By
HealthDay Reporter

MONDAY, Sept. 27, 2004 (HealthDayNews) -- Vietnam veterans were likelier to die in the first five years after their discharge from service than were veterans from the same era who weren't sent to Indochina.

But then the Vietnam veterans' death rates leveled off over the next 25 years and were comparable to the other veterans, a new study finds.

"Thirty years after service, we are not seeing that service in Vietnam is related to excess mortality," said lead researcher Drue H. Barrett, acting associate director for science at the National Center for Environmental Health, part of the U.S. Centers for Disease Control and Prevention.

"Our study looks at the health legacy of the Vietnam war," Barrett added. "The leading causes of death among Vietnam veterans are similar to the leading causes of death in the U.S. population."

The increased number of deaths among Vietnam veterans during the first five years after discharge was due primarily to fatal motor vehicle accidents, as well as suicides, homicides and drug overdoses, the researchers report.

The study appears in the Sept. 27 issue of the Archives of Internal Medicine.

The research, the Vietnam Experience Study, followed 9,324 Army veterans from the time of their discharge until 2000.

During more than 30 years of follow-up, the researchers found a 7 percent higher death rate among Vietnam veterans compared with the other veterans. However, this was primarily due to the increase in deaths during the first five years after discharge.

"We found no excess mortality after that initial five years after discharge," Barrett said. "There were no differences in any of the disease-related categories of death. We are not finding any differences in disease-related issues of serving in Vietnam."

Dr. Joseph A. Boscarino, a senior scientist in the Division of Health and Science Policy at the New York Academy of Medicine, said he thought "the excess mortality in the first five years is associated with combat stress" -- or posttraumatic stress disorder.

Boscarino, who was not involved with the study, said if the researchers could separate those with PTSD from those without it, the mortality rate of those with PTSD would be higher -- even over 30 years.

Dr. Elisa Triffleman, a psychiatrist and PTSD expert at Yale University School of Medicine, agreed that PTSD could have been behind the higher death rates during the five years after discharge from active duty.

"Although the total contribution of drug-related deaths is small, it can be viewed as a marker for other on-going problems among the living, such as continuing drug use and other psychiatric disorders."

Boscarino said similar problems have been seen among Australians who served in Vietnam and also among Gulf War veterans and U.S. soldiers who served in Bosnia. He said he's also seeing similar psychological problems among soldiers returning from Iraq.

Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine, noted that the study looked only at mortality rates.

A comparable assessment of quality of life would be helpful in tallying the full and long-term consequences of combat service, he said.

"That information will unfortunately be relevant to yet another generation of young Americans, currently heeding the call to duty," Katz said.

More information

The National Institute of Mental Health has more about posttraumatic stress disorder.

SOURCES: Drue H. Barrett, Ph.D., acting associate director for science, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta; Joseph A. Boscarino, M.D., M.P.H., senior scientist, Division of Health and Science Policy, the New York Academy of Medicine, New York; Elisa Triffleman, M.D., research affiliate, Yale University School of Medicine, New Haven, Conn.; David L. Katz, M.D., M.P.H., associate clinical professor of public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Sept. 27, 2004, Archives of Internal Medicine

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