The United States spends more than $100 billion annually on health care for more than 30 million active military and veterans. Using data compiled from longitudinal studies of World War II, Korean War, and Vietnam War veterans, the contributors to this groundbreaking book examine the effects of military service across the lifespan.

The prevalence of negative trauma and posttraumatic stress disorder (PTSD) among military veterans is well known. But other, more subtle, effects of military service — particularly on health and well-being in later life — are less understood among researchers as well as medical and mental health professionals who care for veterans.

Chapters in this book provide crucial insights into the impact of military service, including the surprising finding that service can be a protective factor in some contexts, throughout the aging process.

Topic areas include the effects of combat and stress on longevity and brain functioning; the use of memory, cognition, and ego development at various points in life; the relationship between experiences of discrimination and the later development of PTSD; marriage longevity; employment; and the ways notions of patriotism and nationalism among service personnel and their families may change over time.

Table of Contents



Introduction: Understanding the Long-Term Outcomes of Military Service
Avron Spiro III, Richard A. Settersten Jr., and Carolyn M. Aldwin

I. Psychosocial Dynamics

  1. Two Faces of Wartime Experience: Collective Memories and Veterans' Appraisals in Later Life
    Richard A. Settersten Jr., Claudia Recksiedler, Bethany Godlewski, and Glen H. Elder Jr.
  2. Midlife Ego Development of World War II Veterans: Contributions of Personality Traits and Combat Exposure in Young Adulthood
    Johanna C. Malone, Laura M. L. Distel, and Robert J. Waldinger
  3. Perceived Racial, Ethnic, and Gender Discrimination Among Male and Female Vietnam-Era Veterans and PTSD Symptoms Later in Life
    Daniel H. Kabat, Steven D. Stellman, and Jeanne Mager Stellman
  4. Using a Life Course Perspective to Examine the Prevalence of Marriage in Military Families
    Shelley MacDermid Wadsworth, Sarah Mustillo, Anthony J. Faber, and Abigail Tolhurst Christiansen
  5. Labor Force Participation Among Older Veterans
    Alair MacLean, Meredith A. Kleykamp, and John Robert Warren
  6. Nationalism and Patriotism Among World War II Veterans and Their Baby-Boom Children
    Merril Silverstein, Andrew S. London, and Janet M. Wilmoth

II. Health Dynamics

  1. Military Service Experiences and Older Men's Trajectories of Self-Rated Health
    Janet M. Wilmoth, Andrew S. London, and William J. Oliver
  2. Studying Longitudinal Links From Early Adult Adversity to Later-Life Well-Being: American Repatriated Prisoners of the Vietnam War
    Lewina O. Lee, Avron Spiro III, Anna L. Tyzik, Daniel W. King, and Lynda A. King
  3. The Impact of Military Service on Stress, Health, and Well-Being in Later Life
    Carolyn M. Aldwin, Crystal L. Park, Soyoung Choun, and Hyunyup Lee
  4. Exploring the Veteran Mortality Differential: The Influence of War Era and Smoking Behavior
    Scott D. Landes, Monika Ardelt, and Ann T. Landes
  5. Military Service and Changes in Memory Performance During Later Life
    Robert S. Stawski, Meghann L. Fenn, Chenkai Wu, and Gwenith G. Fisher
  6. Long-Term Influences of Combat Exposure and Posttraumatic Stress Symptoms on Brain Structure, Health, and Functioning: The Vietnam Era Twin Study of Aging
    Carol E. Franz, Michael J. Lyons, and William S. Kremen
  7. The Effects of Combat and Posttraumatic Stress Disorder on Longevity
    George E. Vaillant and Diane Highum Vaillant

III. Implications for Practice and Policy

  1. Mental Health Considerations and Service Utilization in Older Adult Nonveterans and Veterans
    Anica Pless Kaiser, Joan M. Cook, Joyce Wang, Eve Davison, and Paula P. Schnurr
  2. Aging Veterans and Long-Term Outcomes of Military Service: Implications for Practice and Policy
    Richard A. Settersten Jr., Carolyn M. Aldwin, and Avron Spiro III


About the Editors

Online Resources

Editor Bios

Avron (Ron) Spiro III is research professor of epidemiology and psychiatry at Boston University Schools of Public Health and Medicine. He is the director of psychosocial research at the VA Normative Aging Study at the VA Boston Healthcare System and is also affiliated with the Massachusetts Veterans Epidemiology Research and Information Center, the National Center for PTSD, and the Center for Healthcare Organization and Implementation Research.

He is a recipient of a Senior Research Career Scientist award from the Clinical Science R&D Service of the U.S. Department of Veterans Affairs (VA) and is a fellow of APA Division 5 (Quantitative and Qualitative Methods) and APA Division 20 (Adult Development and Aging) and of the Behavior and Social Sciences Section of the Gerontological Society of America.

Dr. Spiro has been funded by the National Institutes of Health (NIH) and the VA, and is the author or coauthor of more than 250 publications. He was coprincipal investigator (with Carolyn Aldwin) of an NIH grant to establish a research network on Lifespan Outcomes of Military Service and coinvestigator on several projects funded by NIH or the VA studying health, personality, cognition, and aging.

His current work involves examining the effects of health and disease on cognitive aging, modeling longitudinal changes in personality in relation to health, developing a lifespan approach to health and aging in veterans, and studying mental disorders and their impact on health and functioning.

Richard A. Settersten Jr. is endowed director of the Hallie Ford Center for Healthy Children and Families, and professor of social and behavioral health sciences at Oregon State University. A fellow of the Gerontological Society of America (GSA), he has held leadership roles in the GSA and the American Sociological Association (ASA).

His coedited book (with Jacqueline L. Angel), Handbook of Sociology of Aging, won the 2012 Outstanding Publication Award of the ASA's Section on Aging and the Life Course, and an earlier book, Lives in Time and Place, won the Kalish Award of the GSA. He coedited (with Vern L. Bengtson) the third edition of the Handbook of Theories of Aging and is coeditor (with Megan McClelland) of the journal Research in Human Development.

The MacArthur Foundation and NIH have supported his research. He has also participated in National Academy of Sciences / Institute of Medicine panel discussions on the health and well-being of young adults and on new directions in social demography, social epidemiology, and sociology of aging.

He collaborated with Ron Spiro and Carolyn Aldwin on a grant from the NIH to establish a research network on Lifespan Outcomes of Military Service.

Carolyn M. Aldwin is the Jo Anne Leonard endowed director for the Center for Healthy Aging Research and professor of human development and family sciences, Oregon State University. She received her doctorate in adult development and aging from the University of California, San Francisco.

She is a fellow of the Gerontological Society of America, as well as both APA Division 20 (Adult Development and Aging) and APA Division 38 (Health Psychology).

Dr. Aldwin received the 2011 Developmental Health Psychology Award from these divisions and is a former president of Division 20. She has authored or edited eight books and more than 125 other publications on stress, stress-related growth, coping, health, and the long-term effects of military service on health in later life.

Her work has been funded by the National Institute on Aging, the National Science Foundation, and the Templeton Foundation. She was coprincipal investigator (with Avron Spiro) on a grant from NIH to establish a research network on Lifespan Outcomes of Military Service.

Reviews & Awards

This exemplary volume summarizes decades of study on veterans' health, mental health, and well-being. With contributions by leaders in the field, it is sure to influence our understanding of the needs of veterans and thereby lead to significant advances in public policy. For scholars interested in longitudinal studies, this book will affect models and methods for the conduct of studies of long-term effects of military experiences and exposure to traumatic life events.
—Terence M. Keane, PhD
Associate Chief of Staff — Research & Development, VA Boston Healthcare System; Director, Behavioral Science Division, National Center for Posttraumatic Stress Disorder; Professor of Psychiatry and Psychology and Assistant Dean for Research, Boston University School of Medicine, Boston, MA