A retrospective cohort study of U.S. service members returning from Afghanistan and Iraq: Is physical health worsening over time?

Michael J. Falvo, Jorge M. Serrador, Lisa M. McAndrew, Helena K. Chandler, Shou En Lu, Karen S. Quigley

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: High rates of mental health disorders have been reported in veterans returning from deployment to Afghanistan (Operation Enduring Freedom: OEF) and Iraq (Operation Iraqi Freedom: OIF); however, less is known about physical health functioning and its temporal course post-deployment. Therefore, our goal is to study physical health functioning in OEF/OIF veterans after deployment. Methods. We analyzed self-reported physical health functioning as physical component summary (PCS) scores on the Veterans version of the Short Form 36 health survey in 679 OEF/OIF veterans clinically evaluated at a post-deployment health clinic. Veterans were stratified into four groups based on time post-deployment: (1Yr) 0 - 365 days; (2Yr) 366 - 730 days; (3Yr) 731 - 1095 days; and (4Yr+) > 1095 days. To assess the possibility that our effect was specific to a treatment-seeking sample, we also analyzed PCS scores from a separate military community sample of 768 OEF/OIF veterans evaluated pre-deployment and up to one-year post-deployment. Results: In veterans evaluated at our clinic, we observed significantly lower PCS scores as time post-deployment increased (p = 0.018) after adjusting for probable post-traumatic stress disorder (PTSD). We similarly observed in our community sample that PCS scores were lower both immediately after and one year after return from deployment (p < 0.001) relative to pre-deployment PCS. Further, PCS scores obtained 1-year post-deployment were significantly lower than scores obtained immediately post-deployment (p = 0.02). Conclusion: In our clinical sample, the longer the duration between return from deployment and their visit to our clinic, the worse the Veteran's physical health even after adjusting for PTSD. Additionally, a decline is also present in a military community sample of OEF/OIF veterans. These data suggest that, as time since deployment length increases, physical health may deteriorate for some veterans.

Original languageEnglish (US)
Article number1124
JournalBMC public health
Issue number1
StatePublished - 2012

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health


  • Health surveys
  • Military personnel
  • Operation enduring freedom
  • Operation iraqi freedom
  • Quality of life
  • Veterans
  • Veterans health


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