A total of 1,836 (18%) of those patients died during the follow-up period. The cumulative mortality risk for the 10 years following their initial treatment was 22% ---three times greater than expected. Leading causes overall were heart disease (20%), suicide (13%), and unintentional injury (12.7%).

Among the general population, suicide was only the ninth leading cause of death (1.8%) during that study period. However, among women veterans in the study, it was the leading cause (25%). And among male veterans in the study, it was the second leading (12.7%).

In general, military populations that have passed physician examinations are considered to be in better health than the general population, but, in this situation, “the ‘healthy soldier effect' is no reason to think that veterans should be more emotionally and mentally resilient than anyone else," said Donald Wiebe, PhD, one of the authors of the study. "The consequences of military service can include both physical and emotional health challenges that veterans continue to face long after their 'war' is no longer on the front page."

In their published study, Wiebe and his colleagues noted that the increased risk for suicide among veterans depends greatly on the population studied. A study of 500,000 middle-aged and elderly men found that veteran status did not, in and of itself, confer an increased risk of death from suicide. This contradicts another large prospective cohort study that found an increased risk of suicide among veterans.

One study of veterans who received treatment at VA facilities found a 66% greater risk for suicide than the general population, while two recent studies of Vietnam and Gulf War-era veterans found no greater risk. However, an examination of Vietnam veterans who were deployed in combat, those who were wounded, and those with PTSD, showed higher rates of suicide among all three of those subpopulations.

While OEF/OIF veterans display a “healthy soldier effect” for all-cause mortality, studies are showing that they have a suicide risk higher than that among previous veteran cohorts, and higher than that among the general population. Former OEF/OIF veterans and those with PTSD have a 33% greater risk for suicide.

The next step for Wiebe and his group is to analyze the data in a search for more specific risk factors for suicide and other premature causes of death.

Back to August Articles