Elsevier

Women's Health Issues

Volume 26, Issue 2, March–April 2016, Pages 225-231
Women's Health Issues

Gender-Based Violence
Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans

https://doi.org/10.1016/j.whi.2015.09.013Get rights and content

Abstract

Objectives

Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts.

Methods

Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined.

Results

The sample included 781 women veterans. Compared with the oldest age group (≥65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77–6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25–7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32–9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64.

Conclusions

Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care.

Section snippets

Study Population

Data were collected via a web-based survey about women veterans' health from February to May 2013. Details of recruitment procedures have been previously reported (Lehavot, Browne, & Simpson, 2014). Briefly, advertisements were disseminated to online listservs serving women veterans and via Facebook, a social networking website. Because the original main aim of the survey was to describe differences between sexual minority and heterosexual women veterans, sexual minority women were oversampled

Characteristics of the Sample

The study sample was largely Caucasian (84.1%), middle-aged (mean, 48.94 years; SD, 15.52), heterosexual (62.9%), and educated (college graduate or more, 52.6%; Table 1). Although the youngest cohorts (18–24 and 25–34 years) overwhelmingly completed their service in the current Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) era, other cohorts' service experience was spread across multiple service eras (Figure 1).

Prevalence of Sexual Assault, Sexual Harassment, and Physical Victimization

Sexual assault, sexual harassment, and

Discussion

Using data from a national online survey of women veterans, we found variation in the prevalence of sexual assault, sexual harassment, and physical victimization during military service by age cohort, even after accounting for race/ethnicity, education, amount of time spent in service, and sexual orientation. Although recent attention to this issue has largely focused on younger women, the likelihood of reporting these adverse experiences in this sample was highest among women in midlife, aged

Acknowledgments

This research was supported by funding from the VSN-20 Mental Illness, Research, Education, and Clinical Center (MIRECC) to Drs. Lehavot and Simpson. Dr. Lehavot was supported by a VA Career Development Award from CSR&D (1K2 CX000867).

The authors have no conflicts of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

Carolyn J. Gibson, PhD, MPH, is an Advanced Fellow in Women's Health at the San Francisco VA Medical Center. Her research focuses on women's mental health, the menopausal transition, and healthy aging.

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    Carolyn J. Gibson, PhD, MPH, is an Advanced Fellow in Women's Health at the San Francisco VA Medical Center. Her research focuses on women's mental health, the menopausal transition, and healthy aging.

    Kristen E. Gray, PhD, is a Post-doctoral Fellow in Health Services Research & Development at the VA Puget Sound Health Care System. Her research focuses on chronic disease and health disparities among women veterans.

    Jodie G. Katon, PhD, is a Health Science Research Specialist at VA Puget Sound Health Care System and Senior Epidemiology Consultant for VA Office of Women's Health Services. Her research focuses on reproductive health of women veterans.

    Tracy L. Simpson, PhD, is a Clinician Investigator, VA Puget Sound Health Care System, and Associate Professor, University of Washington Department of Psychiatry and Behavioral Sciences. Her work focuses on PTSD and substance use comorbidity and randomized clinical trials.

    Keren Lehavot, PhD, is Core Investigator at the Health Services Research & Development, Center of Innovation, VA Puget Sound, and Assistant Professor, University of Washington Department of Psychiatry and Behavioral Sciences. Her research focuses on women veterans' mental health and health disparities.

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