Xintong Wang , Carlos A. Flores , Alfonso Flores-Lagunes
{"title":"The effects of Vietnam-era military service on the long-term health of veterans: A bounds analysis","authors":"Xintong Wang , Carlos A. Flores , Alfonso Flores-Lagunes","doi":"10.1016/j.jhealeco.2025.102984","DOIUrl":null,"url":null,"abstract":"<div><div>We analyze the short- and long-term effects of the U.S. Vietnam-era military service on veterans’ health outcomes using a restricted version of the National Health Interview Survey 1974–2013 and employing the draft lotteries as an instrumental variable. We conduct inference on the health effects of military service for individuals who comply with the draft-lotteries assignment (the “compliers”), as well as for those who volunteer for enlistment (the “always takers”). The causal analysis for volunteers, who represent over 70% of veterans, is novel in this literature that typically focuses on the compliers. Since the effect for volunteers is not point-identified, we employ sharp nonparametric bounds that rely on a mild mean weak monotonicity assumption. We examine a large array of health outcomes and behaviors, including mortality, up to 38 years after the end of the Vietnam War. We do not find consistent statistical evidence of detrimental health effects on compliers, in line with prior literature. For volunteers, however, we document that their estimated bounds show statistically significant detrimental health effects that appear around 10 years after the end of the conflict. As a group, veterans experience similar statistically significant detrimental health effects from military service. These findings have implications for policies regarding compensation and health care of veterans after service.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102984"},"PeriodicalIF":3.4000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Health Economics","FirstCategoryId":"96","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167629625000189","RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
We analyze the short- and long-term effects of the U.S. Vietnam-era military service on veterans’ health outcomes using a restricted version of the National Health Interview Survey 1974–2013 and employing the draft lotteries as an instrumental variable. We conduct inference on the health effects of military service for individuals who comply with the draft-lotteries assignment (the “compliers”), as well as for those who volunteer for enlistment (the “always takers”). The causal analysis for volunteers, who represent over 70% of veterans, is novel in this literature that typically focuses on the compliers. Since the effect for volunteers is not point-identified, we employ sharp nonparametric bounds that rely on a mild mean weak monotonicity assumption. We examine a large array of health outcomes and behaviors, including mortality, up to 38 years after the end of the Vietnam War. We do not find consistent statistical evidence of detrimental health effects on compliers, in line with prior literature. For volunteers, however, we document that their estimated bounds show statistically significant detrimental health effects that appear around 10 years after the end of the conflict. As a group, veterans experience similar statistically significant detrimental health effects from military service. These findings have implications for policies regarding compensation and health care of veterans after service.
期刊介绍:
This journal seeks articles related to the economics of health and medical care. Its scope will include the following topics:
Production and supply of health services;
Demand and utilization of health services;
Financing of health services;
Determinants of health, including investments in health and risky health behaviors;
Economic consequences of ill-health;
Behavioral models of demanders, suppliers and other health care agencies;
Evaluation of policy interventions that yield economic insights;
Efficiency and distributional aspects of health policy;
and such other topics as the Editors may deem appropriate.