Well-Being of US Military Veterans

This survey study analyzed data from a nationally representative sample of US veterans to examine ratings and correlates of well-being.


Introduction
The National Academies of Science, Engineering, and Medicine recently published a report 1 that suggests a transition from a reactive disease-oriented medical care system to one that prioritizes disease prevention, health, and well-being.The report evaluated and made recommendations for the US Department of Veterans Affairs' national implementation of a Whole Health initiative, which emphasizes a person-centered, values-based approach to health and well-being. 2 To help inform this initiative, this cross-sectional survey study analyzed data from a nationally representative sample of US veterans to examine ratings and correlates of well-being.

Methods
A total of 2435 veterans participated in the 2022 National Health and Resilience in Veterans Study (NHRVS; eMethods in Supplement 1).This study followed the AAPOR reporting guidelines, and participants provided electronic informed consent.The ethics committee of VA Connecticut Healthcare System approved the NHRVS.
Well-being was assessed using the 12-item Flourishing Measure, 3 which assesses 6 domains of well-being-happiness and life satisfaction, mental and physical health, meaning and purpose, character and virtue, close social relationships, and financial and material stability (Cronbach α = 0.91).Ratings range from 0 to 10 (higher scores indicate higher well-being) and are averaged to yield an overall measure of well-being (eTable in Supplement 1).
Analyses of variance were conducted between June 10 and 12, 2023, to compare well-being ratings by age, sex, and race and ethnicity.Pearson correlations (Bonferroni-corrected α = .05/33= .002)and multivariable linear regression (2-sided P < .05)were then conducted to identify significant correlates of well-being.Interaction terms were incorporated into this analysis to evaluate the potential role of protective psychosocial characteristics (eg, purpose in life) in moderating associations between negative correlates of well-being (eg, physical health conditions).
Among veterans with a greater number of physical health conditions, those with a higher purpose in life scored substantially higher (effect size difference, Cohen d > 1.80) than those with lower purpose in life.

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JAMA Network Open | Psychiatry
Well-Being of Veterans Younger, female, and Hispanic veterans had the lowest well-being scores, with the largest magnitude difference observed between veterans aged 65 years or older (mean age, 74.5 years) and veterans aged 21 to 54 years (mean age, 44.1 years) (effect size difference, Cohen d = 0.77) (Figure).

Table . Sample
Characteristics and Correlates of Well-Being Among US Veterans a Overall model: F 13,2,243 = 184.57;P < .001.The "other, non-Hispanic" race and ethnicity group included American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and multiracial veterans.