Chronic Condition Burden by Veteran Status Veterans Health Administration Enrollment, and Age Using Nationally Representative Survey Data

Background

Historically, US Veterans have reported higher chronic disease burden than non-Veterans. However, whether Veteran and Veterans Affairs (VA) coverage status continue to be associated with chronic disease burden or how these associations vary by age, especially among younger Veterans, is unknown.

Objective

To examine the number of chronic conditions among male Veterans with and without VA coverage, and male non-Veterans, overall and by age group.

Design and Participants

Using 2018 National Health Interview Survey data, our sample included 2301 male Veterans and 9243 male non-Veterans.

Main Measures

The primary outcome was a number of chronic conditions, measured as a count (range 0–15) and categorically (0, 1, 2, 3+). We created a 3-category main independent variable (Veteran with VA coverage, Veteran without VA coverage, non-Veteran). Generalized linear regression models were used to estimate relationships between Veteran and VA coverage status and count of chronic conditions, overall and by age group (18–44, 45–64, 65+), adjusting for sociodemographic characteristics.

Key Results

Veterans with VA coverage, Veterans without VA coverage, and non-Veterans had an age-standardized mean of 1.44, 1.16, and 1.09 chronic conditions, respectively. In adjusted analyses, Veterans with VA coverage had 0.36 (95% CI: 0.25–0.46) more conditions and Veterans without VA coverage had 0.12 (95% CI: 0.04–0.21) more conditions compared with non-Veterans. In age-stratified analyses, Veterans with VA coverage aged 18–44 had 0.22 (95% CI: 0.06–0.38) more conditions; 45–64, 0.71 (95% CI: 0.41–0.99) more conditions; and 65+, 0.38 (95% CI: 0.18–0.57) more conditions compared with similar-aged non-Veterans.

Conclusions

Veterans with VA coverage had the greatest number of chronic conditions, including when stratified by age group.