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Womens Health Issues. 2015 Nov-Dec;25(6):649-57. doi: 10.1016/j.whi.2015.08.006. Epub 2015 Oct 1.

Prospective Analysis of Health and Mortality Risk in Veteran and Non-Veteran Participants in the Women's Health Initiative.

Author information

VA Palo Alto Health Care System, Mental Illness Research, Education and Clinical Center, Palo Alto, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. Electronic address:
Division of Epidemiology, Family and Preventive Medicine, University of California, San Diego, La Jolla, California.
RAND Corporation, Santa Monica, California; Pardee RAND Graduate School, Santa Monica, California.
University of Washington School of Nursing, Seattle, Washington.
VA Greater Los Angeles Health Care System, Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, California; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
VA Puget Sound Health Care System, Seattle, Washington; School of Public Health, University of Washington, Seattle, Washington.
Department of Epidemiology & Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, New York.
VA Palo Alto Health Care System, Geriatrics Research, Education and Clinical Center, Palo Alto, California; Department of Medicine, Center for Primary Care & Outcomes Research, Stanford University School of Medicine, Stanford, California.
Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Obstetrics and Gynecology, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Department of Medicine, Stanford Center for Prevention Research, Stanford University School of Medicine, Stanford, California.



The health of postmenopausal women veterans is a neglected area of study. A stronger empirical evidence base is needed, and would inform the provision of health care for the nearly 1 million U.S. women veterans currently 50 years of age or older. To this end, the present work compares salient health outcomes and risk of all-cause mortality among veteran and non-veteran participants of the Women's Health Initiative (WHI).


This study features prospective analysis of long-term health outcomes and mortality risk (average follow-up, 8 years) among the 3,706 women veterans and 141,009 non-veterans who participated in the WHI Observational Study or Clinical Trials. Outcome measurements included confirmed incident cases of cardiovascular disease (CVD), cancer, diabetes, hip fractures, and all-cause mortality.


We identified 17,968 cases of CVD, 19,152 cases of cancer, 18,718 cases of diabetes, 2,817 cases of hip fracture, and 13,747 deaths. In Cox regression models adjusted for age, sociodemographic variables, and health risk factors, veteran status was associated with significantly increased risk of all-cause mortality (hazard ratio [HR], 1.13; 95% CI, 1.03-1.23), but not with risk of CVD (HR, 1.00; 95% CI, 0.90-1.11), cancer (HR, 1.04; 95% CI, 0.95-1.14), hip fracture (HR, 1.16; 95% CI, 0.94-1.43), or diabetes (HR, 1.00; 95% CI, 0.89-1.1).


Women veterans' postmenopausal health, particularly risk for all-cause mortality, warrants further consideration. In particular, efforts to identify and address modifiable risk factors associated with all-cause mortality are needed.

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