Study on Vietnam-era women veterans will be largest ever
September 11, 2009
Christmas, 1968. Army nurse Joan
Furey, a curly-haired 22-year-old
brunette, was visiting her folks on Long
Island. She broke the news to them: She
had requested to go to Vietnam.
"They were very emotional, crying.
They were very, very proud, but also very
frightened," she recalls. Her dad, a
decorated World War II combat veteran,
hugged her and told her to take care of
herself.
A little over a year later, Furey would
come back home a changed person. What
she had seen and experienced as a nurse,
she says, "was beyond anything civilian
life could prepare you for."
Understanding the experience of
women like Furey and the long-term
health effects of their service in Vietnam is
the goal of a new VA study. As many as
10,000 women, most now in their 60s, are
expected to take part. The sample will
include women who served in Vietnam
and, for comparison, those who served
stateside or elsewhere in Asia, such as in
Japan, Korea, Guam or the Philippines.
"We're going to be looking at current
and lifetime prevalence of a range of
physical and mental health outcomes,"
says study co-chair Kathy Magruder, PhD,
MPH, an epidemiologist at the Charleston
(S.C.) VA Medical Center. She notes that
the study is the largest and most
comprehensive effort to date to look at this
population.
Among the key questions the researchers
hope to answer: How many of the women
developed posttraumatic stress disorder or
depression after their service, and how
many cope with these conditions till today?
Are these conditions more prevalent among
those who served in Vietnam, and to what
extent have they led to physical health
problems?
Magruder says it's difficult to predict
whether the prevalence of PTSD will be
similar to what was found when smaller
groups of Vietnam-deployed women were
studied in the 1980s. Then, it was about 8.5
percent.
"There are cases of remission, as well as
new onset and delayed onset. There could
be new traumas totally unrelated to military
service," notes Magruder. "Also, we're
using different instruments now—there's a
whole new diagnostic system. So we don't
know what we're going to find."
Chairing the study with Magruder are
Amy Kilbourne, PhD, MPH, a mentalhealth
researcher for VA in Ann Arbor; and
Han Kang, DrPh, who directs VA's
Environmental Epidemiology Service and
the War-Related Illness and Injury Study
Center in Washington, DC.
About 8,000 of the women VA expects to
enroll in the new study were part of earlier
research by Kang on birth outcomes. That
study, published in 2000, found higher rates
of birth defects in the children of women
who had served in Vietnam compared with
those who had served elsewhere. The causes
for the increased risk remain unknown, but
researchers believe they may include
exposure to herbicides such as Agent
Orange.
The new study will include mail surveys,
phone interviews and reviews of medical
records. Teasing out the complex links
between Vietnam deployment and various
health factors—especially over the course
of 40 years—will be a challenge for the
researchers.
Says Magruder, "There are two things
we can be really certain about—whether
they served in Vietnam or elsewhere, and
second, their current mental and physical
health." She points out that most of the
prospective respondents are nurses and have
experience reporting health conditions.
In terms of mental conditions, the
researchers will ask mainly about PTSD,
depression, anxiety and substance abuse. The
physical conditions they'll focus on include
cardiovascular disease, diabetes, multiple
sclerosis, Parkinson's disease, brain cancer,
breast cancer, and gynecological cancers.
Some of the conditions have been linked in
past research to exposure to trauma or
environmental toxins; others don't have a
particular military tie-in but are common
among aging women.
Along with probing the prevalence of various conditions, the
researchers will ask about demographics and life and military
factors such as years of nursing experience, pre-existing health
conditions, childhood traumas, wartime exposures or injuries,
homecoming, social support, and health behaviors, such as
cigarette smoking or alcohol use.
Magruder points out that even though four decades have passed
since the war, she and her team expect that study volunteers will
harbor vivid memories of their wartime experiences and how they
coped afterward. Many may still struggle with mental or physical
illness linked to their service. "For many of these women, the
effects of the war are still present in their daily lives," says
Magruder.
Most of the women expected to take part in the study have not
been regular users of VA health care. Nonetheless, VA—which has
ramped up programs for women in recent years—will use the
results to improve care and services for this Vietnam-era
population.
"These women, for the most part, are in their early 60s," notes
Magruder. "They may have a lot more years. It's important for us
to know what they're dealing with."
The findings may also shed light on what the newest generation
of women veterans—those returning from Iraq and Afghanistan—may face in the years ahead.
This article originally appeared in the September 2009 issue of VA Research Currents.