Activity limitation among veterans and non-veterans in Puerto Rico compared to veterans and non-veterans in the Continental U.S.

Abstract

Introduction: Veterans are shown to be a high-risk population for physical diseases, mental disorders and suicide. Different measures of quality of life have been developed to compare populations’ health. Three components are common to all HRQOL measures – health perception, socio-economic factors, and functionality. Methods: Mean limited activity days was used as a proxy measure of HRQoL. Tests of bivariate associations helped review patterns of associations. A negative binomial logistic regression model was used to determine the contribution of each independent variable. Significance was set at 0.05. Results: Puerto Rico residents were more likely to have non-veteran status than their Continental U.S. counterparts. Mean limited activity days were higher among residents of Puerto Rico compared to residents of the Continental U.S. and among veterans of the Vietnam War Era compared to non-veterans and veterans of other war eras. Compared to non-veterans, Gulf War Era veterans (GWVs) had 0.30 times the risk of developing mean limited activity days and Vietnam War Era veterans (VWVs) had 0.24 times the risk. An interaction measure was included in the regression model and found to have a significant effect. Discussion: We found no significant difference in risk of developing mean limited activity days between veterans and non-veterans residing in Puerto Rico compared to those residing in the Continental U.S. There is evidence that GWVs and VWVs were exposed to a multiplicity of chemical toxins in their war scenarios. GWVs residing in Puerto Rico were found to report 3 times the risk in developing mean limited activity days than GWVs residing in the Continental U.S. Conclusion: Our results highlight the importance of examining disparities in the health of the U.S. territories’ populations. They may suggest the need of implementing more aggressive health care to address the specific situation of veterans in the U.S. Territories.