Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of Major Depression. Assessing childhood poverty in service members may identify risk for depression in later life.
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Natalie Bareis / Briana Mezuk / Journal of Affective Disorders / NIH - Major Depression (MD) is the most common psychiatric disorder among middle-age and older adults, affecting between 15% and 20% of this population (Aldrich, 2016; Diefenbach and Goethe, 2006). MD is associated with premature mortality from lack of self-care, diminished functioning, and suicide (Fiske et al., 2009). There is a growing body of research that indicates mental health in middle age and later-life is influenced by exposures experienced much earlier in the life course, including in childhood. For example, adverse childhood experiences (ACEs), such as experiencing neglect and abuse, are associated with MD in adults across the lifespan (Culpin et al., 2015). Even less severe exposures such the experience of poverty early in life have been associated with depression in older adults (Johnson et al., 1999).
Childhood poverty is also associated with entrance into military service. Prior research indicates that individuals who experienced poverty and other ACEs in childhood are more likely to enroll in military service (at least in the all-volunteer era (Segal et al., 1998)), with Blosnich et al. (2014) hypothesizing “that the military may serve as a route for a subset of persons to escape dysfunctional home environments, at least among men.” (p. E4). It is also notable that the racial make-up of the military has changed substantially over time, becoming more racially-diverse in recent decades (2014 Demographics: Profile of the Military Community, 2014; Barnes et al., 2013). Thus, military service may provide a pathway out of poverty, ultimately altering individuals’ mental and physical health trajectories (Chatterjee et al., 2009).
However, military service also puts individuals at risk of exposure to combat and other types of trauma, exposures that have established negative relationships with MD and other forms of psychopathology in later life (Cabrera et al., 2007; Conner et al., 2014; Hoge et al., 2004). For example, studies of identical twins who both served in the military during the Vietnam War have shown combat exposure is associated with later risk of post-traumatic stress disorder many years after service ends (Goldberg et al., 1990; Koenen et al., 2002). In sum, the long term implications of childhood poverty and military service on MD is poorly understood. Extant studies have been limited in scope (i.e., use of non-representative samples; have not examined specific elements of military service history; have relied on non-specific measures of psychological distress) (Blosnich et al., 2014; Montgomery et al., 2013).
The goal of this study is to examine the relationships between childhood poverty and military service with MD in a nationally-representative sample of older men using data from the Health and Retirement Study. The objectives of this analysis are to: 1) Examine the relationship between childhood poverty and MD; 2) Examine the relationship between military service and MD; and 3) Assess whether the relationship between childhood poverty and MD is mediated or moderated by history of military service among men. We hypothesized that the relationship between childhood poverty and MD would be partially mediated by history of military service. If that is the case then the relationship between childhood poverty and MD will be reduced, but still significant after controlling for history of military service.