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Differences in functional and structural social support among female and male veterans and civilians

APA Citation:

Campbell, S. B., Gray, K. E., Hoerster, K. D., Fortney, J. C., & Simpson, T. L. (2021). Differences in functional and structural social support among female and male veterans and civilians. Social Psychiatry and Psychiatric Epidemiology, 56, 375-386. https://doi.org/10.1007/s00127-020-01862-4

Abstract Created by REACH:

This study examined the role of social support in the lives of civilians and veterans while accounting for sex differences. Two types of social support were evaluated: functional support, which can be understood as “the perception of receiving emotional or practical support when needed” (p. 2), and structural support, which can be understood as the number of people and/or social networks (i.e., social network diversity) with whom an individual is regularly connected. With a sample of 34,331 participants (31,406 civilians and 2,925 veterans), differences in functional and structural support for civilian and veteran men and women were examined while considering both nonmodifiable factors (i.e., age, sex, and race) and modifiable factors (i.e., physical and mental health, childhood environment). The results suggest that veterans have less functional and structural support compared to civilians, and women veterans reported having the lowest support.

Focus:

Veterans
Other

Branch of Service:

Multiple branches

Military Affiliation:

Veteran

Subject Affiliation:

Veteran
Civilian

Population:

Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)
Aged (65 yrs & older)
Very old (85 yrs & older)

Methodology:

Cross-Sectional Study
Quantitative Study
Secondary Analysis

Authors:

Campbell, Sarah B., Gray, Kristen E., Hoerster, Katherine D., Fortney, John C., Simpson, Tracy L.

Abstract:

Purpose: Social support is an important correlate of health behaviors and outcomes. Studies suggest that veterans have lower social support than civilians, but interpretation is hindered by methodological limitations. Furthermore, little is known about how sex influences veteran-civilian differences. Therefore, we examined veteran-civilian differences in several dimensions of social support and whether differences varied by sex. Methods: We performed a cross-sectional analysis of the 2012-2013 National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative sample of 34,331 respondents (male veterans = 2569; female veterans = 356). We examined veteran-civilian differences in functional and structural social support using linear regression and variation by sex with interactions. We adjusted for socio-demographics, childhood experiences, and physical and mental health. Results: Compared to civilians, veterans had lower social network diversity scores (difference [diff] = - 0.13, 95% confidence interval [CI] - 0.23, - 0.03). Among women but not men, veterans had smaller social network size (diff = - 2.27, 95% CI - 3.81, - 0.73) than civilians, attributable to differences in religious groups, volunteers, and coworkers. Among men, veterans had lower social network diversity scores than civilians (diff = - 0.13, 95% CI - 0.23, - 0.03); while among women, the difference was similar but did not reach statistical significance (diff = - 0.13, 95% CI - 0.23, 0.09). There was limited evidence of functional social support differences. Conclusion: After accounting for factors that influence military entry and social support, veterans reported significantly lower structural social support, which may be attributable to reintegration challenges and geographic mobility. Findings suggest that veterans could benefit from programs to enhance structural social support and improve health outcomes, with female veterans potentially in greatest need.

Publisher/Sponsoring Organization:

National Center for Biotechnology Information

Publication Type:

Article
REACH Publication

Author Affiliation:

Department of Veterans Affairs (VA) Puget Sound Health Care System, Research and Development Service, SBC
US Department of Veterans Affairs (VA) Puget Sound Health Care System, Research and Development Service, KEG
US Department of Veterans Affairs (VA) Puget Sound Health Care System, Research and Development Service, KDH
US Department of Veterans Affairs (VA) Puget Sound Health Care System, Research and Development Service, JCF
US Department of Veterans Affairs (VA) Puget Sound Health Care System, Mental Health Service, TLS

Keywords:

gender differences, social support, veterans

View Research Summary:

REACH Publication Type:

Research Summary

Sponsors:

TPH-61-000-23/Office of Academic Affiliations, Department of Veterans Affairs
CDA 16-154/U.S. Department of Veterans Affairs
CDA 12-263/U.S. Department of Veterans Affairs
RCS 17-153/U.S. Department of Veterans Affairs

REACH Newsletter:

  August 2020

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