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Among Vets, Higher Rank Predicts Better Health

Retired military officers consistently report better health than their lower-ranking counterparts.
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As anyone who has served in the military can tell you, there are many advantages to earning a higher rank. Better pay. More autonomy. Greater respect.

And then there’s that most important long-term benefit: better health.

Research recently published in the journal Armed Forces and Society finds “a persistent association between rank in the U.S. armed forces and self-rated health” among veterans.

“Officers are less likely than are enlisted men to report fair or poor health, even after controlling for a variety of socioeconomic characteristics,” according to the study, authored by sociologist Alair MacLean of Washington State University, Vancouver and economist Ryan Edwards of Queens College, City University of New York.

MacLean and Edwards examined data from four large surveys: The 2003 Survey of Retired Military, the 2001 National Survey of Veterans, the Panel Study of Income Dynamics, and the Wisconsin Longitudinal Study, which follows a large sample of high school graduates born in 1939.

“In each of the four data sets, enlisted veterans report worse health than do officers,” they report. “In both the Survey of Retired Military and National Survey of Veterans, about 35 percent of enlisted veterans report their health as fair or poor, compared to only about 20 percent of officers.”

This gap was smaller in the other two surveys, which include data on a wide range of people rather than exclusively veterans. MacLean and Edwards note that veterans in those surveys “were unlikely to have served for more than four years,” while those in the first two surveys often had long-term military careers. This suggests “the protective effect of officer status stems at least in part from length of service,” they write.

That said, the officer health advantage can also be found when comparing veterans and nonveterans. In the Panel Study of Income Dynamics, “enlisted veterans report worse health than do nonveterans,” the researchers write. On the other hand, officer veterans report better health than nonveterans — even though they were older on average. “In the Wisconsin Longitudinal Study, enlisted veterans report the same rates of poor and fair health as do nonveterans, and a majority of officer veterans report excellent health.”

Not surprisingly, retired officers tend to have higher levels of income and education than other retired vets, and such markers have long been associated with poorer health. And the data contains indications that officers tend to emerge from a somewhat different demographic than enlisted personnel. “Except in very rare cases,” officers report higher levels of education at the time of their enlistment.

That said, the results of the study “strongly suggest that rank is more than just a proxy for socioeconomic status,” the researchers write. “Health gradient by rank is independent of similar gradients by education and income.”

So why do retired officers report better health? The researchers present three possible causes (which could, of course, work in combination): stress levels, personal behavior and access to health care.

Officers “appear to have more control than enlisted men over their work environment, and may be at lower risk of psychosocial stress,” MacLean and Edwards note. Having no choice but to obey orders — even those you consider foolish or counterproductive — takes an emotional toll, which can gradually have physical consequences.

“Officers may obtain better access to medical care because of their position in the hierarchy,” they add. Or they may have better health “because they live healthier lifestyles, and are less likely to smoke or drink excessively.”

This ambiguity makes it problematic to suggest specific policy changes to address this health disparity. But the researchers note that programs could be put in place to reduce unnecessary stress among enlisted personnel, educate them regarding healthy lifestyle choices, and address any inequalities found in the veterans health care system.

One other interesting finding of the study: The military’s culture of racial equality appears to have health benefits for soldiers and sailors of color.

“Longer-serving veterans appear not to have experienced one well-known health disparity, namely, the negative effect of being African-American,” MacLean and Edwards write. “Among nondisabled veterans in the military samples, African-Americans were as healthy as whites.”