Veteran Status Research Articles

“Almost Too Late”: The Merchant Navy Redress Campaign and the Struggle for Veteranhood

This article will assess the role of Canada’s Merchant Navy during the Second World War and appraise shifting government attitudes towards the civilian mariners in veterans’ legislation in the postwar period. By examining the factors that contributed to the civilian mariners’ initial exclusion as veterans, this study sheds light on the complex process whereby the state evaluates and then reassesses what is owed to those who serve. The redress campaign to achieve veteranhood from the early 1980s provides new insight into how these veterans marshalled resources and mobilized their own personal wartime histories as part of a broader movement in that decade of re-engaging with the Second World War. As part of their efforts, the mariners first had to engage with other veterans and win them over as allies. In their struggle with the state, the mariners asserted that the risk they faced, the casualties they suffered, and the wartime government’s management of the fleet, meant that Ottawa had greater responsibilities in regard to their postwar care and that they had earned veteran status. This is the first sustained study of the redress campaign that ran for almost twenty years, from the early 1980s to 2000. It demonstrates that the concept of “veteranhood” is fluid, and that once neglected wartime narratives can be reincorporated into the nation’s military legacy.

Social determinants of mortality from COVID-19: A simulation study using NHANES.

BackgroundThe COVID-19 epidemic in the United States is widespread, with more than 200,000 deaths reported as of September 23, 2020. While ecological studies show higher burdens of COVID-19 mortality in areas with higher rates of poverty, little is known about social determinants of COVID-19 mortality at the individual level.Methods and findingsWe estimated the proportions of COVID-19 deaths by age, sex, race/ethnicity, and comorbid conditions using their reported univariate proportions among COVID-19 deaths and correlations among these variables in the general population from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). We used these proportions to randomly sample individuals from NHANES. We analyzed the distributions of COVID-19 deaths by race/ethnicity, income, education level, and veteran status. We analyzed the association of these characteristics with mortality by logistic regression. Summary demographics of deaths include mean age 71.6 years, 45.9% female, and 45.1% non-Hispanic white. We found that disproportionate deaths occurred among individuals with nonwhite race/ethnicity (54.8% of deaths, 95% CI 49.0%–59.6%, p < 0.001), individuals with income below the median (67.5%, 95% CI 63.4%–71.5%, p < 0.001), individuals with less than a high school level of education (25.6%, 95% CI 23.4% –27.9%, p < 0.001), and veterans (19.5%, 95% CI 15.8%–23.4%, p < 0.001). Except for veteran status, these characteristics are significantly associated with COVID-19 mortality in multiple logistic regression. Limitations include the lack of institutionalized people in the sample (e.g., nursing home residents and incarcerated persons), the need to use comorbidity data collected from outside the US, and the assumption of the same correlations among variables for the noninstitutionalized population and COVID-19 decedents.ConclusionsSubstantial inequalities in COVID-19 mortality are likely, with disproportionate burdens falling on those who are of racial/ethnic minorities, are poor, have less education, and are veterans. Healthcare systems must ensure adequate access to these groups. Public health measures should specifically reach these groups, and data on social determinants should be systematically collected from people with COVID-19.

Dietary Intake and Elevated C-Reactive Protein Levels in US Military Veterans.

Elevated inflammatory markers, such as high sensitivity C-reactive protein (hs-CRP), have been associated with the pathogenesis of cardiovascular disease (CVD)-related diseases. However, limited studies have evaluated the potential association between dietary consumption and hs-CRP levels in a large, nationally representative sample, and fewer have investigated their role in ethnic and racial minority military populations. The goal of this study is to explore the relationship between dietary intake, health behaviors, and hs-CRP in individuals with prior military status and whether these associations differ by race/ethnicity. A complex, multistage, probability sample design was used from the National Health and Nutrition Examination (NHANES) 2015–2018 waves. Our results indicate that previously deployed military service members had a higher prevalence of clinically elevated hs-CRP levels than civilians. Differences in hs-CRP among deployed veterans and civilians remained even after multivariable adjustment. Individuals classified as overweight and obese demonstrated clinically elevated hs-CRP levels compared with those with a normal body mass index (BMI). Dietary factors did not attenuate the association between changes in hs-CRP levels and veteran status. These findings suggest the need for further investigation into how military-specific stressors contribute to unfavorable health outcomes for the military population.

Physical and psychological functioning in veterans with diabetes: Disease-related versus service-related effects.

Research on veterans with diabetes (VWD) suggested elevated rates of mental illness and substance use disorder but used samples studied 14-21 years ago without comparator groups. To inform translational research and care-delivery models for diabetes, the purpose of this study was to compare VWD, nonveterans with diabetes (NVWD), and veterans without diabetes (VWOD) on physical and psychological functioning. The study was a retrospective analysis of cross-sectional data from the National Survey on Drug Use and Health, a population-based household-interview survey, 2015 to 2018. Psychological disorders and high-risk substance use were identified with validated scales and standard diagnostic definitions. Regardless of veteran status, diabetes was associated with impaired health: self-rated poor health 9.3% VWD (n = 1,320), 9.0% NVWD (n = 10,246), 3.5% VWOD (n = 8,314); past-year hospitalization 20.4-23.9% for those with diabetes, 12.9% for VWOD (p < .001); obesity 49.0-54.8% for those with diabetes, 31.8% for VWOD. Mental illness was more prevalent in those with diabetes (17.0-21.8%) than in VWOD (14.8%); high-risk substance use was less prevalent (9.7-9.8% vs. 14.0%, p < .001). Post hoc analysis by active-duty service era identified high rates of psychological problems, including mental illness (29.7%), among VWD with recent service. Diabetes is associated with similar impairments in veterans and nonveterans. Among VWD, recent service may increase psychological risk. Findings support guideline-recommended patient-centered care for VWD and NVWD. Translational research should assess expansion of Veterans Health Administration (VHA) multidisciplinary disease- and self-management models to non-VHA settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Mental Health of Older Veterans Ages 58-99 Years: 2016-2017 VE-HEROeS Findings

Mental health and its correlates were examined in U.S. Vietnam War veterans approximately fifty years after the War. The 2016-2017 VE-HEROeS (Vietnam Era Health Retrospective Observational Study) was a mail survey of the health of U.S. Vietnam War veterans who served between February 28, 1961 and May 7, 1975 and matched US non-veteran controls. ‘Veteran status’ represented wartime experience for three cohorts: ‘theater’ veterans with service in Vietnam, Cambodia, or Laos, non-theater veterans with service elsewhere, and non-veterans with no military service. Veterans and non-veterans, aged 58-99 years, were randomly selected from a veteran sampling frame (n=9.87 million) derived from the Department of Veterans Affairs’ USVETS dataset and a commercial address database, respectively. Questionnaires were mailed to 42,393 veterans and 6,885 non-veterans; the response rate for veterans was 45% (n=18,866) and 67% (n=4,530) for non-veterans. Weighted bivariate and multivariable analyses were conducted to examine poor overall mental health, via the SF-8TM Mental Health Component Summary score (MCS), and other mental health measures by veteran status and socioeconomic, health, and other military characteristics. Nearly 50% of all theater veterans reported poor overall mental health (MCS<50). Prevalence of mental health measures was greatest for theater veterans and successively decreased for non-theater veterans and non-veterans. Key correlates significantly (P< 0.02) associated with poor MCS included veteran status, race/ethnicity, income, physical health, health perception, trauma, distress, depression, posttraumatic stress disorder (Primary Care DSM-5 PTSD screen), and drug use. Results indicate a high burden of poor mental health among those who served in-theater.

Risk Aversion Among Male Older Adults: Does Veteran Status Matter?

Risk aversion determines how people make decisions and is known to predict a wide array of economic outcomes. This study assessed whether there are veteran status differences in risk aversion utilizing the Health and Retirement Study. Risk aversion is based on hypothetical financial gambles (N=2,121; 2006 wave) and self-reported risk attitudes on selected topics (N= 4,980; pooled 2014 and 2016 waves of the Leave-Behind Survey). Results from multivariate analyses reveal that veterans were more likely to be risk averse than nonveterans in financial matters, occupation, and health, but veteran status is not statistically significant in explaining risk taking in driving and leisure, and sport risk. Further research is needed to discern the role of military service-related experiences in determining levels of risk aversion among veterans and the extent to which risk aversion accounts for veteran status differences in later-life economic outcomes. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.

Veteran Status Matters! Life Course Perspectives on the Health and Well-Being of Aging Veterans

Military service during early life can result in exposure to traumatic events that can reverberate throughout life. Although much attention is focused on the negative effects of military service, many veterans report positive effects. These papers explore life course effects of military service on veterans’ health and well-being. Three used national US longitudinal cohorts (HRS, MIDUS); two sampled veterans from Oregon or from Korea. Three compared veterans to non-veterans; two examined veterans only. Cheng and colleagues found that veterans in HRS are more likely to be risk-averse than non-veterans. Risk aversion matters because it determines how people make decisions and predicts a wide array of health and economic outcomes. Kurth and colleagues examined Oregon veterans from several wars, finding PTSD symptoms were highest among Vietnam combat veterans, the oldest cohort; there were no differences among non-combat veterans. Piazza and colleagues examined in MIDUS the impact of veteran status on cortisol, a stress biomarker, finding older veterans more likely had non-normative patterns than did younger or non-veterans. Lee and colleagues studied patterns of mental health among Korean Vietnam veterans, identifying two patterns as ‘normal’ and ‘resilient’ encompassing half the sample; these veterans demonstrated positive outcomes of military service. Frochen and colleagues compared depression trajectories between veterans and non-veterans in HRS, finding veterans had less depression than non-veterans, but among veterans, trajectories varied based on extent of service. in sum, these papers demonstrate that military service can have positive as well as negative effects on veterans’ health and well-being in later life. Aging Veterans: Effects of Military Service across the Life Course Interest Group Sponsored Symposium.

COVID-19 Infections Among Healthcare Personnel in the United States Veterans Health Administration, March to August, 2020.

We investigated COVID-19 infection and death among healthcare personnel (HCP) in the United States Veterans Health Administration. HCP with positive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction tests between March 1 and August 31, 2020 were included. Risk ratios were calculated for sex, age, race/ethnicity, Veteran status, occupation category, facility of employment by inpatient COVID-19 test percent positivity and death. Five thousand nine hundred twenty five HCP were COVID-19-infected out of 131,606 tested (4.5% positivity). Highest risk for COVID-19 infection included: HCP working in hospitals with more than 15% inpatient COVID-19 test positivity, nursing staff, non-Hispanic Black, and Hispanic or Latino HCP and HCP who were Veterans. Among 18 HCP who died after COVID-19 infection, male sex, age more than or equal to 65 years, and Veteran status were significant risk factors. Robust national surveillance testing methods are needed to accurately monitor HCP COVID-19 infections and deaths to improve HCP safety.

Identification/Non-Identification Among U.K. Veterans in Scotland

This article seeks to establish how, and why, older U.K. Armed Forces veterans resident in Scotland identify as veterans. We consider both the profile and the nature of the aged veteran population in Scotland and consider the nature of inclusion and exclusion by both the individual and community elements. Our consideration of the population and nature of the Scottish resident U.K. veteran is drawn from research amongst the older veteran population in Scotland, specifically those 65 years of age and older, as this includes periods of volunteer and required service from the U.K. population. The data is sourced from our 3-year study around the support needs of older veterans who are currently residing in Scotland. Our findings illustrate that individuals come from a variety of diverse geographical origins, and express different experiences in the U.K. Armed Forces; including nature of recruitment, branch of service, length of service, deployment theatres, and differing levels of engagement in active conflicts. Extant research identifies a divide between the official U.K. institutional definitions of a veteran, which is very broad and inclusive, and the interpretation of veteran status by those who have actually been members of the U.K. Armed Forces. The U.K. Government term is extremely inclusive and so much wider than many comparative definitions as it includes anyone who has performed military service for the length of one day and/or drawn one day’s pay as a service member. Therefore, from an institutional perspective there is no perceived barrier to identifying as a U.K. veteran even for those who were negatively dismissed from service or discharged prior to formal completion of service periods. Yet, our current research reinforces previous findings that non-identification among ex-U.K. service personnel as veterans is widespread for a variety of different reasons. It is clear that the Government’s definition of a veteran is much wider and more inclusive than the perceptions of the ex-service community itself, and this appears to be the case among the wider U.K. public as well, for reasons which are wide ranging and sometimes contradictory. We found that awareness amongst the older veteran community on who is a veteran and how the term is defined is still unclear. Older veterans, that is those who meet the Government’s definition, still regularly report uncertainty on whether or not someone who did compulsory National Service can be classed as a veteran or if it is determined by length of service, and such confusion seems widespread. In addition, the exact nature of the veteran population in Scotland is also far from precise. While other countries have a long history of recording service personnel, both during and beyond service, the U.K. has no such measurable data or established clear support mechanisms for veterans, and this may have been a strong, historically contributing factor. This article therefore seeks to establish the reasons for veteran self-identification, or non-identification, but also the nature of the veteran community in Scotland, and the wider reasons why some former service personnel feel unwilling, or unable, to include themselves within that community.

Generations of Veterans: Socioeconomic Attainment from World War II to the Contemporary Era

AbstractScholars have long examined how generations or, more technically, cohorts produce social change. According to theory, people’s lives are shaped by the years in which they were born because they experience, along with their peers, particular historical events at the same points in the life course. Despite the importance of history, however, many scholars have evaluated cohorts not defined by clear start and end dates, but rather by arbitrary cut points, such as five-year intervals. In contrast, this article uses defined changes in military service in the United States stemming from shifts between war and peace, and from draft to volunteer service to assess how cohorts have contributed to change in socioeconomic attainment. It uses the Current Population Survey from 1971 to 2017, which has not previously been used to evaluate how veteran status may have produced shifting outcomes across cohorts. It finds evidence that cohorts had different average income overall and between groups, with veterans earning more money than nonveterans who were eligible to serve during the draft era before the Vietnam War. These gaps are partially explained by racial and educational differences. The findings provide a model for analyses of changes in the relative status of other groups, as well as information about how the role of military service in social mobility changed historically.

The Design and Implementation of a Heart Disease Reversal Program in the Veterans Health Administration: Before and During the COVID-19 Pandemic.

Heart disease continues to be the leading cause of death in the US, and the number of people with cardiovascular disease (CVD) is rising. CVD is more prevalent among military veterans than nonveterans, and veteran status is associated with higher risk of incident heart disease after controlling for socioeconomic status, other medical diseases, depression, and lifestyle. Many patients seeking care in the Veterans Health Administration, including those who undergo cardiac catheterization, meet the criteria for multimorbidity (defined as ≥ 2 chronic diseases). The Heart Disease Reversal Program (HDRP) is a novel interdisciplinary, multicomponent lifestyle program at the US Department of Veterans Affairs (VA) Sacramento VA Medical Center. This program is a streamlined adaptation of behavioral/lifestyle interventions aimed at promoting partial reversal (regression) of atherosclerotic heart disease and achievement of comprehensive cardiovascular risk reduction. HDRP was developed and implemented within a VA behavioral medicine clinic and successfully adapted for delivery through videoconferencing during the COVID-19 pandemic. Patient satisfaction survey data indicate a very high level of patient acceptability. We found direct-to-patient clinical outreach an effective method for launching a disease reversal program. Beyond the clinical benefits to patients, there is significant value and benefit added to the health care system by offering an intervention within the disease reversal paradigm. Efforts of the health care team to reverse a disease can be considered the highest aim of medicine and health care.

QuickStats: Percentage* of Adults Aged ≥20 Years Who Had Chronic Pain,† by Veteran Status and Age Group - National Health Interview Survey, United States, 2019§.

QuickStats: Percentage* of Adults Aged ≥20 Years Who Had Chronic Pain,† by Veteran Status and Age Group - National Health Interview Survey, United States, 2019§.

The life course of homeless female Veterans: Qualitative study findings

Introduction: Homelessness among Veterans is a significant problem in the United States, and female Veterans, one of the fastest-growing groups in the homeless population, are four times more likely to become homeless than their male peers. The purpose of this article is to share findings of a qualitative study that examined the life course that created a pathway into homelessness for 14 female Veterans in the United States. Methods: Data were collected using a life history grid and semi-structured interview guide in two 90-minute face-to-face interviews with each participant. Qualitative content analysis of the interview transcripts was conducted to identify major themes across the lifespans of study participants. Results: Six major themes shared by the participants emerged: traumatic experiences across the lifespan, entering the military to escape circumstances, racism, gender-related discrimination and sexism, difficulty transitioning from military to Veteran status, and positive childhood experiences and proud moments during military service. Discussion: The findings suggest a range of policy, housing and service needs. The study demonstrates the unique experiences of female Veterans that require gender-specific responses. The female Veterans in this study experienced exposure to multiple traumatic events pre-military, during service, and post service. Female Veterans’ increased risk of becoming homeless indicates the need for practitioners to address mental health, substance use, re-integration stability, and other health care needs and use trauma-informed interventions to ensure high-quality care. Practitioners also need to be well-versed in military and Veteran culture to provide the linkages to care and support systems required by these Veterans.

Associations among ACEs, Health Behavior, and Veteran Health by Service Era.

Objectives: Despite substantial research linking adverse childhood experiences (ACEs) and health, it is unclear how associations differ by veteran status and military service era (draft, volunteer era). The current study evaluated differences in ACEs and health by veteran status and era, increasing understanding important for service provision as the volunteer era veteran population increases. Methods: Behavioral Risk Factor Surveillance System 2012 data were used in univariate and weighted multivariable logistic regression models to assess associations among veteran status, service era, ACEs, and health. Results: Volunteer era veterans experienced the most ACEs (M = 2.42); draft era veterans experienced the fewest (M = 1.04). Individuals reporting 3 or more ACEs were 3.67 times (95% CI = 3.22-4.19) more likely to endorse depression, 1.32 times (95% CI = 1.17-1.48) more likely to report poorer general health, and 1.77 times (95% CI = 1.58-1.97) more likely to endorse poorer physical health, compared to those reporting none. Volunteer era veterans were 2.43 times more likely to report poorer physical health (95% CI = 1.49-3.97) than draft era veterans, adjusting for ACEs. Conclusions: ACEs were associated with poorer health independent of veteran status and service era. Volunteer era veterans experienced more ACEs; need for trauma-informed services supporting whole health may increase.

The Effect of PTSD Symptom Change on Suicidal Ideation in a Combined Military and Civilian Sample Engaged in Cognitive Processing Therapy

In light of the well-established relationship between posttraumatic stress disorder (PTSD) and suicidal ideation (SI), there has been a push for treatments that simultaneously improve symptoms of PTSD and decrease SI. Using data from a randomized controlled hybrid implementation-effectiveness trial, the current study investigated the effectiveness of Cognitive Processing Therapy (CPT; Resick, Monson, & Chard, 2016) on PTSD and SI. The patient sample (N = 188) was diverse in military and veteran status, gender, and comorbidity, and 73% of the sample endorsed SI at one or more points during CPT. Participants demonstrated significant improvement in SI over the course of CPT. Multilevel growth curve modeling revealed a significant association between PTSD symptom change and change in SI. Results from cross-lagged multilevel regressions indicated that PTSD symptoms predicted SI in the next session, yet SI in a given session did not predict PTSD symptoms in the next session. Potentially relevant clinical factors (i.e., military status, gender, depression diagnosis, baseline SI, study consultation condition) were not associated with the relationship between PTSD symptoms and SI. These results add to the burgeoning literature suggesting that evidence-based treatments for PTSD, like CPT, reduce suicidality in a range of individuals with PTSD, and that this reduction is predicted by improvements in PTSD symptoms.

Sexual and Gender Minority Status and Firearms in the Household: Findings From the 2017 Behavioral Risk Factor Surveillance System Surveys, California and Texas.

Although lesbian, gay, bisexual, and transgender (LGBT) people have a higher prevalence of reporting a lifetime suicide attempt than non-LGBT people, suicide prevention research on access to lethal means (eg, firearms) among LGBT people is limited. Our study examined (1) the presence of firearms in the home and (2) among respondents with firearms in the home, the storage of firearms as stored unloaded, stored as loaded and locked, or stored as loaded and unlocked. We used data from the 2017 Behavioral Risk Factor Surveillance System surveys from California and Texas (N = 11 694), which were the only states to include items about both sexual orientation and gender identity and the status of firearms in the home. We used logistic regression analysis to assess the association of sexual orientation and gender identity with having firearms in the home while accounting for sociodemographic characteristics and survey state. All analyses were weighted to account for the complex sampling design. Approximately 4.2% of the sample identified as lesbian, gay, and bisexual (LGB). About 18.2% of LGB people reported firearms in the home compared with 29.9% of their heterosexual peers. After adjusting for sex, age, race/ethnicity, educational attainment, and military veteran status, LGB respondents had significantly lower odds of reporting firearms in the home than their heterosexual peers (adjusted odds ratio = 0.47; 95% CI, 0.27-0.84). Among respondents with firearms in the home, firearm storage did not differ by sexual orientation. Further research is needed to examine whether lower odds of firearms in the home are protective against suicide deaths among LGB populations.

Self-Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower-Limb Amputation.

Interventions targeting psychosocial factors may improve rehabilitation outcomes for prosthesis users after lower-limb amputation (LLA), but there is a need to identify targeted factors for minimizing disability. To identify psychosocial factors related to disability for prosthesis users after LLA in middle age or later. Cross-sectional study. General community. Participants with LLA (N = 122) were included in this cross-sectional study if their most recent LLA was at least 1 year prior, they were ambulating independently with a prosthesis, and they were between 45 and 88 years old. Not applicable. Disability, the primary outcome, was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS). Candidate psychosocial variables included self-efficacy, social support, and motivation, measured using the Self-Efficacy of Managing Chronic Disease questionnaire (SEMCD), Multidimensional Scale of Perceived Social Support questionnaire (MSPSS), and modified contemplation ladder (mCL), respectively. The hypothesis was that greater self-efficacy, social support, and motivation would be associated with lower disability when controlling for covariates. The covariate model, including etiology, age, sex, U.S. military veteran status, LLA characteristics, time since LLA, medical complexity, and perceived functional capacity, explained 66.1% of disability variability (WHODAS 2.0). Backward elimination of candidate psychosocial variables stopped after removal of motivation (P = .10), with self-efficacy (P < .001) and social support (P = .002) variables remaining in the final model. The final model fit was statistically improved (P < .001) and explained an additional 6.1% of disability variability when compared to the covariate model. Greater self-efficacy and social support are related to lower disability after LLA. Findings suggest there may be a role for interventions targeting increased physical function, self-efficacy, and social support for ambulatory prosthesis users after LLA in middle age or later, especially when complicated by multiple chronic conditions.

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Impact of Race/Ethnicity, Veteran Status, and Place of Birth on Attitudes Towards Welfare Recipients: An Experimental Approach.

The current study explored the differences in the public's attitudes and emotions towards welfare recipients based on their race/ethnicity, birthplace, and veteran status. Participants read a mock news story created for the current study about a woman labeled as a "welfare queen" who was receiving assistance, but persuaded the reader to be sympathetic to her case. The mock news story varied based on the race/ethnicity, veteran status, and birthplace of the welfare recipient. Participants assessed the welfare recipient on various evaluative measures. A 4 (race/ethnicity: White/Black/Hispanic/Asian) × 2 (veteran status: veteran/not veteran) × 2 (country of origin: born in the US/not born in the US) between-subjects ANOVA was performed on the attitude and personality evaluations of the welfare recipient. The general pattern of results showed that welfare recipients were evaluated more positively when they were veterans, born in the United States, or were White or Asian. Conversely, the public evaluated the welfare recipient more negatively or held more aversive emotions towards them when they were Hispanic, Black, not born in the United States, or not a veteran. This research adds to the psychological literature and nonprofit sector by testing the persistence of stereotypes on the perception of individual welfare recipients.

Prevalence of Self-Reported Depression Symptoms and Perceived Anxiety Among Community-Dwelling U.S. Adults Reporting Tinnitus

Purpose The aim of this study was to examine the relationship between tinnitus and self-reported mental health distress, namely, depression symptoms and perceived anxiety, in adults who participated in the National Health and Nutrition Examinations Survey between 2009 and 2012. A secondary aim was to determine if a history of serving in the military modified the associations between tinnitus and mental health distress. Method This was a cross-sectional study design of a national data set that included 5,550 U.S. community-dwelling adults ages 20 years and older, 12.7% of whom were military Veterans. Bivariable and multivariable logistic regression was used to estimate the association between tinnitus and mental health distress. All measures were based on self-report. Tinnitus and perceived anxiety were each assessed using a single question. Depression symptoms were assessed using the Patient Health Questionnaire, a validated questionnaire. Multivariable regression models were adjusted for key demographic and health factors, including self-reported hearing ability. Results Prevalence of tinnitus was 15%. Compared to adults without tinnitus, adults with tinnitus had a 1.8-fold increase in depression symptoms and a 1.5-fold increase in perceived anxiety after adjusting for potential confounders. Military Veteran status did not modify these observed associations. Conclusions Findings revealed an association between tinnitus and both depression symptoms and perceived anxiety, independent of potential confounders, among both Veterans and non-Veterans. These results suggest, on a population level, that individuals with tinnitus have a greater burden of perceived mental health distress and may benefit from interdisciplinary health care, self-help, and community-based interventions. Supplemental Material https://doi.org/10.23641/asha.12568475