Well-Being and Suicidal Ideation in U.S. Veterans: Age Cohort Effects During Military-to-Civilian Transition.

Abstract

Life transitions often bring stress and uncertainty and may lead to poor long-term health outcomes if not navigated successfully. Every year over 200,000 U.S. service members transition from military to civilian life. Given that transition may be particularly challenging for younger individuals this study examined younger military Veterans' well-being during transition and its impact on suicidal ideation as compared with middle-aged Veterans. Using data from the Veterans Metrics Initiative (TVMI) study (N=6,615), latent class analysis was used to identify age-stratified subgroups of Veterans (18-34 and 35-54 years) based on health, vocational, financial, and social well-being 1 year following military discharge. Negative binomials models were used to examine associations between subgroups and suicidal ideation at 4 data points. Data were collected in 2016-2019 and analyzed in 2024. Four subgroups were identified for younger and middle-aged Veterans. For younger Veterans, subgroups included high well-being (32.3%); low well-being (24.7%); poor health and social well-being (17.3%); and poor financial well-being with health risk (25.7%). Middle-aged Veterans subgroups included high well-being with health risk (37.4%); low well-being (20.6%); poor health and social well-being (21.8%), and poor financial well-being with health risk (20.2%). Subgroups with poorer well-being had an increased rate of suicidal ideation compared with those with the highest well-being, with the strongest association with the low well-being subgroups (younger IRRs=10.1-51.0; middle-aged IRRs=11.3-26.0), followed by poor health and social well-being subgroups (younger IRRs=3.9-22.3; middle-aged IRRs=4.9-10.2). Findings highlight the importance of considering age cohort effects in efforts to enhance well-being and reduce suicidal ideation among transitioning Veterans.