Health and Aging Post Conflict: War's Ending Effects Among Survivors in Vietnam

项目总结 这个项目的主要目标是理清战争暴露对健康的长期影响， 越南战争幸存者的社会关系和物质福利。次要目标是 评估老年人对关键早期生活事件的自我报告的有效性，特别是在 战时。在这项研究中，越南是独一无二的例证，因为它的战争动员水平处于历史高位， 幸存者进入了许多健康和生命历程的转变，这是老年人的典型特征。第二十 世纪武装冲突在越南这样的发展中国家最为普遍，在那里我们有 几乎不知道战争暴露对疾病和老年人负担的长期影响 身体、心理和社会健康，但人口进入老年和 直接经历过战争的人正在迅速增长。这些早期生活中的战争曝光与 与全球社会、经济和人口变化有关的许多急性和慢性应激源 南。这项研究将注意力集中在战争上，因为它可能有助于或损害健康的衰老。 为了实现这一目标，我们将创建一个纵向数据集，用于跨学科研究战争和 它对越南老龄化人口的健康和其他方面的福祉的影响。我们会 采用分层随机抽样策略，对居住在四个区的4900名60-80岁老年人进行了调查 位于越南北部，根据他们在战争中的暴露程度(轰炸强度)进行分层。跟进 与第一波幸存者和死者近亲的面谈将在三年后进行，允许 分析与战争暴露有关的健康、死亡率、复原力和生命历程转变。我们会 将关键的理论和概念重点放在战争暴露的多维测量上， 其中包括正式服兵役，民兵参与，以及双方经历的创伤事件 军人和平民生活中的男人和女人。我们将使用调查和生物标记技术来测量 身体、功能和心理领域的健康。提供服务的战时记录 成员允许采用创新的测量方法并测试自我报告的有效性 曝光。有目的的抽样和兄弟姐妹数据将阐明队列选择性暴露和生存。 项目团队将利用收集的数据来检查战争暴露、 压力环境、社会关系和老年人健康。我们将采用纵向分析 解决关于战争暴露的持久影响的问题的技术，包括关于 战争损害健康或促进复原力的机制，以及性别和 物质幸福，它调解和缓和了战争和健康之间的联系。结果将是 在公共卫生领域的学者、政策制定者和从业人员社区中广泛传播， 老年学和相关领域，为受战争影响的人口量身定做预防、护理和支助。

PROJECT SUMMARY The primary goal of this project is to disentangle the long-term effects of war exposure upon health, social relations, and material wellbeing in Vietnamese survivors of the Vietnam War. A secondary goal is to assess the efficacy of older adults' self-reports of critical early life events, notably experienced during wartime. Vietnam is uniquely illustrative for this study, given its historically high levels of war mobilization, and survivors' entrance into many health and life course transitions typical of older adulthood. Twentieth century armed conflict has been most pervasive in developing countries like Vietnam, where we have virtually no knowledge of the long-term effects of war exposure on the burden of disease and older adult physical, psychological and social wellbeing, but where the population both moving into old age and having directly experienced war is growing rapidly. These early-life war exposures are intertwined with many acute and chronic stressors linked to social, economic and demographic change in the global south. This study directs attention toward war as it may contribute to or detract from healthy aging. To meet this goal, we will create a longitudinal dataset for cross-disciplinary study of exposure to war and its impact on health and other aspects of wellbeing amongst the aging Vietnamese population. We will use a stratified random sampling strategy to survey 4,900 older adults aged 60-80 living in four districts of northern Vietnam, stratified by their widely variable exposure to war (bombing intensity). Follow-up interviews with Wave 1 survivors and decedents' next-of-kin will be conducted three years later, allowing analysis of health, mortality, resilience and life course transitions as they relate to war exposure. We will place critical theoretical and conceptual emphasis upon multi-dimensional measures of war exposure, which encompass formal military service, militia participation, and traumatic events experienced by both men and women in military and civilian life. We will use survey and biomarker techniques to measure health across physical, functional and psychological domains. War-era records issued to service members permit an innovative measurement approach and a test of the validity of self-reported exposure. Purposive sampling and sibling data will illuminate cohort selective exposure and survival. The project team will utilize the assembled data to examine dynamic linkages between war exposure, stress environments, social relations, and older adult health. We will employ longitudinal analytical techniques to address questions about war exposure's enduring effects, including questions about the mechanisms through which war scars health or fosters resilience, and the variables, such as gender and material wellbeing, which mediate and moderate associations between war and health. Results will be disseminated widely across communities of scholars, policy-makers, and practitioners in public health, gerontology and allied fields, to tailor prevention, care and support in war-affected populations.