Early-Life War Exposure and Later-Life Chronic Pain in Vietnam: Risk, Resilience, and Timing

Life course theories predict that early-life war experiences will impact later-life health through both risk and resilience processes, which may vary by age cohort. This study uses data on older adults from the 2018 Vietnam Health and Aging Study (N = 1,826) to explore associations between early-life war experiences and later-life moderate/severe chronic pain, highlighting the role of war-related risk or protective factors and testing for heterogeneity across child, adolescent, and young adult cohorts. Regression models reveal that Vietnam War exposures dramatically increase the risk of later-life pain and that war generates both risk and protective factors (e.g., greater social engagement). However, Karlson, Holm, and Breen mediation analyses show that the impact of war on pain is primarily driven by increases in physical and mental health problems. Wartime children were more vulnerable to the effects of wartime violence on later-life pain than older age cohorts, demonstrating the importance of age at exposure to traumatic experiences.