Office of Research & Development
According to federal law, the United States' military involvement in the Vietnam War began in February 1961 and lasted until May 1975. Approximately 2.7 million American men and women served in Vietnam. During the war, more than 58,000 servicemen and women lost their lives.
Vietnam Veterans represent the largest cohort of American Veterans in terms of service era.
While the majority of Vietnam Veterans successfully readjusted to postwar life,
a substantial minority of Vietnam-era Veterans have suffered from a variety of psychological problems, and have experienced a wide range of life-adjustment problems.
During the Vietnam War, the U.S. military used more than 19 million gallons of various herbicides for defoliation and crop destruction in the Republic of Vietnam. Veterans who served in Vietnam anytime during the period beginning Jan. 9, 1962, and ending May 7, 1975, are presumed to have been exposed to herbicides.
VA established an Agent Orange Registry to study the health effects associated with exposure to herbicides such as Agent Orange. Veterans who served in Vietnam, or in other areas throughout the world where herbicide was sprayed, who are interested in participating in an Agent Orange Registry health exam should speak to the environmental health coordinator at their local VA medical center.
VA's War Related Illness and Injury Study Center, (WRIISC), located at the VA medical centers in Palo Alto, Calif.; Washington, D.C.; and East Orange, N.J., develops and provides post-deployment health expertise to Vietnam Veterans and their health care providers through clinical programs, research, education, and risk communication. VA's Post Deployment Health Services directs the center.
Congress established VA's Vet Center program in 1979, after recognizing that a significant number of Vietnam-era Veterans were still experiencing readjustment problems. Today, the Vet Center program provides a broad range of counseling, outreach, and referral services to Vietnam Veterans, and Veterans of other periods of armed hostilities after the Vietnam era. A national directory of VA's 300 Vet Centers can be found here.
VA research has long committed itself to provide Vietnam Veterans with high-quality health care to meet their specific needs.
VA researchers have long recognized the importance of gathering reliable and generalizable information on Vietnam Veterans and those who served during the Vietnam era, in order to inform health care policies and practices. Investigators have carried out many studies of this kind, focusing on Vietnam Veterans' health and well-being. These studies include mental and physical health outcomes among both women and men.
In addition, assessments of Vietnam Veterans over time are providing new and unique information on the long-term trajectory of mental and behavioral health conditions following exposure to combat. These assessments not only provide information on the needs of that generation, but also offer insights that will help guide long-term prevention and treatment efforts for Veterans of more recent conflicts.
NVVRS study results—In 1983, Congress mandated that VA conduct a study on postwar psychological problems among Vietnam Veterans. VA contracted with an external entity, the Research Triangle Institute, to conduct the National Vietnam Veterans Readjustment Study (NVVRS).
The purpose of the study, completed in 1988, was to obtain accurate prevalence rates of postwar psychological problems in Vietnam-era Veterans. The study also provided an extensive report of disabilities related to Vietnam service, including posttraumatic stress disorder (PTSD).
Study researchers concluded that, across more than 100 indexes of life-adjustment, the majority of Vietnam Veterans appeared to have successfully readjusted to postwar life, and the majority at the time of the study were experiencing few symptoms of psychological disorders.
However, the NVVRS also revealed that a substantial minority of Vietnam-era Veterans were suffering from a variety of psychological problems such as PTSD, and were experiencing a wide range of life-adjustment problems, such as marital trouble and work difficulties. Over the course of their lifetimes through 1988, 30.9 percent of men in the study and 26.9 percent of the women had developed PTSD. An additional 22.5 percent of men, and 21.2 percent of women had developed what the researchers called "partial" PTSD. They also found that only a small number of these Veterans actually sought mental health care.
In a reanalysis of the data in 2003, researchers with VA's National Center for PTSD found that, contrary to the initial analysis of the NVVRS data, a large majority of Vietnam Veterans struggled with chronic PTSD symptoms, with four of five reporting recent symptoms when interviewed 20 to 25 years after their Vietnam service.
Suicidality study based on NVVRS data—A 2012 study led by researchers at the San Francisco VA Medical Center and the University of California, San Francisco, used NVVRS data to determine that the experience of killing in war was strongly associated with thoughts of suicide. The research team found Veterans with more experiences involving killing were twice as likely to have reported suicidal thoughts, compared with Veterans who had fewer or no experiences.
They also determined the link between killing and actually attempting suicide was not as significant as the link between killing and suicidal thoughts.
NVVLS study results—More recently, Congress directed that a follow-up to the NVVRS be conducted to improve understanding about the long-term effects of military service in Vietnam. VA is managing this follow-up study, called the National Vietnam Veterans Longitudinal Study (NVVLS). The NYU Langone Medical Center's department of psychiatry and Abt Associates are conducting the study.
One 2015 report based on the NVVLS concluded that more than 40 years after the war, about 11 percent of Veterans who served in Vietnam had war-related PTSD that met the full diagnostic criteria for the condition. About 3 percent had subthreshold war-zone PTSD. About 85 percent were considered "negative" for PTSD.
Another finding of the NVVLS, also published in 2015, is that among male Vietnam Veterans who served in the Vietnam War, those who had PTSD related to their combat service were nearly twice as likely to die in the 25 years between the NVVRS and NVVLS studies, compared with those who did not have PTSD. This held true even after the researchers accounted for demographic factors such as sex and ethnicity. In addition, PTSD was associated with increased mortality due to cancer and external causes of death.
VE-HEROeS study—The Vietnam Era Health Retrospective Observational Study (VE-HEROeS) is a large-scale nationwide study that will assess the health and well-being of Vietnam-era Veterans and compare their health to that of their U.S. counterparts who did not serve in the military. VA invited approximately 43,000 Vietnam-era Veterans and approximately 11,000 members of the general population to complete a survey with questions about their military service (if applicable), general health, aging experience, and lifestyle. A smaller group of participants were asked to participate in a medical-records review. VE-HEROeS will be the first study to comprehensively evaluate the physical health and well-being of Vietnam Veterans since the completion of the Vietnam Experience Study, conducted by the Centers for Disease Control in 1988. Researchers are currently analyzing data from this study.
Army Chemical Corps study—The Army Chemical Corps Vietnam-Era Veterans Health Study (2012-2013) is designed to learn if high blood pressure (hypertension) and some chronic respiratory diseases are related to herbicide exposure during the Vietnam War. Among U.S. Army Chemical Corps Veterans, VA researchers found an association between both hypertension risk and exposure to herbicides, and hypertension risk and military service in Vietnam.
During the Vietnam War, from 1962 to 1971, the U.S. military sprayed more than 19 million gallons of defoliants and herbicide over rural areas of South Vietnam, and in Laos and Cambodia, in an attempt to deprive the enemy of food and vegetation cover.
The operation was called Operation Ranch Hand. Veterans who served in Vietnam any time during the period beginning Jan. 9, 1962, and ending May 7, 1975, are presumed to have been exposed to herbicides.
Agent Orange Registry—VA established the Agent Orange Registry to track the special health concerns of Veterans who may have been exposed to Agent Orange during their military service. This program includes a comprehensive medical examination, including exposure and medical histories, laboratory tests, and a physical exam. A VA health professional discusses the results with the Veteran in a face-to-face consultation and a follow-up letter. The exam is cost-free to Veterans and does not require enrollment in VA health care or VA benefit programs.
Presumptive service connection—Veterans may be eligible for disability compensation if they have a disability related to Agent Orange exposure during service and were discharged under other than dishonorable conditions. VA has recognized certain cancers and other health problems as associated with exposure to herbicides during service.
Veterans with qualifying Vietnam service, and service in the Korean demilitarized zone, are presumed to have been exposed to Agent Orange. Other Veterans may be eligible if theycan document that they were exposed.
IOM reports—On Aug. 31, 2010, VA published the final version of a regulation to establish presumptions of service connection between exposure to herbicides in Vietnam and Parkinson's disease, ischemic heart disease, and B-cell leukemias. The decision was based on an analysis of findings from the Institute of Medicine's (IOM) 2008 report, "Veterans and Agent Orange." Since 1994, IOM has published scientific reviews on the long-term health effects of herbicides on Vietnam Veterans every two years.
IOM's most recent report, published in 2016, is the 10th and final in the series. Researchers found evidence that bladder cancer and hypothyroidism are more strongly linked to Agent Orange exposure than previously thought. But a review of the existing research did not support a previously held belief that spina bifida occurs in the offspring of exposed Veterans at higher rates.
The report also recommended that VA grant service-connected presumption to Veterans with "Parkinson's-like symptoms," not just those diagnosed with Parkinson's disease related to Agent Orange exposure. VA is currently reviewing these recommendations.
The Health and Medicine Division (HMD) (formally known as the Institute of Medicine) released Post-Vietnam Dioxin Exposure in Agent Orange-Contaminated C-123 Aircraft on Jan. 9, 2015. VA established qualification for benefits related to Agent Orange exposure for some Veterans due to this report. Other illnesses VA recognizes as presumptively service-connected for exposure to herbicide during the Vietnam War can be found here.
Air Force Health Study—In 1979, Congress directed that a study be conducted of the military personnel likely to have been the most highly exposed to Agent Orange herbicide in Vietnam: those who conducted missions as part of Operation Ranch Hand.
In the study, formally called the Air Force Health Study (AFHS), Veterans who participated in the operation gave biospecimens such as serum, urine, adipose tissue, and semen, as did a comparison group of Air Force personnel who served in Southeast Asia at the time but were not involved in herbicide spraying operations.
The initial physical examination and surveying of AFHS subjects was conducted in 1982, and subsequent cycles were conducted in 1985, 1987, 1992, 1997, and 2002. The Air Force's final report on these surveys was issued in 2005. After the study concluded, Congress directed that the research assets that were collected be transferred to IOM.
A later public law instructed VA to work with IOM to make the AFHS assets available to scientific investigators for peer-reviewed pilot studies and other research. The data are available from IOM, and can be used for research studies not only on Agent Orange, but also on the long-term health of Veterans, other effects of Vietnam service, the health impacts of aging, and disease-related biomarkers.
Skin cancer and Agent Orange—In 2014, investigators at the Washington, D.C., VA Medical Center and the University of Texas M.D. Anderson Cancer center published a study analyzing the medical records of 100 men who joined the Agent Orange registry at the D.C. medical center between August 2009 and January 2010.
They found that the rate of non-melanoma invasive skin cancer among these Veterans was 52 percent, which is about twice as high as among men of the same age in the general population. The risk of skin cancer was highest (73 percent) among Veterans involved in spraying Agent Orange. The risk was also higher among men with the lightest skin types and lighter eyes. Only men with lighter skin types were involved in the study.
However, the researchers found no increased risk of malignant melanoma, the most dangerous type of skin cancer.
Prostate cancer and Agent Orange—A 2013 study by researchers at the Portland VA Health Care System found that Veterans exposed to Agent Orange are not only at higher risk for prostate cancer, but are more likely to have aggressive forms of the disease. The study was based on the records of 2,720 VA patients who had undergone an initial prostate biopsy.
Prostate cancer was diagnosed in a third of the Veterans. The chance of finding cancer was 52 percent higher in those whose records indicated Agent Orange exposure. One in six of all the men biopsied had high-grade, or fast-growing, disease. Exposure to Agent Orange did not raise the risk of low-grade prostate cancer, but it raised the risk of high-grade disease by 75 percent.
In addition, men who had been exposed to Agent Orange tended to be about five years younger at the time of biopsy than non-exposed Veterans. This is another sign of fast-growing cancer.
National twin registry—The Vietnam Era Twin (VET) Registry is an Office of Research and Development resource (CSP #256) that is managed by the Seattle Epidemiologic Research and Information Center (ERIC). The VET Registry consists of approximately 7,000 identical and fraternal male twin pairs, both of whom served in the military during Vietnam.
It is one of the largest national twin registries in the United States, and has members living in all 50 states. Although it was initially formed to address questions about the long-term health effects of service in Vietnam, it has evolved into a resource for genetic studies of mental and physical health conditions.
In addition to twins, selected adult children of twins and the mothers of those children are also VET Registry members. The non-twin groups were added to the registry in the late 1990s, as part of a set of family studies.
Dorsal anterior cingulate and PTSD—In 2011, Seattle ERIC researchers used brain imaging to study the brains of 12 Veterans who were members of the VET registry, served in Vietnam, and developed PTSD. They compared the results to the Veterans' identical twins who did not serve in Vietnam and did not have the illness.
The team also scanned the brains of 14 Veterans who served in Vietnam who did not develop PTSD, and their 14 twin brothers who did not serve in country and also did not develop the illness.
The team found that an area of the brain called the dorsal anterior cingulate is activated more greatly in response to stimuli in the Veterans who developed PTSD and their twins, as opposed to the Veterans and their twins who did not develop PTSD. The dorsal anterior cingulate is a brain region thought to be involved in decision-making, performance monitoring, and other cognitive processes.
Several studies have since corroborated the finding, and this brain area remains a viable potential biomarker of PTSD risk, pending further research.
Health status of Vietnam Veterans with PTSD—A 2014 article using data from the VET registry by Seattle ERIC researchers found that Vietnam Veterans with PTSD have diminished health functioning and increased disability today, compared with those who did not develop PTSD. The same was true for Veterans who saw combat, compared with those who did not.
Other studies involving PTSD and Vietnam Veterans include one by researchers at the Ralph H. Johnson VA Medical Center in Charleston, S.C. The researchers compared treatment outcomes for prolonged exposure therapy (one of the two main evidence-based psychotherapies used by VA clinicians for the disorder) among 112 Veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq.
They found, in 2012, that Veterans from all three groups showed significant improvement in their PTSD symptoms, although Persian Gulf Veterans did not respond to treatment at the same rate or to the same degree as Vietnam Veterans or Afghanistan and Iraq Veterans.
Ways older Veterans confront wartime memories—A 2015 study led by researchers with VA's National Center for PTSD looked at aging Veterans who grapple with their war traumas only later in life. They found that, as they age, many combat Veterans confront and rework their wartime memories in an effort to find meaning and build coherence.
Through reminiscence, life review, and wrestling with issues such as integrity versus despair, they intentionally re-engage with experiences they avoided or managed successfully earlier in their lives. The reflection can lead either to more pain, or to new growth.
According to the research team, while some Veterans can navigate this process alone or with their friends, others may benefit from support groups, which can promote posttraumatic growth and greater inner peace, even if a half-century has passed since their combat experience.
HealthVIEWS study—The HealthVIEWS: Health of Vietnam Era Women's Study, conducted by VA's Cooperative Study Program (CSP #579), was a study of approximately 10,000 women who served in the U.S. military during the Vietnam War. It included those who served in Vietnam, those who served in countries near Vietnam, and those who served primarily in the United States. It is the most comprehensive study to date of the mental and physical health of women Vietnam-era Veterans.
The five-year study looked at the lifetime and current incidence of conditions in women Vietnam-era Veterans, including PTSD, depression, diabetes, heart disease, and disability.
The first paper published as a result of this study, in 2014, found that women Vietnam-era Veterans had a lower risk of death from all causes combined and from diabetes, heart disease, chronic obstructive pulmonary disease, and diseases of the nervous system, compared with other American women of their age.
Women Veterans who served in the United States and in Vietnam did have a higher rate of dying in motor vehicle accidents compared to other American women, just as male Veterans do compared with other men. In addition, nurses who served in Vietnam had twice the risk of death from pancreatic cancer, and nearly five times the risk of brain cancer, compared with nurses who served only in the United States. (In their paper, the researchers discuss why the excess cancer deaths are likely not a result of Agent Orange exposure.)
Women Vietnam Veterans and PTSD—Another paper using data from the HealthVIEWS study, published in 2015, found that 20.1 percent of women Veterans who served in Vietnam have developed PTSD either during or after their service. By contrast, 11.5 percent of those who served near Vietnam, and 14.1 percent of those who served in the United States, have developed PTSD at some time during their lives.
According to the research team, the prevalence of PTSD for women who served in Vietnam was higher than previously documented, and Vietnam service significantly increased the chances of developing PTSD relative to service in the United States. The results suggest that the mental health effects of Vietnam-era service among women Veterans can be long-lasting.
VA has long been a leader in helping Veterans with amputations regain mobility and achieve a maximum amount of independence. VA provides a full range of equipment and services to Vietnam Veterans and all eligible Veterans. These include artificial limbs, durable medical equipment, hearing aids, eyeglasses, ramp and vehicle modifications, and implantable devices such as replacement hips or biological tissues.
Research is an important element of VA's amputation care program. A number of research projects are designed to evaluate new prosthetic devices, and to improve clinical care. VA also works with DoD to support joint research initiatives to determine the value of new technological devices, and how they should be used.
Prosthetic innovations after Vietnam—In the aftermath of the Vietnam War, renewed emphasis was placed on VA's efforts to develop prosthetic devices to meet the needs of Veterans with limb loss. Among the products that emerged during these years were the laser cane, which emits three-pitched tones that correspond with obstacles at head, waist and curb levels; the Seattle Foot, a revolutionary prosthetic foot; and digital hearing aids.
Satisfaction with prosthetics—In a 2010 survey, VA investigators from the Puget Sound Health Care System in Seattle looked at VA's care for Vietnam Veterans and Veterans of the wars in Iraq and Afghanistan who had sustained major traumatic limb loss. Participants reported on their combat injuries; health status; quality of life; and the use and functioning of their prosthetic devices.
Despite the serious injuries they experienced, the health status of 70.7 percent of Vietnam Veterans surveyed, and 85.8 percent of Iraq and Afghanistan Veterans, was rated excellent, very good, or good. However, many health issues persist for Veterans of both eras, including pain, skin problems, TBI, and PTSD.
Anxiety is a normal biological reaction to a stressful event. In some cases, however, anxiety continues for a long period and may worsen over time, with symptoms such as nightmares, racing pulse, and overreactions. In persistent cases, anxiety disorders such as PTSD, panic disorders and phobias may develop.
Depression and anxiety in older Veterans—In 2014, a team from the VA Palo Alto Health Care System and Stanford University School of Medicine examined data on 7,000 men age 50 or older, and found that on the whole, Veterans were no more likely than non-Veterans to have depression or anxiety. However, Vietnam Veterans were twice as likely than Veterans of other eras to have elevated depression and anxiety.
Because Veterans, especially those who served in combat, have generally experienced more stress and trauma in their lives than non-Veterans, the team had expected to see higher rates of depression among Veterans. Instead, they found just the opposite. Older Veterans actually scored better than non-Veterans in the same age group.
The team found 11 percent of Veterans reported elevated rates of depression, compared with 12.8 percent of non-Veterans. For anxiety, 9.9 percent of Veterans reported elevated levels, versus 12.3 percent for non-Veterans. These differences were not considered statistically significant.
Since 1987, VA's Northeast Program Evaluation Center (NEPEC), based in West Haven, Conn., has investigated a range of health issues and VA programs with a heavy focus on mental health, including PTSD and substance abuse. These issues often intertwine with homelessness.
Homelessness and Vietnam combat—In 1991, NEPEC researchers found the proportion of homeless Veterans who had served in Vietnam and been exposed to combat was the same as among non-homeless Veterans. Based on this, the researchers concluded that there does not appear to be a causal relation between homelessness and military service, at least with respect to Vietnam service and exposure to combat.
DoD-ADNI study-In 2014, the National Alzheimer's Disease Neuroimaging Initiative (ADNI), headed by a San Francisco-based VA investigator, began a study to determine whether TBI and PTSD increase Alzheimer's disease risk as Veterans age. The information collected in the study will help researchers learn more about how these issues may affect Vietnam Veterans as they grow older, as well as newer generations of Veterans.
Nationwide, approximately 1,000 Vietnam Veterans are participating in screening interviews and 500 are being interviewed by telephone. Approximately 300 Vietnam Veterans will complete the entire study, which is being funded by the Department of Defense and is referred to as DoD-ADNI.
Prolonged exposure therapy for combat-related posttraumatic stress disorder: comparing outcomes for veterans of different wars. Yoder M, Tuerk PW, Price M, Grubaugh AL, Strachan M, Myrick H, Aciemo R. This study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in prolonged exposure treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with Veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Psychol Serv. 2012 Feb;9(1):16-25.
Killing in combat may be independently associated with suicidal ideation. Maguen S, Metzler TJ, Bosch J, Marmar CR, Knight SJ, Neylan TC. Vietnam Veterans who reported more killing experiences had twice the odds of suicidal ideation, compared to those with fewer or no killing experiences, even after adjustments for demographic variables, PTSD, depression, substance use disorders, and combat exposure. Depress Anxiety. 2012 Nov;29(11):918-23.
Diagnostic performance of the PTSD checklist and the Vietnam Era Twin Registry PTSD scale. Magruder K, Yeager D, Goldberg J, Forsberg C, Litz B, Vaccarino V, Friedman M, Gleason T, Huang G, Smith N. A formal evaluation of the performance of the scales used to evaluate PTSD in VA's PTSD checklist and the Vietnam Era Twin Registry PTSD scale, compared to the composite International Diagnostic Interview. Both scales performed similarly. Epidemiol Psychiatr Sci. 2014 Jun 6:1-8.
HealthVIEWS: mortality study of female US Vietnam era Veterans, 1965-2010. Kang HK, Cypel Y, Kilbourne AM, Magruder KM, Serpi T, Collins JF, Frayne SM, Furey J, Huang GD, Kimerling R, Reinhard MJ, Schumacher K, Spiro A 3rd. Women Vietnam- era Veterans had lower mortality risk from all causes combined and from several major causes, such as diabetes mellitus, heart disease, chronic obstructive pulmonary disease, and nervous system disease relative to comparable US women. Am J Epidemiol. 2014 Mar 15;179(6):721-30.
Effects of traumatic brain injury and posttraumatic stress disorder on Alzheimer's disease in Veterans, using the Alzheimer's Disease Neuroimaging Initiative. Weiner MW, Veitch DP, Hayes J, Neylan T, Grafman J, Aisen PS, Petersen RC, Jack C, Jagust W, Trojanowski JQ, Shaw LM, Saykin AJ, Green RC, Harvey D, Toga AW, Friedl KE, Pacifico A, Sheline Y, Yaffe K, Mohlenoff B, Department of Defense Alzheimer's Disease Neuroimaging Institute. Description of a study that is a first step toward the design and statistical powering of an Alzheimer's disease prevention trial using at-risk Veterans as subjects. Alzheimers Dement. 2014 Jun: 10(3 Suppl);S226-35.
The association of PTSD with physical and mental health functioning and disability (VA Cooperative Study #569: the course and consequences of posttraumatic stress disorder in Vietnam-era veteran twins). Goldberg J, Magruder KM, Forsberg CW, Kazis LE, Ustun TB, Friedman MJ, Litz BT, Vaccarino V, Heagerty PJ, Gleason TC, Huang GD, Smith NL. Vietnam-era Veterans with PTSD have diminished functioning and increased disability. The poor functional status of aging combat-exposed Veterans is of particular concern. Qual Life Res. 2014 Jun;23(5):1579-91.
Depression and anxiety symptoms in male Veterans and non-Veterans: the Health and Retirement Study. Gould CE, Rideaux T, Spira AP, Beaudreau SA. In a community-based sample of men aged 50 and older, Veteran status was not associated with the presence of elevated depression and anxiety symptoms. Int J Geriatr Psychiatry, 2015 Jun;30(6):623-30.
Hypertension-related alterations in white matter microstructure detectable in middle age. McEvoy LK, Fennema-Notestine C, Eyler LT, Franz CE, Hagler DJ Jr, Lyons MJ, Panizzon MS, Rinker DA, Dale AM, Kremen WS. A study of 300 Vietnam Veterans finds that prevention, rather than management, of hypertension may be vital to preserving brain health in aging. Hypertension. 2015 Aug;66(2):317-23.
Prevalence of posttraumatic stress disorder in Vietnam-era women Veterans: the health of Vietnam-era women's study (HealthVIEWS). Magruder K, Serpi T, Kimerling R, Kilbourne AM, Collins JF, Cypel Y, Frayne SM, Furey J, Huang GD, Gleason T, Reinhard MJ, Spiro A, Kang H. The prevalence of PTSD for women Veterans serving in Vietnam is higher than previously documented. JAMA Psychiatry. 2015 Nov;72(11):1127-34.
From late-onset stress symptomology to later-adulthood trauma reengagement in aging combat Veterans: taking a broader view. Davison EH, Kaiser AP, Spiro A 3rd, Moye J, King LA, King DW. Later-adult trauma reengagement can lead positively to personal growth or negatively to increased symptomatology. Gerontologist. 2016 Feb;56(1):14-21.
Newer HealthViEWS studies:
Kilbourne AM, Schumacher K, Frayne SM, Cypel Y, Barbaresso MM, Nord KM, Perzhinsky J, Lai Z, Prenovost K, Spiro A, Gleason TC, Kimerling R, Huang GD, Serpi TB, Magruder KM. Physical health conditions among a population-based cohort of Vietnam-era women Veterans: Agreement between self-report and medical records. J Womens Health (Larchmt) 2017; 26: 1244-1251.
Sternke LM, Serpi T, Spiro A 3rd, Kimerling R, Kilbourne AM, Cypel Y, Frayne SM, Furey J, Huang GD, Reinhard MJ, Magruder K. Assessment of a Revised Wartime Experiences Scale for Vietnam-Era Women: The Health of Vietnam-Era Women's Study (HealthViEWS). Womens Health Issues 2017; 27: 471-477.