The demographics and clinical characteristics of the sample are shown in . The mean age of study subjects was 64.1 years, and the sample was 95.9% male and 85.8% Caucasian. Rates of the six psychiatric diagnoses ranged from 1.9% for bipolar disorder and substance use disorders to 6.2% for PTSD. These rates are representative of those of the general VA population, as we have previously reported (31
). 26.2% of the sample reported that they were current smokers, which is higher than the prevalence of current smoking in the US general population (19.8%) (32
). 31.5% of the LHS sample were obese, which is consistent with reported age-adjusted rates in the general US population (32.2%) (33
). 26.8% of participants reported aerobic exercise at least 3 times per week, which meets the physical activity guidelines of the American College of Sports Medicine and the American Heart Association (34
). 39.9% of participants reported no exercise.
Demographics and Clinical Characteristics of the 1999 Large Health Survey of Veterans (LHS) (n=501,161)
In the bivariate analyses, each of the six psychiatric diagnoses was statistically significantly associated with increased rates of current tobacco use and no weekly exercise, when compared to veterans without that psychiatric diagnosis (). Rates of obesity were also higher among veterans with all of the psychiatric diagnoses except alcohol abuse or dependence (which had significantly lower rates of obesity). The rate of co-occurring obesity, current smoking and no weekly exercise was more than two and a half times higher among veterans with psychiatric diagnoses when compared to veterans with no psychiatric diagnosis—and was highest among veterans with schizophrenia (10.0% of this group) ().
Bivariate correlations (χ2) between Axis I diagnosis and poor health behaviors among respondents to 1999 Large Health Survey of Veterans (n= 501,161)
In the multivariate logistic regression analyses, current smoking was significantly associated with male gender, black race, and all of the psychiatric diagnoses except major depressive disorder. OR (95% CI) for current smoking across the psychiatric diagnoses ranged from 1.74 (1.66, 1.83) for drug abuse and dependence to 3.08 (2.98, 3.19) for alcohol abuse and dependence. Age greater than 50, higher educational level and Hispanic race were all significantly associated with statistically decreased odds of current smoking ().
. Multivariate logistic regression analyses of poor health behaviors by respondents to 1999 Large Health Survey of Veterans (n=501,161)
Veterans with major depressive disorder and PTSD had statistically significantly increased odds of no regular exercise [OR (95% CI) of 1.14 (1.10, 1.17) and 1.09 (1.06, 1.12), respectively]. With adjustment for medical comorbidity, veterans with schizophrenia were significantly less likely to have no regular exercise ().
Obesity (BMI > 30 kg/m2) was significantly associated with female gender; veterans with higher levels of education had lower odds of obesity. Alcohol and drug abuse and dependence were associated with significantly decreased odds of obesity, but all other psychiatric diagnoses were associated with significantly increased odds, ranging from 1.05 (1.01, 1.09) for schizophrenia to 1.25 (1.19, 1.30) for bipolar disorder ().
The final logistic regression model revealed statistically increased odds of the co-occurrence of obesity, current tobacco use and no regular exercise among veterans with each of the psychiatric diagnoses, with the exception of drug use disorders (which was not significantly different from 1). The highest odds were among veterans with schizophrenia, PTSD, and bipolar disorder [OR (95% CI) of 1.37 (1.29, 1.45); 1.26 (1.20, 1.32); and 1.19 (1.11, 1.28), respectively].