Participation in veterans’ associations reduces the negative impacts of low socioeconomic status on health

A research team from the Center for Psychological Research and Social Intervention (CIS-Iscte) analyzed the role of social factors in the health of veterans of the Portuguese Colonial War. The results reveal that the significant levels of physical and psychological health problems among veterans are shaped by social factors such as socioeconomic context. Participation in associations and a sense of belonging may serve as protective factors.

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During their military service in the Portuguese Colonial War, many veterans were repeatedly exposed to highly stressful situations, often of an extreme nature and traumatic nature, such as threats to their lives or physical well-being. Given the challenges of reintegrating into civilian life after the war, such experiences can have lasting effects on these individuals’ physical and psychological health. Ângela Romão, a researcher at CIS-Iscte and the study’s lead author, explains that “post-traumatic stress disorder (PTSD), major depression, and generalized anxiety disorder are among the most commonly identified psychological disorders in veterans of the colonial war.” According to the research team, most previous studies tend to view the veteran as an isolated clinical case, ignoring the broader social context of their health and illness. This study, partially funded by the Ministry of National Defense, is thus the first in the Portuguese context to explore how the social context can shape the impacts of traumatic experiences on health of these veterans.

Luísa Lima, a social psychologist, researcher at CIS-Iscte, and professor at Iscte-Instituto Universitário de Lisboa, explains that the main goal of the study was to “analyze how social determinants, namely socioeconomic status, participation in veterans’ associations, and identification with the armed forces, can impact the health of these former combatants.” The study included 480 Portuguese male veterans aged between 67 and 91.

The study revealed a strong sense of belonging to the armed forces, with 68% expressing pride in being part of the veteran community. In terms of health, just over half (52%) report having a diagnosed physical condition, while 35% report suffering from a chronic psychological condition resulting from exposure to traumatic stressors during military service.

The analysis shows, however, significant differences based on socioeconomic conditions. Among veterans in less favorable economic circumstances, the prevalence of chronic psychological disorders reaches 43%, compared to 23% among those in more favorable circumstances. Similar disparities emerge in terms of educational level: 40% of participants with lower levels of education report these disorders, compared to around 28% of those with higher levels of education. “These results suggest that social vulnerability can significantly increase the risk of suffering from chronic psychological disorders,” states Ângela Romão.

Socioeconomic status also plays a decisive role in how physical and emotional limitations affect daily life. Among veterans in more precarious economic situations, 10% report that health problems always limit their daily activities, a figure that drops to around 6% among those who are better off. Meanwhile, 8% of the latter group say they never feel limited by their health condition, a proportion that contrasts with 23% among those facing greater economic difficulties.

The research team also analyzed how social identity and a sense of belonging moderated the impacts of social variables on health. Participation in veterans’ associations mitigated the negative impact of low socioeconomic status on health, especially among those with high levels of military identification. These effects remained significant after controlling for age and education. For the research team, this is a very important finding, as it is possible to intervene more directly in psychological variables (social identity and sense of belonging) than in social variables (socioeconomic status).

“This research indicates, on the one hand, that socioeconomic context has an impact on veterans’ health and, on the other, how a sense of shared identity can serve as a protective factor,” says Ângela Romão. The research team believes that policy development and interventions should be focused in reducing health inequalities and strengthening support for an aging population. In the specific context of veterans, interventions should be coordinated with veteran associations, as these offer support and recognition based on shared experiences, helping to reduce isolation and promote social reintegration.

In addition to Ângela Romão and Luísa Lima, the research team includes CIS-Iscte researchers Carla Moleiro, Raquel António, and Rita Moura. The study was published in the scientific journal Journal of Military, Veteran and Family Health and is available as open access.