IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/16927.html
   My bibliography  Save this paper

The Psychological Costs of War: Military Combat and Mental Health

Author

Listed:
  • Resul Cesur
  • Joseph J. Sabia
  • Erdal Tekin

Abstract

While descriptive evidence suggests that deployment in the Global War on Terrorism is associated with adverse mental health, the causal effect of combat is not well established. Using data drawn from the National Longitudinal Study of Adolescent Health, we exploit exogenous variation in deployment assignment and find that soldiers deployed to combat zones where they engage in frequent enemy firefight or witness allied or civilian deaths are at substantially increased risk for suicidal ideation, psychological counseling, and post-traumatic stress disorder (PTSD). Our estimates imply lower-bound health care costs of $1.5 to $2.7 billion for combat-induced PTSD.

Suggested Citation

  • Resul Cesur & Joseph J. Sabia & Erdal Tekin, 2011. "The Psychological Costs of War: Military Combat and Mental Health," NBER Working Papers 16927, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:16927
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w16927.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. David H. Autor & Mark G. Duggan & David S. Lyle, 2011. "Battle Scars? The Puzzling Decline in Employment and Rise in Disability Receipt among Vietnam Era Veterans," American Economic Review, American Economic Association, vol. 101(3), pages 339-344, May.
    2. Cesur, Resul & Sabia, Joseph J. & Tekin, Erdal, 2013. "The psychological costs of war: Military combat and mental health," Journal of Health Economics, Elsevier, vol. 32(1), pages 51-65.
    3. Engel, Rozlyn C. & Gallagher, Luke B. & Lyle, David S., 2010. "Military deployments and children's academic achievement: Evidence from Department of Defense Education Activity Schools," Economics of Education Review, Elsevier, vol. 29(1), pages 73-82, February.
    4. Wells, T.S. & Leardmann, C.A. & Fortuna, S.O. & Smith, B. & Smith, T.C. & Ryan, M.A.K. & Boyko, E.J. & Blazer, D., 2010. "A prospective study of depression following combat deployment in support of the wars in Iraq and Afghanistan," American Journal of Public Health, American Public Health Association, vol. 100(1), pages 90-99.
    5. David S. Lyle, 2006. "Using Military Deployments and Job Assignments to Estimate the Effect of Parental Absences and Household Relocations on Children's Academic Achievement," Journal of Labor Economics, University of Chicago Press, vol. 24(2), pages 319-350, April.
    6. Brown, Charles, 1985. "Military Enlistments: What Can We Learn from Geographic Variation?," American Economic Review, American Economic Association, vol. 75(1), pages 228-234, March.
    7. Jason M. Fletcher, 2010. "Adolescent depression and educational attainment: results using sibling fixed effects," Health Economics, John Wiley & Sons, Ltd., vol. 19(7), pages 855-871, July.
    8. Joshua D. Angrist & John H. Johnson IV, 2000. "Effects of Work-Related Absences on Families: Evidence from the Gulf War," ILR Review, Cornell University, ILR School, vol. 54(1), pages 41-58, October.
    9. Angrist, Joshua D. & Chen, Stacey H. & Frandsen, Brigham R., 2010. "Did Vietnam veterans get sicker in the 1990s? The complicated effects of military service on self-reported health," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 824-837, December.
    10. Erdal Tekin & Naci Mocan & Lan Liang, 2009. "Do Adolescents with Emotional or Behavioral Problems Respond to Cigarette Prices?," Southern Economic Journal, John Wiley & Sons, vol. 76(1), pages 67-85, July.
    11. Carlos Dobkin & Reza Shabani, 2009. "The Health Effects Of Military Service: Evidence From The Vietnam Draft," Economic Inquiry, Western Economic Association International, vol. 47(1), pages 69-80, January.
    12. Angrist, Joshua D. & Krueger, Alan B., 1999. "Empirical strategies in labor economics," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 23, pages 1277-1366, Elsevier.
    13. Susan L. Ettner & Richard G. Frank & Ronald C. Kessler, 1997. "The Impact of Psychiatric Disorders on Labor Market Outcomes," ILR Review, Cornell University, ILR School, vol. 51(1), pages 64-81, October.
    14. Erdal Tekin & Naci Mocan & Lan Liang, 2009. "Do Adolescents with Emotional or Behavioral Problems Respond to Cigarette Prices?," Southern Economic Journal, John Wiley & Sons, vol. 76(1), pages 67-85, July.
    15. Yu-Chu Shen & Jeremy Arkes & Boon Wah Kwan & Lai Yee Tan & Thomas V. Williams, 2009. "The Effect of OEF/OIF Deployment Intensity on the Rate of Posttraumatic Stress Disorder Among Active Duty Population," NBER Working Papers 15203, National Bureau of Economic Research, Inc.
    16. Chris Rohlfs, 2010. "Does Combat Exposure Make You a More Violent or Criminal Person? Evidence from the Vietnam Draft," Journal of Human Resources, University of Wisconsin Press, vol. 45(2).
    17. Barry T. Hirsch & Stephen L. Mehay, 2003. "Evaluating the Labor Market Performance of Veterans Using a Matched Comparison Group Design," Journal of Human Resources, University of Wisconsin Press, vol. 38(3).
    18. Sabia, Joseph J. & Rees, Daniel I., 2008. "The effect of adolescent virginity status on psychological well-being," Journal of Health Economics, Elsevier, vol. 27(5), pages 1368-1381, September.
    19. Kelly Bedard & Olivier Deschênes, 2006. "The Long-Term Impact of Military Service on Health: Evidence from World War II and Korean War Veterans," American Economic Review, American Economic Association, vol. 96(1), pages 176-194, March.
    20. Susan L. Ettner & Richard G. Frank & Ronald C. Kessler, 1997. "The Impact of Psychiatric Disorders on Labor Market Outcomes," NBER Working Papers 5989, National Bureau of Economic Research, Inc.
    21. Pinka Chatterji & Alison Cuellar, 2006. "How Do Youth with Mental Disorders Fare in the Juvenile Justice System?," NBER Working Papers 12437, National Bureau of Economic Research, Inc.
    22. Glen H. Elder & Lin Wang & Naomi J. Spence & Daniel E. Adkins & Tyson H. Brown, 2010. "Pathways to the All‐Volunteer Military," Social Science Quarterly, Southwestern Social Science Association, vol. 91(2), pages 455-475, June.
    23. Meredith A. Kleykamp, 2006. "College, Jobs, or the Military? Enlistment During a Time of War," Social Science Quarterly, Southwestern Social Science Association, vol. 87(2), pages 272-290, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Resul Cesur & Alexander Chesney & Joseph J. Sabia, 2016. "Combat Exposure, Cigarette Consumption, And Substance Use," Economic Inquiry, Western Economic Association International, vol. 54(3), pages 1705-1726, July.
    2. Lyk-Jensen, Stéphanie Vincent & Weatherall, Cecilie Dohlmann & Jepsen, Peter Winning, 2016. "The effect of military deployment on mental health," Economics & Human Biology, Elsevier, vol. 23(C), pages 193-208.
    3. Cesur, Resul & Sabia, Joseph J. & Tekin, Erdal, 2015. "Combat exposure and migraine headache: Evidence from exogenous deployment assignment," Economics & Human Biology, Elsevier, vol. 16(C), pages 81-99.
    4. Brighita Negrusa & Sebastian Negrusa, 2014. "Home Front: Post-Deployment Mental Health and Divorces," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 895-916, June.
    5. Resul Cesur & Joseph J. Sabia & W. David Bradford, 2024. "The effect of combat deployments on veteran opioid abuse," Health Economics, John Wiley & Sons, Ltd., vol. 33(6), pages 1284-1318, June.
    6. Johnston, David W. & Shields, Michael A. & Siminski, Peter, 2016. "Long-term health effects of Vietnam-era military service: A quasi-experiment using Australian conscription lotteries," Journal of Health Economics, Elsevier, vol. 45(C), pages 12-26.
    7. Jason M. Lindo & Charles Stoecker, 2014. "Drawn Into Violence: Evidence On “What Makes A Criminal” From The Vietnam Draft Lotteries," Economic Inquiry, Western Economic Association International, vol. 52(1), pages 239-258, January.
    8. Kıbrıs, Arzu & Cesur, Resul, 2023. "Does War Foster Cooperation or Parochialism? Evidence from a Natural Experiment among Turkish Conscripts," IZA Discussion Papers 15969, Institute of Labor Economics (IZA).
    9. Cesur, Resul & Freidman, Travis & Sabia, Joseph J., 2020. "War, traumatic health shocks, and religiosity," Journal of Economic Behavior & Organization, Elsevier, vol. 179(C), pages 475-502.
    10. Resul Cesur & Joseph J. Sabia & Erdal Tekin, 2020. "Post-9/11 War Deployments Increased Crime among Veterans," NBER Working Papers 27279, National Bureau of Economic Research, Inc.
    11. Hjalmarsson, Randi & Lindquist, Matthew, 2016. "The Causal Effect of Military Conscription on Crime and the Labor Market," CEPR Discussion Papers 11110, C.E.P.R. Discussion Papers.
    12. Hou, Benyufang & Liu, Hong & Wang, Sophie Xuefei, 2020. "Returns to military service in off-farm wage employment: Evidence from rural China," China Economic Review, Elsevier, vol. 59(C).
    13. Sebastian Negrusa & Brighita Negrusa & James Hosek, 2014. "Gone to war: have deployments increased divorces?," Journal of Population Economics, Springer;European Society for Population Economics, vol. 27(2), pages 473-496, April.
    14. Paul Bingley & Petter Lundborg & Stéphanie Vincent Lyk-Jensen, 2021. "Brothers in Arms: Spillovers from a Draft Lottery," Journal of Human Resources, University of Wisconsin Press, vol. 56(1), pages 225-268.
    15. David Card & Ana Rute Cardoso, 2012. "Can Compulsory Military Service Raise Civilian Wages? Evidence from the Peacetime Draft in Portugal," American Economic Journal: Applied Economics, American Economic Association, vol. 4(4), pages 57-93, October.
    16. Xintong Wang & Carlos A. Flores & Alfonso Flores-Lagunes, 2020. "The Effects of Vietnam-Era Military Service on the Long-Term Health of Veterans: A Bounds Analysis," Center for Policy Research Working Papers 234, Center for Policy Research, Maxwell School, Syracuse University.
    17. Chunkai Zhao & Jianhao Guo, 2022. "Are Veterans Happy? Long-term Military Service and the Life Satisfaction of Elderly Individuals in China," Journal of Happiness Studies, Springer, vol. 23(2), pages 477-508, February.
    18. Tsai, Alexander C. & Venkataramani, Atheendar S., 2015. "Communal bereavement and resilience in the aftermath of a terrorist event: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 146(C), pages 155-163.
    19. Bruno Frey, 2012. "Well-being and war," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 59(4), pages 363-375, December.
    20. D. Mark Anderson & Resul Cesur & Erdal Tekin, 2015. "Youth Depression And Future Criminal Behavior," Economic Inquiry, Western Economic Association International, vol. 53(1), pages 294-317, January.

    More about this item

    JEL classification:

    • H56 - Public Economics - - National Government Expenditures and Related Policies - - - National Security and War
    • I1 - Health, Education, and Welfare - - Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:16927. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.