How Working Conditions in Civilian Jobs Can Affect Veterans' Health and Well-Being

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Too often, policy discussions focus on employment rates over the quality of the jobs that are available to veterans. Ensuring safe and healthy working conditions for veterans should be a priority of policies and programs to improve employment opportunities for this population. Veterans have already put their lives and health on the line for their country, sometimes with long-term effects that make them vulnerable to additional hazards on the job. Understanding why veterans choose the occupations they do and the risks they are exposed to could lead to policies that improve veteran health and support for all workers.

There has been a great deal of interest in improving employment opportunities for veterans, and the past few years have brought positive trends (Hall et al., 2014; Babajide, 2016). Unemployment among veterans fell from an average of 8.7 percent in 2010 to 2.8 percent in 2022, and these rates have been consistently lower than those of nonveterans (Bureau of Labor Statistics, 2023a). However, these statistics do not account for the quality of the jobs available to veterans. In 2021, President Joe Biden stated that his administration's goal was to create "millions of good jobs" for veterans and their spouses (White House, 2021). Although pay is important, good jobs provide more than decent earnings. The U.S. Department of Labor defines good jobs as those that not only offer good pay and benefits but that also have fair hiring practices, are inclusive and equitable, support unions, have good organizational cultures, offer career advancement, and provide safe and healthy working conditions — that is, they minimize risks to physical and mental health (U.S. Department of Labor, undated-a).

Working conditions are an important component of health and well-being for all workers. Veterans, who have put their lives and health on the line for their country, should have access to safe, health-enhancing civilian jobs after leaving military service. An important first step in identifying potential areas for improvement is understanding the working conditions that veterans currently experience and how various policies and programs promote safe and healthy workplaces. Using national survey data, we examined differences in the types of jobs that veterans and nonveterans hold and explored implications of these differences and areas for future research.

Why Do Working Conditions Matter?

The average working-age veteran is already in poorer health than the average nonveteran, so policies that prioritize worker health are particularly important for this population (Kramarow and Pastor, 2012; Kazis et al., 1998). Research has shown how working conditions directly affect workers' physical and mental health (Peckham et al., 2019), and the economic cost is also significant. Each year, there are roughly 18 million work-related injuries in the United States (National Institute for Occupational Health and Safety [NIOSH], 2023). These injuries result in direct costs of more than $50 billion annually and much more in indirect costs (Marucci-Wellman et al., 2015). A 2015 study tracked costs related to the most common nonfatal workplace injuries in the United States — from falls, overexertion, and interpersonal violence at work — and found that they had increased by $2 billion in just the 12 years between 1998 and 2010, after adjusting for inflation (Marucci-Wellman et al., 2015).

Physical injuries and illnesses affect workers in a wide range of occupations, including manufacturing, construction, agriculture, and office-based sectors (Bureau of Labor Statistics, 2022, 2023c). Some of these workers face extreme temperatures and are at risk of hyperthermia or heat stroke. There were more than 30,000 heat injuries and 436 heat-related deaths among U.S. workers from 2011 to 2021 (Bureau of Labor Statistics, 2023b). Exposure to airborne contaminants is also a persistent problem for many workers. Between 15 and 30 percent of workers in the laboratory, plumbing, and tile/marble industries are exposed to airborne crystalline silica, and an estimated 1.3 million workers in the construction industry are exposed to asbestos (Yassin, Yebesi, and Tingle, 2005; American Thoracic Society, 2004). Repetitive motion or ergonomic injuries (e.g., carpal tunnel syndrome) can affect workers in both blue-collar (e.g., plumbers) and white-collar jobs (e.g., computer programmers). Such injuries likely contribute to the health problems responsible for the largest amounts of health care spending — low back and neck pain ($134.5 billion, according to 2016 U.S. public and private health insurance and out-of-pocket payment data) and other musculoskeletal conditions ($129.8 billion) (Dieleman et al., 2020).

Work-related health problems are not always physical, and all workers — including those who have very limited physical duties — can be exposed to psychosocial hazards on the job. Many Americans work long hours, which can negatively affect sleep hygiene and mental health (Afonso, Fonseca, and Pires, 2017). Thirty-eight percent of U.S. workers put in more than 40 hours per week, and 13 percent exceed 50 hours (Whitley and Burgard, 2023). In surveys of U.S. working conditions, 46 percent of workers reported that they were often rushed or pressed for time (Whitley and Burgard, 2023), which can contribute to illness and mental health problems (Nätti, Oinas, and Anttila, 2015; Zuzanek, 1998). Interpersonal conflict, which can also have a negative impact on mental health and the cardiovascular system, affects a significant number of workers (Brissette and Cohen, 2002; Jacob and Kostev, 2017). According to NIOSH data, 10 million workers in the United States (approximately 5 percent) believe that their working environment is hostile, and 6.5 million (approximately 3 percent) think it is unsafe (NIOSH, 2020).

Although there is still a need for more research into how policies on working conditions can improve worker health, the COVID-19 pandemic prompted national conversations about the trade-offs that workers often make between their health and well-being and their need for income and benefits (Office of the Surgeon General, 2022). Research indicates that the freedom to make decisions on the job, having a positive impact or sense of meaning, and opportunities to do a variety of tasks are all associated with positive health outcomes (Mikkelsen et al., 1999; Allan et al., 2018; Zaniboni, Truxillo, and Fraccaroli, 2013). Furthermore, workers value health-enhancing working conditions (Maestas et al., 2023).

Pressing Issues

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Veterans Are Uniquely Vulnerable to Poor Working Conditions

Military service is physically and psychologically demanding, and the effects of these experiences can follow veterans after they transition to civilian life. For veterans, physical and psychosocial hazards in their civilian jobs can exacerbate these preexisting conditions.

Compared with nonveterans, veterans report more musculoskeletal injuries, and working-age veterans report poorer health, more chronic conditions, and more work limitations than their nonveteran counterparts (Hinojosa and Hinojosa, 2016; Kramarow and Pastor, 2012). In recent years, there has been greater awareness of the long-term health effects of noncombat military occupational dangers. For example, the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics Act of 2022, known as the PACT Act, was passed to address service members' widespread exposure to burn pits and other environmental hazards. Among other changes, the law expanded screenings for veterans who may be at risk of developing cancer or chronic health conditions. Of the 5 million veterans screened by late 2023, 43 percent reported a toxic exposure (VA, 2023). The health effects of these military exposures could be exacerbated by poor working conditions in veterans' civilian jobs.

Exposure to psychological hazards is also common in military service. Estimates of the lifetime prevalence of posttraumatic stress disorder (PTSD) are as high as 29 percent for Operation Iraqi Freedom and Operation Enduring Freedom veterans (National Center for PTSD, 2023). Veterans are also more likely than their nonveteran peers to experience mental distress, depression, and anxiety (Grossbard et al., 2013).

Because of veterans' increased vulnerability to on-the-job hazards as a result of their military service, it is important to ensure that they have access to safe and supportive civilian job opportunities.

Veterans May Be More Likely to Work in Unhealthy Jobs

We examined data on veterans' and nonveterans' employment status, disability status, and occupation from the U.S. Census Bureau's American Community Survey (ACS), a nationwide, continuous survey of the U.S. population. We wanted to get a sense of how these characteristics differed among veterans and nonveterans at specific ages, which could show how differences between veterans and nonveterans evolve as these groups age. We focused our analyses on men in the early (26–30 years) and later (51–55 years) phases of their working years. We focused on men in this initial analysis because around 90 percent of veterans are men. Future research should include a comprehensive analysis of working conditions that explores differences by age, gender, race/ethnicity, and other demographic factors. (See the appendix for more details about our sample and variables.)

To identify broad differences in labor force participation, we examined the percentage of veterans and nonveterans who reported being employed, unemployed, and not in the labor force. Note that the term unemployed refers to people seeking work, while the phrase not in the labor force refers to people who have left the workforce because they are unable to work or have other responsibilities. To understand differences in overall health and function, we examined the percentage of veterans and nonveterans who reported having at least one disability. Military service experiences and unhealthy working conditions are both potential causes of disability (Lahelma et al., 2012; Tsai and Rosenheck, 2016). Our analysis did not examine the reasons for differences in disability rates; additional research would be needed to determine whether occupational hazards could be causally related to disability disparities.

Among employed veterans and nonveterans, we examined these five occupation categories: (1) management, business, science, and arts; (2) service; (3) sales and office; (4) natural resources, construction, and maintenance; and (5) production, transportation, and material moving. These are broad categories that include diverse occupations. Generally, management, business, science, and arts jobs offer more opportunities for creativity, autonomy, and variety compared with the other occupation types (Maestas et al., 2017). In contrast, natural resources, construction, and maintenance occupations and production, transportation, and material moving occupations typically involve greater physical demands and exposure to potential hazards (National Safety Council, undated). Service occupations and sales and office occupations may involve more psychologically stressful working conditions (American Psychological Association, 2023).

According to ACS data and as shown in Table 1, for both age groups of men, veterans and nonveterans have comparable unemployment rates; however, veterans are less likely to be employed and more likely to not be in the labor force relative to their nonveteran counterparts. Furthermore, across both age groups, veterans are more likely than nonveterans to report having a disability.

Table 2 shows occupation groups for employed veterans and nonveterans, also from ACS data. Among men ages 26–30, veterans are less likely to hold jobs in management, business, science, and arts (25 percent versus 34 percent for nonveterans) and more likely to work in service (19 percent versus 16 percent for nonveterans) or natural resources, construction, and maintenance (21 percent versus 16 percent for nonveterans). Differences for the remaining two occupation groups were smaller (within 2 percentage points.) Among men ages 51–55, the distribution of veterans and nonveterans across major occupation categories are more similar; only one of the five occupation groups — natural resources, construction, and maintenance — has more than a 1-percentage-point difference for veterans compared to nonveterans (16 percent and 18 percent, respectively).

Directions for Future Research

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In sum, veterans are more likely to report having a disability compared to nonveterans. In both age groups that we examined, similar percentages of veterans and nonveterans are unemployed, but veterans are more likely than nonveterans to not be in the labor force. Furthermore, younger veterans appear more likely to hold jobs in occupation groups that involve greater physical and psychosocial hazards, and they are less likely to hold jobs that offer autonomy and creativity, compared with their nonveteran counterparts. This is concerning given that veterans already face additional vulnerabilities to their physical and mental health because of their service experiences. We did not find differences in the overall occupation groups between veterans and nonveterans in their early 50s. It is possible that younger veterans will eventually get jobs similar to those of older veterans as they age or that these differences will persist and these generations have fundamentally different occupational trajectories.

Our analysis sheds new light on the topic of veterans' working conditions, but this area of research is still emerging. Future studies should look more thoroughly at working conditions across the veteran population — for instance, by linking detailed occupation codes with estimates of working conditions to provide a more nuanced descriptions of working conditions for veterans with various types of service experiences and other factors (O*NET OnLine, 2023).

Policymakers, employers, and organizations that connect veterans with employment opportunities would benefit from a more comprehensive analysis of trends in veterans' choice of civilian occupation crosswalked with data on how their working conditions vary both by job and by demographic characteristics, such as gender, race/ethnicity, age, and parental status.

The following recommendations highlight initial opportunities to target research funding to support interventions that promote safe and healthy workplaces for veterans.

Examine Differences in Working Conditions by Gender and Race/Ethnicity

Given that most veterans are men and that civilian occupations held by men typically differ from the jobs held by women, data on working conditions across the veteran population tend to obscure the experiences of women veterans (Wong and Charles, 2020). Women currently make up 10 percent of veterans, but that share is expected to increase in the future (U.S. Department of Labor, undated-b; VA National Center for Veterans Analysis and Statistics, 2021). Beyond ensuring that employment transition programs meet the needs of this population, tracking these veterans' employment trajectories will provide insights into the civilian workplace hazards that they face and can inform outreach and interventions.

It is also important to consider how working conditions differ by veterans' race/ethnicity. RAND research has found that Black veterans generally have higher incomes and more economic stability than Black nonveterans, but they also have more work-related limitations, more chronic pain, and higher rates of hypertension (Piquado et al., 2022). Across the overall population of U.S. workers, Black workers have more physically demanding occupations and fewer opportunities to learn on the job compared with White workers (Whitley and Burgard, 2023); more research is needed to determine whether these patterns are similar for veterans, as well as how they intersect with gender differences.

Evaluate the Resources Available to Veterans as They Transition to Civilian Employment

There is a need to better understand how veterans transition to civilian life — in particular, how successful they are in applying their military experience to the civilian job market, the impact of educational opportunities, and why veterans end up taking jobs with more physical hazards. Physically hazardous jobs tend to employ workers with less education (Fujishiro, MacDonald, and Howard, 2020), and veterans earn college degrees at rates comparable to nonveterans (Wenger and Ward, 2022). However, there is recent evidence that veterans who have used the Post-9/11 GI Bill to obtain government-paid college education experienced a decline in income compared with veterans who separated before the policy was enacted (Barr et al., 2021). Some veterans who used Post-9/11 GI Bill benefits enrolled in for-profit schools and graduated with degrees in general disciplines, such as business administration (Kofoed, 2020). It is possible that these recent veterans entered the civilian workforce with education that was not highly valued in the labor market and that some of these veterans resorted to jobs with high levels of physical hazards because those were the opportunities that were available. Further research is needed to clarify the potential relationship between GI Bill use and working conditions.

It is similarly possible that military service is undervalued in general in the civilian labor market. Military occupational experience may not align in an obvious way with the requirements of civilian jobs (Wenger, Roer, and Wong, 2023). There is evidence that veteran status may be negatively associated with intergenerational mobility when controlling for education status — and veterans' post-separation earnings are generally lower than when they were on active duty (Bailey and Sykes, 2018; Goldman et al., 2021). This lack of experience could be an additional factor driving veterans to jobs with more physical hazards or other less-than-ideal working conditions. However, post-separation earnings are higher in some civilian occupations, especially those in intelligence and information technology (Goldman et al., 2021), implying that some military occupations impart skills and experiences that are valuable to civilian employers. There is a gap in the research when it comes to the link between military occupations and post-separation career opportunities and working conditions.

Explore Policy Avenues to Improve Both Employment Transitions and Working Conditions for Veterans

Improving physical and psychosocial working conditions for all Americans will implicitly improve working conditions for veterans: A rising tide lifts all boats. Policymakers have a role to play in ensuring the safety and well-being of workers by, for instance, enforcing basic occupational safety and health standards and implementing new approaches to promote physical and psychological safety at work (Occupational Safety and Health Administration, 2014; Office of the Surgeon General, 2022).

That said, with additional research on military-to-civilian employment transitions and veterans' civilian career trajectories, policymakers and veteran-serving organizations may be better to poised to partner with employers to direct veterans into "good jobs," thus improving their working conditions. We identified two promising pathways for research to inform policies that could improve civilian employment opportunities for veterans, starting when they transition out of the military:

• Learn what works to aid employment transition support for all veterans. The transition from military to civilian life can be difficult for many veterans, but it is made even more challenging by the fact that no single federal agency or branch of the military is responsible for the process. For example, the Transition Assistance Program is an interagency initiative that includes, among others, the U.S. Departments of Defense, Veterans Affairs, and Labor. Each military service can customize the program to meet the needs of its personnel, the program covers many other aspects of military-to-civilian transitions beyond employment, and only some modules are mandatory (U.S. Department of Defense, undated). There is also a patchwork of nonprofit employment transition resources that provide such services as individualized career counseling and connections to veteran-friendly employers. Prior RAND research examined differences in civilian career earnings by military occupational specialty and level of educational attainment, highlighting potential gaps in transition assistance for service members who are entering the civilian labor market (Goldman et al., 2021). However, that study did not look specifically at working conditions. Additional research could shed greater light on best practices and ensure that available programs are effective in helping veterans obtain high-quality jobs that limit their exposure to physical and psychosocial hazards.
• Regulate Post-9/11 GI Bill benefits to promote gainful employment. The Biden administration is reviving the Obama-era "gainful employment" rule that regulated for-profit and some career-focused nonprofit education programs (U.S. Department of Education, 2023). The proposed rule would cut off access to federal financial aid for schools whose graduates do not earn enough discretionary income to pay their education debt. Post-9/11 GI Bill benefits could be regulated in a similar way: Schools would be able to accept payment with these benefits only if their veteran graduates earn more, on average, than their military basic pay before separation. Systematic analysis of veteran students' use of tuition benefits and subsequent career paths will be necessary for enforcing this new rule if it takes effect.

Policy changes like these should be informed by robust data on veterans' employment outcomes, including the quality of the jobs they secure, their earnings, their satisfaction with their career opportunities, and the workplace conditions that they experience. Ongoing evaluation of these and other metrics will help ensure that policy changes are effective in helping veterans obtain good jobs in safe and healthy workplaces.

Appendix

Data on veterans' and nonveterans' employment, disability status, and occupations are from the U.S. Census Bureau's 2019 American Community Survey (ACS) one-year sample from the Integrated Public Use Microdata Series (IPUMS):

• We used 2019 ACS data to capture occupation patterns prior to possible changes as a result of the COVID-19 pandemic.
• We included individuals who had complete data on employment type, sex, age, veteran status, and disability status. The overall sample consisted of 2,433,934 nonveterans and 204,214 veterans, identified using the ACS IPUMS veteran status variable. Individuals who reported being on active duty in the past but not currently were coded as veterans.
• We limited this analysis to men in two specific age ranges to control for confounding due to gender and age, given that occupation type and veteran status vary by both these factors. Future analyses should examine working conditions among both men and women — veterans and nonveterans — across all ages.
  • The 26–30 age range captured younger and presumably early-career workers, while the 51–55 age range captured older and presumably late-career workers. That said, we note that veterans leave the military at various ages, and they may or may not enter the civilian labor market at levels of seniority and career development already achieved by same-age nonveteran counterparts.
  • Our analytic subsamples consisted of 98,439 men ages 26–30 (3,926 veterans and 94,513 nonveterans) and 104,411 men ages 51–55 (12,567 veterans and 91,844 nonveterans). Our occupation analysis included only the subsample of veterans and nonveterans who reported working.
• We categorized employment status as employed, unemployed, or not in the labor force. We defined disability as having at least one of the following: cognitive difficulty, ambulatory difficulty, independent living difficulty, self-care difficulty, or vision or hearing difficulty.
• We based the occupation groups in our analysis on 2010 U.S. Census occupation codes (U.S. Census Bureau, 2022): management, business, science, and arts occupations (codes 0010–3540); service occupations (3600–4650); sales and office occupations (4700–5940); natural resources, construction, and maintenance occupations (6000–7630); and production, transportation, and material moving occupations (7700–9750).
• To identify differences between veterans and nonveterans in the percentage of the population in each occupation group, we used multinomial logistic regression. We used an alpha of 0.05 to determine statistical significance.
• All analyses used IPUMS person-level survey weights, and analyses were conducted in Stata/MP 18.0

References

Topics

• Occupational Safety and Health
• Veterans Employment
• Workplace Well-Being