From service to silence: The critical need for research on aging women Veterans’ health

Abstract

Canadian Veterans are an aging population, yet research that examines how women Veterans experience aging is limited. Given the need for high-quality evidence to inform health policy and practice, the lack of knowledge regarding aging women Veterans limits the ability to ensure that systems are designed to support this group as they age. This article discusses ways to support research capacity on aging women Veterans by drawing on insights from two existing bodies of research: civilian aging research and research on the health of women Veterans, primarily at mid-life. These two areas of scholarship offer insights that can support future research directed toward understanding the health and well-being of older women Veterans. The article submission builds on earlier calls for military and Veteran health researchers to adopt gendered and intersectional approaches that reflect the diverse realities of this population. Researchers, funders, and Veteran-serving organizations are urged to prioritize inclusive research that can inform policies and services designed to support the health and well-being of all women Veterans as they age.

Lay Summary

In Canada, the population of Veterans is aging, and women Veterans make up a growing portion of this group. Despite this shift, little is known about how women Veterans experience aging, and the existing research does not reflect the full range of women’s experiences, especially of those with intersecting identities. These gaps may limit how health care and community and social services can be designed and delivered in a way that meets their needs. This article highlights the urgent need to understand the lives of aging women Veterans and how their past military service, gender, and social circumstances shape their health, caregiving roles, financial well-being, and access to services in later life. The authors discuss how insights from existing research on civilian populations and the Veteran health literature can support future research on aging women Veterans. Finally, they describe a clear call to action by proposing considerations for future research on aging women Veterans within the military and Veteran research community.

Introduction

Canadian Veterans are an aging population,¹ and with this changing demographic, it is necessary to understand the impact of military service on the health and well-being of aging Veterans.² This article focuses on the health and well-being of aging women Veterans. In 2021, 59.7% of Canadian women Veterans were older than age 55 years,³ yet aging women Veterans continue to be overlooked in research, particularly in the Canadian context,⁴ a reflection of women’s long-standing invisibility rooted in male-centric research frameworks, historically insufficient sex- and gender-disaggregated health and socio-demographic data, and the under-recognition of caregiving and non-traditional service roles.^5–7 In the military and Veteran context, Eichler has previously described how health research has historically adopted “sex- and gender-blind approaches,”^{5(p. 143)} which has limited understanding of health and well-being and has subsequently influenced the equitability of Veteran programs, services, and policies for women and equity-deserving groups of Veterans. For instance, only recently have national health surveys and Veteran research programs been able to consistently report findings that include data disaggregated by sex and gender.^1,3,8 Women Veterans are also not a monolithic group; they represent diverse racial, ethnic, sexual, and socio-economic backgrounds.⁵ The impact of these intersecting identities on women Veterans’ aging experiences, ranging from health disparities to access to care, remains largely unexplored. Part of rectifying the historical marginalization of women Veterans requires attending to gaps in research, policy, and practice and represents an important step toward ensuring health equity among aging Veterans.

In the Canadian Veteran health literature, a small body of peer-reviewed and grey literature has examined the experiences of aging women Veterans. A recent mixed-methods report by Veterans Affairs Canada (VAC) described how women Veteran participants experience aging, including gender-based forms of discrimination, which affect their access to home care, and gendered aspects of social isolation and financial stressors.¹ However, the majority of the literature on aging women Veterans is from the United States,^7,9,10 where health conditions such as menopause, arthritis, heart failure, diabetes, osteoporosis, chronic pain, and substance use have been identified as research priorities.⁹ In 2024, the Journal of Aging and Women published a special issue on the topic of aging women Veterans — primarily in the U.S. context — with research spanning the topics of social isolation, mental health, caregiving, and psychosocial determinants of physical health among aging women Veterans.⁷ This small body of research further stresses the need for dedicated research on women Veterans, particularly considering the contextual differences for Canadian Veterans.

Building on existing calls for more dedicated and rigorous research on women Veterans and increasing research efforts to address these critical knowledge gaps,^6,11 the authors advocate for researchers, first, to consider both age and gender as consequential to understanding the health outcomes of Canadian Veterans and, second, to position older women Veterans as a sub-population of both the Veteran and the civilian populations with particular personal experiences and understanding of their health and well-being in later life, health services usage, and health outcomes. They use existing insights from the literature on civilian older women and research on the health and well-being of women Veterans, primarily at mid-life, to advocate for research focused on the health outcomes of older women Veterans and the continuum of care. As researchers working across disciplines, including the social sciences, health sciences, and topics including women’s health, aging, caregiving, and health policy, the authors seek to advance methodologically and theoretically grounded approaches by identifying key aging-related issues that have historically been neglected in research on women Veterans and offer a starting point for future studies to deepen and expand this emerging area of inquiry.

Insights from the existing literature on women’s health, aging, and Veterans’ health research

Health outcomes

Although less is known about women Veterans’ health outcomes in later life, research is increasingly shedding light on the health and well-being of Canadian women Veterans at mid-life, which raises questions about how these health outcomes relate to later-life experiences. Women Veterans’ health outcomes are affected by their military service and gaps in research, services, and women-centric health care.^1,11,12 Research has identified that women experience health conditions differently from men Veterans and compared with civilian women.¹² For example, the 2022 Canadian Veteran Health Survey (CVHS) found that women Veterans were less likely to report cardiovascular disease, hypertension, and diabetes than men.¹ However, they were more likely to report an anxiety or mood disorder, fibromyalgia, and osteoporosis.¹ Women Veterans face an increased risk of gender-based forms of violence and experience the transition from the military to civilian life differently.^13,14

Aging research among the Canadian civilian population has also highlighted how aging experiences differ for women, including disparities in health outcomes, socio-economic status, caregiving responsibilities, and exposure to gendered ageism.¹⁵ A report by Women’s Age Labs highlight how (civilian) women’s health experiences are shaped by health conditions that affect women specifically, including menopause and cervical cancer, and also by health conditions where women and men present differently (e.g., heart attacks). Women in Canada have been found to have a higher risk of dementia, in addition to experiencing gendered modifiable risk factors for dementia.¹⁶

Taken together, these two bodies of literature highlight the need for age-related research on women Veterans’ health and suggest gaps in the understanding of menopause, mental health, posttraumatic stress disorder, and dementia and the long-term impacts of trauma and gender-based violence.^11,17,18 Furthermore, research is needed that not only understands the prevalence of certain health conditions but also examines the impact of structural determinants of health. It is essential to acknowledge that research has been ongoing in Canada to address knowledge gaps related to the health of women Veterans.⁶ For example, VAC has launched targeted funding opportunities to explore under-researched areas affecting women Veterans, including a scoping review on the biopsychosocial impacts of perimenopause, menopause, and post-menopause on women Veterans’ health and well-being outcomes.¹⁹ Eichler et al. also note various research initiatives underway in Canada, including those supported by VAC, the Atlas Institute for Veterans and Families, and the Chronic Pain Centre of Excellence for Canadian Veterans.⁶ With the body of research on women Veterans’ health growing, it is the ideal time to identify priorities specifically related to aging in the Canadian context.

Continuum-of-care research

Most older adults in Canada are widely regarded as wanting to age in their homes and communities, and, simultaneously, many Canadians are aging at home with more complex health and social needs (e.g., multimorbidity, social isolation).²⁰ Determining how services ranging from primary and acute care to home and long-term care (LTC) can be redesigned to meet these changing needs has been a key focus of aging-related research. Research has yet to examine the experience of older women Veterans in accessing and using services across the continuum of care, including services specific to Veterans and general health, social, and LTC services.² For example, the 2021 Canadian census revealed that the rate of women+ Veterans (5.2%) living in a senior citizen’s residence or LTC home was nearly twice that of men+ Veterans (2.7%),³ yet researchers do not know why this discrepancy exists or what factors contribute to this difference.

People who provide unpaid caregiving to their aging family members or friends play a critical role in supporting them to age in place.²⁰ In Canada, women in later life provide more care hours per week compared with men, which has been associated with increased stress and poor well-being.^21,22 Despite historical policy attention directed toward supporting the spouses of aging Veterans and a body of research in the military family literature examining caregiving,^23,24 very little is known about aging women Veterans’ provision of unpaid care to others or, conversely, about their own needs for caregiving in later life. Recent census data indicated that Canadian women+ Veterans have a higher likelihood of living alone, being widowed, divorced, or separated, and having a lower income compared with men+ Veterans,³ all of which can intensify caregiving burden as they age. Without intentional research on this topic, the caregiving responsibilities of women Veterans may go unrecognized, limiting understanding of the best ways to address their caregiving needs in later life.

Call to action: Building research capacity to understand the well-being of aging women Veterans

There is an opportunity to build research capacity to close persistent gaps and to centre the lived experiences of aging women Veterans in all stages of inquiry and intervention. We advocate for the use of intersectional and life-course perspectives that trace how military service intersects with gender, race, class, sexuality, and age over time. A broad view of military exposure and the Veteran identity can ensure an understanding of the long-term health of and social consequences for a broad range of older women Veterans, including those with histories of trauma, caregiving, or non-combat service. Additional theoretical approaches can support research on how military service affects the health and well-being of aging women Veterans. For instance, a political economy lens offers a powerful framework for examining the systemic disadvantages faced by aging women Veterans.²⁵ It moves beyond individual experiences to expose how power structures, economic policies, and institutional designs, often shaped by patriarchal norms, have historically determined resource allocation and access to benefits.²⁵ A feminist lens is indispensable for dissecting the experiences of aging women Veterans, moving beyond mere demographic categorization to unveil how gender, as a fundamental organizing principle, shapes their lives.^6,25 This perspective critically examines patriarchal structures in the military and society and advocates for recognizing diverse women Veteran identities, challenging male-normative assumptions, and ultimately demanding policy and research that centres women Veterans’ lived experiences and combats gender-based inequities throughout the life course.

Fostering interdisciplinary approaches, including the integration of life course perspectives, political economy, and intersectional feminist theories, would enable researchers to better understand the complex interplay of factors shaping the experiences of aging women Veterans and develop more holistic and effective support systems. This work requires sustained funding and interdisciplinary collaboration across military and Veteran studies, gerontology, public health, sociology, psychology, and feminist studies to move the field forward. Understanding the aging processes of women Veterans requires research that spans methodologies (quantitative, qualitative, mixed methods, participatory approaches) and disciplines.

Addressing the invisibility of aging women Veterans in health and social systems requires intentionally supporting and funding research that explicitly focuses on aging women Veterans, particularly those from equity-deserving groups. As noted by Eichler et al.,⁶ existing resources can help ensure funding meets these criteria, such as the Sex and Gender Equity in Research Guidelines and Gender-Based Analysis Plus approaches.^26,27 Moreover, policy efforts should support the redesign of data collection tools — including health surveys, administrative data sets, and service evaluations — using participatory approaches that meaningfully involve diverse older women Veterans. This will ensure that data accurately capture the complexity of their identities, experiences, and needs in later life.

In conclusion, research must centre on aging women Veterans as a distinct and priority population. This means addressing persistent gaps in areas such as health and well-being outcomes in later life, unpaid caregiving, and access to age-appropriate services. It also requires broadening both methodological and theoretical approaches and ensuring that the voices and lived experiences of women Veterans inform research design, evidence generation, and program development. Without inclusive and robust research, policy makers and health care providers lack the necessary evidence to design and deliver effective, targeted interventions. As national attention grows regarding both Veteran well-being and the gendered dynamics of aging, there is a timely opportunity to shape a research and policy agenda that fully reflects the diversity of those who have served. Not only is this an issue of equity, but it is also critical to developing systems that are responsive to the needs of all Veterans across the life course.

Biographies

Madison Brydges, PhD, is an adjunct professor in the Paramedicine Collaborative, Department of Family and Community Medicine, University of Toronto, and an Associate Fellow at the National Institute on Ageing at Toronto Metropolitan University. She is a qualitative health studies researcher with a focus on the sociology of health and aging, community health, and health care professions. She has more than 10 years of experience as a paramedic in Ontario.

Stephanie Hatzifilalithis, PhD, is a scientist at Women’s College Hospital in the Women’s Age Lab and an assistant professor at the Dalla Lana School of Public Health, University of Toronto. Her research focuses on climate change, aging in place, and health equity, with the goal of strengthening health systems and policies to better support women and older adults across the life course.

Maurita T. Harris, PhD, is an assistant professor at Wilfrid Laurier University with appointments in user experience design and social justice and community engagement. Her research investigates how technologies shape well-being across the life course, with an emphasis on aging, digital health, and health and racial equity. Using a human factors and community-engaged approach, her interdisciplinary work integrates perspectives from community health, design, gerontology, psychology, and social justice to inform more equitable, usable, and meaningful technologies.

Kristina Kokorelias, PhD, is translational research scientist, clinical stream, in the Healthy Ageing and Geriatrics Program at Sinai Health. She holds appointments as Assistant Professor in the Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, and the Institute for Life Course and Aging at the University of Toronto and as Affiliate Scientist at the KITE Research Institute, University Health Network. Kokorelias’s research aims to improve the well-being of older adults with complex health needs and their caregivers.

Funding Statement

No funding was received for this article.