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The aim of the study was to report the mental and physical health of a population-based cohort of Gulf War and Gulf Era veterans 20 years after the war.A multimode (mail, Web, or computer-assisted telephone interviewing) heath survey of 14,252 Gulf War and Gulf Era veterans. The survey consisted of questions about general, physical, mental, reproductive, and functional health.Gulf War veterans report a higher prevalence of almost all queried physical and mental health conditions. The population as a whole, however, has a significant burden of disease including high body mass index and multiple comorbid conditions.Gulf War veterans continue to report poorer heath than Gulf Era veterans, 20 years after the war. Chronic disease management and interventions to improve health and wellness among both Gulf War and Gulf Era veterans are necessary.