Health Of Service Members Research Articles

Improving Care During Peacetime, War, and Disasters: A Call for Agile Military Civilian Strategic Alliances.

Improving Care During Peacetime, War, and Disasters: A Call for Agile Military Civilian Strategic Alliances.

Stressful life events and trajectories of depression symptoms in a U.S. military cohort

Depression is a common mental disorder that may comprise distinct, underlying symptom patterns over time. Associations between stressful life events throughout the civilian lifecourse—including during childhood—and adult depression have been documented in many populations, but are less commonly assessed in military samples. We identified different trajectories of depression symptoms across four years in a military cohort using latent class growth analysis, and investigated the relationship between these trajectories and two domains of civilian life experiences: childhood adversity (e.g., being mistreated during childhood) and more proximal stressful experiences (e.g., divorce). A four-group depression model was identified, including a symptom-free group (62%), an increasing symptom group (13%), a decreasing symptom group (16%), and a “chronic” symptom group (9%). Compared to the symptom-free group, soldiers with childhood adversity were more likely to be in the chronic depression, decreasing, and increasing symptom groups. Time-varying adult stressors had the largest effect on depression symptoms for the increasing symptom group compared to other groups, particularly in the last two years of follow-up. This study indicates the importance of considering events from throughout the lifecourse—not only those from deployment—when studying the mental health of servicemembers.

Associations between spouse and service member prescriptions for high-risk and long-term opioids: A dyadic study

BackgroundEstimates suggest approximately 2.4% of service members, and 15% of service members who have engaged in recent combat, report misusing pain relievers in the past year. This study explores the extent to which military spouses’ obtainment of opioids is associated with their service member partners’ obtainment of opioid prescriptions, in addition to other factors such as service member health, state prescribing patterns, and sociodemographic characteristics. MethodsData were drawn from the Millennium Cohort Family Study, a large, longitudinal survey of married spouses of service members from all service branches, and archival data analyzed from 2018 to 2020. The dependent variables were spouse long-term opioid therapy and spouse opioid prescriptions that pose a high risk of adverse outcomes. ResultsSeven percent of spouse and service member dyads met the criteria for high-risk opioid use, generally because they had purchased a prescription for a ≥90 Morphine Milligram Equivalents daily dose (76.7% for spouses, 72.8% for service members). Strong associations were found between spouse and service member opioid therapies (OR = 5.53 for long-term; OR = 2.20 for high-risk). ConclusionsFindings suggest that reducing the number of long-term and high-risk opioid prescriptions to service members may subsequently reduce the number of similar prescriptions obtained by their spouses. Reducing the number of service members and spouses at risk for adverse events may prove to be effective in stemming the opioid epidemic and improve the overall health and safety of military spouses and thus, the readiness of the U.S. Armed Forces.

US Department of Defense Support of Civilian Vector Control Operations Following Natural Disasters.

The United States Department of Defense (DoD) employs advanced-degreed entomologists as Preventive Medicine and Public Health Officers in the Army, Navy, and Air Force. While the primary objective of military entomologists is service member health and readiness ("force health protection"), military entomology resources can provide support to civil authorities as directed by the President or Secretary of Defense through Department of Defense Directive 3025.18, Defense Support of Civil Authorities (DSCA). The employment of DSCA is complex and involves the consideration of such factors as the proper request process, funding, legality, risk, appropriateness, and readiness. Once approved and mobilized, however, military preventive medicine assets can be of significant help to civil authorities when dealing with emergency vector control. This paper will address some of the policy issues surrounding the use of DSCA, outline the resources available from the individual military services, and provide examples of DoD contingency vector control support to civil authorities.

The Role of Service Member Mental Health and Marital Satisfaction in Postdeployment Family Reintegration

ABSTRACTThe postdeployment period is critical for National Guard members readjusting to the family unit. This study sought to determine whether marital satisfaction protects against reintegration difficulties. Army National Guard members (N = 114) who recently returned from a 12-month deployment to Iraq completed mental health, marital satisfaction, and family reintegration assessments. Linear and ordinary least squares regression models were used. Although few service members reported symptoms of depression, anxiety, and posttraumatic stress disorder exceeding clinical cutoff points, marital satisfaction significantly moderated the relationship between service member mental health and family reintegration. These findings highlight the potentially protective role of satisfying and supportive marital relationships. Results have implications for the health of service members and well-being of military families after a combat deployment.

The Department of Defense Chemical and Biological Defense Program: An Enabler of the Third Offset Strategy.

The US Department of Defense (DOD) established programs to defend against chemical and biological weapons 100 years ago because military leaders understood that the operational capability of the US military is diminished when service member health is compromised. These threats to operational readiness can be from an overt attack using chemical and biological threats but may also arise from natural exposures. In the current era of rapidly emerging technologies, adversaries are not only rediscovering chemical and biological weapons; they are also displaying an increased propensity to employ them to cause strategic instability among deployed forces or nations undergoing conflict. The United States's investments in its Chemical and Biological Defense Program (CBDP) can be a critical enabler of the third offset strategy, which is a DOD initiative that seeks to maximize force capability to offset emerging threats. To realize this vision, the CBDP must make fundamental changes in acquiring and employing effective technologies so that enemy use of chemical and biological agents against US assets is no longer a viable option. Maximization of US force health status will provide a strategic advantage over theater opponents more vulnerable to operational degradation from chemical and biological threats.

Health Dynamics of Military and Veteran Couples: A Biopsychorelational Overview

The purpose of this review article is to present the current state of military and veteran couple’s health by addressing biological, psychological, and relational risks and resiliencies. Articles were selected using key words such as “military couple, dyad, or relationship” and were searched in the following databases: PsychInfo, Military and Government Collection, and Medline. Literature trends reveal that the role of the military spouse is no longer secondary, but is crucial to the health of the military and veteran couple. The spouse is recommended to be a part of the biopsychosocial assessment that service members receive and also be assessed themselves for stress derived symptoms such as hypertension, post traumatic stress, and depression. Assessments for health should occur sooner after deployment and at more frequent intervals given the dynamic nature of stress on health over time. The health of service members and veterans is couched within their personal and familial relationships, thus medical family therapists are the most well prepared to attend to the dynamics between health, stress, and relational well-being across the lifespan of military and veteran couples.

Expert Panel: Future Directions of Technological Advances in Prevention, Assessment, and Treatment for Military Deployment Mental Health

This expert panel was convened at CyberTherapy 14, in Verbania, Italy, on June 23, 2009, for the purpose discussing current and future uses of technology for the mental health of deployed military service members. Panel members were selected on the basis of their being military mental health providers working with advanced technology either in combat zones or in military treatment facilities, or developing technology to be used in these settings. The panel was charged with examining both appropriate and inappropriate use of current technologies to assist with the psychological health of service members in the field. The panel was also tasked with pointing out areas where technology can further develop to support the psychological health of the field-deployed service member.

Hospitalization due to injuries in the military: Evaluation of current data and recommendations on their use for injury prevention

Introduction: Injuries inflict the largest health impact on military populations in terms of hospitalization. Hospitalized injuries result in the largest direct costs of medical care and the most lost workdays, include the largest proportion of disabling injuries, and have the largest impact on troop readiness. Efforts are now beginning to focus on how injury surveillance data can be used to reduce the burden of injuries. This article examines the value of administrative hospital discharge databases in the military for routine injury surveillance, as well as investigation of specific injury problems, including musculoskeletal conditions that are frequently sequelae of old injuries. Methods: Data on hospitalizations for injuries and musculoskeletal conditions were obtained from separate administrative agencies for the Army, Navy, and Air Force. Since 1989, a Standard Inpatient Data Record (SIDR) has been used to ensure uniformity in data collection across the services utilizing standard ICD-9 codes. Cause of injury was coded using special military cause codes (STANAG codes) developed by NATO. Data were analyzed on both nature and cause of injury. Denominator data on troop strength were obtained from the Defense Manpower Data Center (DMDC). Results: Hospital records data indicate that injuries and musculoskeletal conditions have a bigger impact on the health of service members and military/combat readiness than any other ICD-9 Principal Diagnostic Group (higher incidence and higher noneffective rate or days not available for duty). Hospitalization rates for injury appeared to decline for all services from 1980 to 1992. In 1992, service-specific injury hospitalization rates per 1000 person-years were 15.6 for the Army, 8.3 for the Navy (enlisted only), and 7.7 for the Air Force, while the corresponding hospitalization rate for musculoskeletal conditions was higher in all three services: 28.1, 9.7, and 12.0, respectively. Conclusions: Military hospital discharge databases are an important source of information on severe injuries and are more comprehensive than civilian databases. They include detailed injury information that can be useful for injury prevention and surveillance purposes. Specifically, it can be used to identify high-risk groups or hazards for targeting prevention resources. These may vary widely by service, rank, and job tasks. Hospital discharge data can also be used to evaluate the effectiveness of interventions for reducing injury rates. Recommendations were submitted to further improve data collection and the use of hospital data for research and injury prevention.