Surgeon General's Health Research Articles

0385 Risk Assessment of Sleep Disorder Comorbidity Across Active Duty Army Installations from Military Medical Databases

Abstract Introduction The impact of sleep disorders on active duty Soldiers’ medical readiness is clinically significant. Sleep disorders present high comorbidity with disease states directly impacting medical readiness, ranging from musculoskeletal injury (MSK-I), obesity, and drug dependence. The current study performed a risk assessment of sleep disorder comorbidity with MSK-I, obesity, and drug dependence across active duty United States Army installations. Methods Health incidences (percent active duty per installation) were queried from the Office of the Surgeon General Health of the Force (HoF) report, specifically for Fiscal Year (FY) 2017 (n = 471,000; 85.5% male, > 70% between 18 -34). Nonparametric ranked tests identified active duty Army installations at low risk (green; < 25% percentile relative to mean rank), moderate risk (amber; 25% - 50%), and high risk (red; > 75% percentile). Linear regressions determined extent of comorbidity of sleep disorders with MSK-I, obesity, and drug dependence (tobacco use and substance abuse). Results Mean rank comparisons for sleep disorders vs. injury index (p=0.499), obesity (p=0.306), tobacco use (p=0.378), and substance abuse (p=0.591) did not differ for each installation. Further, there was a high degree of co-morbidity for mean percentage of diagnosed sleep disorder with injury index (p<0.001; r2 = 0.517), obesity (p<0.001; r2 = 0.963), tobacco use (p<0.001; r2 = 0.928), and substance abuse (p<0.001; r2 = 0.968). Conclusion In general, large infantry and artillery training units located in the Southeastern United States were “in the red” for not meeting medical readiness standards. A few exceptions include Virginia-Maryland triangle, a heavily populated area. These data demonstrate strong geographical influences on health risk comorbidity in active duty Soldiers comparable to civilian sectors. Support Military Operational Medicine Research Program

Web sites selling cigarettes: how many are there in the USA and what are their sales practices?

OBJECTIVESTo estimate the number and geographic location of web sites selling cigarettes in the USA, and to examine their sales and marketing practices.METHODSComprehensive searches were conducted using four keyword terms...