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Morris PA, Lindsay KG, Agana P, Watson K, Willson D. National study of sleep health for student servicemembers/veterans. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37966943 DOI: 10.1080/07448481.2023.2280778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
Objective: Investigate sleep health for student servicemember/veterans (SSM/Vs). Method: Data from the National College Health Assessment was used, including 88,178 participants in 2018 and 67,972 in 2019. Propensity score matching was used to compare SSM/Vs (n = 2984) to their most similar non-SSM/V counterparts (n = 1,355). Responses were analyzed using a multivariate analysis of covariance (MANCOVA). Results: SSM/Vs reported significantly higher levels of some sleep health issues than the matched peer group, including more instances of trouble falling asleep, waking too early, and higher rates of insomnia and sleep disorders. However, SSM/Vs reported fewer days per week feeling sleepy and similar impacts of sleep issues on academics when compared to the peer group. Conclusion: Institutions of higher education should consider training faculty and staff to recognize impacts of poor sleep health for SSM/Vs to establish effective practices to support this unique population.
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Affiliation(s)
- Phillip A Morris
- Leadership, Research, and Foundations, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Keston G Lindsay
- Human Physiology and Nutrition, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Patience Agana
- Leadership, Research, and Foundations, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Kathryn Watson
- Leadership, Research, and Foundations, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
| | - Dale Willson
- Leadership, Research, and Foundations, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
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Godby Vail S, Dierst-Davies R, Kogut D, Degiorgi Winslow L, Vargas J, Koeppl P, Marshall-Aiyelawo K. Behavioral health and treatment-seeking behaviors among deployed vs. non-deployed service members: How impactful is deployment on well-being? MILITARY PSYCHOLOGY 2022; 35:107-118. [PMID: 37133492 DOI: 10.1080/08995605.2022.2083468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Increasing attention has been dedicated to studying behavioral health of non-deployed military personnel. This investigation explored the impacts of a variety of sociodemographic and health factors on key behavioral health outcomes among active duty personnel. A secondary analysis was conducted using 2014 Defense Health Agency Health Related Behaviors Survey data (unweighted n = 45,762, weighted n = 1,251,606). Three logistic regression models investigated factors associated with reporting symptomatology consistent with depression, anxiety, and stress. We found that after adjusting for sociodemographic and other health variables (e.g., sleep), deployment was associated with stress but not anxiety or depression. Although deployed personnel were more likely to report increased levels of stress overall, few differences with respect to the sources of stressors were identified. While behavioral health screening and treatment needs may differ for non-deployed and deployed personnel, programs to support mental and physical well-being among all service members should be robustly promoted.
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Belding JN, Castañeda SF, Jacobson IG, LeardMann CA, Porter B, Powell TM, Kolaja CA, Seelig AD, Matsuno RK, Carey FR, Rivera AC, Trone DW, Sheppard B, Walstrom J, Boyko EJ, Rull RP, For The Millennium Cohort Study Team. The Millennium Cohort Study: The First 20 Years of Research Dedicated to Understanding the Long-Term Health of US Service Members and Veterans. Ann Epidemiol 2021; 67:61-72. [PMID: 34906635 DOI: 10.1016/j.annepidem.2021.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 01/22/2023]
Abstract
The Millennium Cohort Study, the US Department of Defense's largest and longest running study, was conceived in 1999 to investigate the effects of military service on service member health and well-being by prospectively following active duty, Reserve, and National Guard personnel from all branches during and following military service. In commemoration of the Study's 20th anniversary, this paper provides a summary of its methods, key findings, and future directions. Recruitment and enrollment of the first 5 panels occurred between 2001 and 2021. After completing a baseline survey, participants are requested to complete follow-up surveys every 3 to 5 years. Study research projects are categorized into 3 core portfolio areas (psychological health, physical health, and health-related behaviors) and several cross-cutting areas and have culminated in more than 120 publications to date. For example, some key Study findings include that specific military service-related factors (e.g., experiencing combat, serving in certain occupational subgroups) were associated with adverse health-related outcomes and that unhealthy behaviors and mental health issues may increase following the transition from military service to veteran status. The Study will continue to foster stakeholder relationships such that research findings inform and guide policy initiatives and health promotion efforts.
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Key Words
- Abbreviations
- Army STARRS, Army Study to Assess Risk and Resilience in Servicemembers
- DoD, Department of Defense
- Millennium Cohort Study, military, veterans, deployment, risk factors, protective factors, physical health, mental health, health-related behaviors, longitudinal cohort
- OEF, Operation Enduring Freedom
- OIF, Operation Iraqi Freedom
- OND, Operation New Dawn
- PTSD, posttraumatic stress disorder
- VA, Department of Veterans Affairs
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Affiliation(s)
- Jennifer N Belding
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Sheila F Castañeda
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Isabel G Jacobson
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Cynthia A LeardMann
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Ben Porter
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA; Mississippi State University, Mississippi State, Mississippi, USA
| | - Teresa M Powell
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Claire A Kolaja
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Amber D Seelig
- VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Rayna K Matsuno
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Felicia R Carey
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Anna C Rivera
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Daniel W Trone
- Naval Health Research Center, San Diego, California, USA
| | - Beverly Sheppard
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Jennifer Walstrom
- Leidos, San Diego, California, USA; Naval Health Research Center, San Diego, California, USA
| | - Edward J Boyko
- VA Puget Sound Health Care System, Seattle, Washington, USA
| | - Rudolph P Rull
- Naval Health Research Center, San Diego, California, USA.
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Marshall-Aiyelawo K, Gliner M, Pedraza O, Beekman J, Messinger S, Roshwalb A. Patient Experience in Obstetrics in a Military Patient Satisfaction Survey: Findings and Recommendations for Improvement. Mil Med 2021; 188:e1207-e1213. [PMID: 34741452 DOI: 10.1093/milmed/usab431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/20/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION This study examines the care experience of obstetric patients within the Military Health System and compares them to those of medical and surgical care patients. Specifically, the study seeks to (1) examine how obstetric inpatient experience ratings differ from medical and surgical inpatient experience ratings, (2) understand specific aspects of care that drive overall experience ratings within this population, (3) test whether adherence to nursing practices such as hourly rounding and nurse leader visits affect experience ratings, and (4) describe ways that patient experience information can be presented to healthcare providers to improve performance. MATERIALS AND METHODS Data for this study include Military Health System patient experience survey data (based on the Hospital Consumer Assessment of Healthcare Providers and Systems) collected from 2011 through 2019. Analysis includes data collected from 338,124 patients aged 18 years and older. Our analysis involved z-test comparisons of patient experience measure scores, trend analysis, logistic regression-based driver analysis, and correlations. RESULTS Obstetric ratings are generally lower than those of medical and surgical patients; however, they have been improving at a slightly faster rate year over year. Effective nurse communications with patients are a particularly strong driver for improving their overall care experiences, and practices like hourly nurse rounding, nurse leader visits, and nurse-patient shift change conversations are positively correlated with obstetric patient experience ratings. CONCLUSIONS This study contextualizes how obstetric inpatient experience ratings differ from those of medical and surgical care patients. Healthcare administrators and policymakers should be aware that obstetric patients may have unique needs and expectations that lead to patient experience ratings differing from those of medical and surgical patients. Effective nurse-patient communications, hourly rounding, nurse leader visits, and nurse-patient shift change conversations could be strategies used to improve obstetric experience ratings.
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Kaufmann PG, Havens DS, Mensinger JL, Bradley PK, Brom HM, Copel LC, Costello A, D'Annunzio C, Dean Durning J, Maldonado L, Barrow McKenzie A, Smeltzer SC, Yost J. The COVID-19 Study of Healthcare and Support Personnel (CHAMPS): Protocol for a Longitudinal Observational Study. JMIR Res Protoc 2021; 10:e30757. [PMID: 34582354 PMCID: PMC8500345 DOI: 10.2196/30757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Early in the development of the COVID-19 pandemic, it was evident that health care workers, first responders, and other essential workers would face significant stress and workplace demands related to equipment shortages and rapidly growing infections in the general population. Although the effects of other sources of stress on health have been documented, the effects of these unique conditions of the COVID-19 pandemic on the long-term health and well-being of the health care workforce are not known. OBJECTIVE The COVID-19 Study of Healthcare and Support Personnel (CHAMPS) was designed to document early and longitudinal effects of the pandemic on the mental and physical health of essential workers engaged in health care. We will investigate mediators and moderators of these effects and evaluate the influence of exposure to stress, including morbidity and mortality, over time. We will also examine the effect of protective factors and resilience on health outcomes. METHODS The study cohort is a convenience sample recruited nationally through communities, professional organizations, networks, social media, and snowball sampling. Recruitment took place for 13 months to obtain an estimated sample of 2762 adults who provided self-reported information administered on the web through structured questionnaires about their work environment, mental and physical health, and psychosocial factors. Follow-up questionnaires will be administered after 6 months and annually thereafter to ascertain changes in health, well-being, and lifestyle. Participants who consented to be recontacted form the longitudinal cohort and the CHAMPS Registry may be contacted to ascertain their interest in ancillary studies for which they may be eligible. RESULTS The study was approved by the Institutional Review Board and launched in May 2020, with grants from Travere Therapeutics Inc, McKesson Corporation, anonymous donors, and internal funding from the M. Louise Fitzpatrick College of Nursing at Villanova University. Recruitment ended in June 2021 after enrolling 2762 participants, 1534 of whom agreed to participate in the longitudinal study and the registry as well as to be contacted about eligibility for future studies. CONCLUSIONS The CHAMPS Study and Registry will enable the acquisition of detailed data on the effects of extended psychosocial and workplace stress on morbidity and mortality and serve as a platform for ancillary studies related to the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04370821; https://clinicaltrials.gov/ct2/show/NCT04370821. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/30757.
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Affiliation(s)
- Peter G Kaufmann
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Donna S Havens
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Janell L Mensinger
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Patricia K Bradley
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Heather M Brom
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Linda C Copel
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Alexander Costello
- Department of Mathematics and Statistics, Villanova University, Villanova, PA, United States
| | - Christine D'Annunzio
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Jennifer Dean Durning
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Linda Maldonado
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Ann Barrow McKenzie
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Suzanne C Smeltzer
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
| | - Jennifer Yost
- M. Louise Fitzapatrick College of Nursing, Villanova University, Villanova, PA, United States
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- Villanova University, Villanova, PA, United States
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Teplova AE, Bakker HAHM, Perry SIB, van Etten-Jamaludin FS, Plat MCJ, Bekkers MBM. The Impact of Deployment and Combat Exposure on Physical Health Among Military Personnel: A Systematic Review of Incidence, Prevalence, and Risks. Mil Med 2021; 187:e1074-e1085. [PMID: 34296281 DOI: 10.1093/milmed/usab302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 07/11/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The impact of deployment and combat on mental health of military personnel is well described. Less evidence is available to demonstrate and summarize the incidence, prevalence, and risks of these exposures on physical health. This study aims to (1) systematically review the available literature to determine the incidence and prevalence of physical health conditions among military personnel during and after deployment and (2) investigate the risks of deployment and combat exposure on physical health. METHODS A systematic review using the PubMed and EMBASE databases was performed. The literature search was limited to articles written in English, published from 2000 through 2019. The quality of studies was assessed with the Joanna Briggs Institute Appraisal Checklist. The results were grouped per system or condition of physical health and presented by forest plots without a combined effect size estimate. RESULTS Thirty-two studies were found eligible for this review. We identified a wide variety of incidence and prevalence rates of numerous physical health conditions and a high heterogeneity across the included studies. Acute respiratory symptoms, diarrhea, musculoskeletal injuries, pain, and tinnitus were found to be the most incident or prevalent conditions. Except for hearing loss, no associations with deployment and physical health problems were observed. An increased risk for asthma, headache, hearing loss, and pain was reported in relation to the combat exposure. CONCLUSION Given the characteristics of included studies and extracted data, the magnitude of the found differences in incidence and prevalence rates is most likely to be due to methodological heterogeneity. The specific exposures (e.g., infrastructure, environmental conditions, and activities during deployment) are suggested to be the determinants of (post) deployment physical health problems and need to be addressed to decrease the impact of deployment. Findings from this systematic review highlight which conditions should be addressed in response to service members' health and wellness needs in the (post)deployment phase and may be used by clinicians, researchers, and policy-makers. However, knowledge gaps regarding the potential risk factors during deployment and combat still exist. Studies using consistent methods to define and measure the physical health conditions and specific exposures are needed.
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Affiliation(s)
- Alina E Teplova
- Department of Physical, Medicine and Rehabilitation, Basalt Rehabilitation, Medical Centre Haaglanden: Medisch Centrum Haaglanden, The Hague 2512 VA, The Netherlands
| | | | - Sander I B Perry
- Department of Data Science and Epidemiology, University of Amsterdam, University Medical Center Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Faridi S van Etten-Jamaludin
- Research Support, Medical Library AMC, University of Amsterdam, University Medical Center Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - Marie-Christine J Plat
- Expertcentre Force Health Protection, Military Healthcare Organisation, Ministry of Defence, Doorn 3941 PW, The Netherlands
| | - Margaretha B M Bekkers
- Expertcentre Force Health Protection, Military Healthcare Organisation, Ministry of Defence, Doorn 3941 PW, The Netherlands
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Warner R, Avery JC, Neuhaus S, Davies MJ. Australian Veterans of the Middle East Conflicts 2001–2010: Select Reproductive Health Outcomes Part 2 — Prenatal, Fetal, and Neonatal Outcomes. FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s2661318220500085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Following on from Part 1 of these companion articles, which described the maternal and paternal cohort of the Middle East Area of Operations (MEAO) Census Study, this manuscript aims to describe fetal and infant characteristics and outcomes from the self-report data, including live deliveries, stillbirths, all other pregnancy losses, and unknown outcomes. Methods: A descriptive analysis was performed on the clinical variables where data were reported. Descriptive statistics (means, frequencies, percentiles) were used to describe the occurrence of adverse gestational outcomes. Odds ratios were also calculated for perinatal outcomes. Infant characteristics and outcomes were evaluated using statistical analysis software IBM SPSS v26. Results: There were 15,417 pregnancies reported by respondents to the MEAO Census Study. Of these, 74% (11,367) resulted in a live delivery, 0.75% in a stillbirth, and 20% in another type of pregnancy loss (ectopic pregnancy, miscarriage, termination). The unadjusted odds of an adverse perinatal outcome were higher in the MEAO Census population than in the general Australian population, notably stillbirth (OR = 3.11, 95% CI 2.56–3.80), perinatal death (OR = 3.80, 95% CI 3.26–4.44), and neonatal death (OR = 5.43, 95% CI 4.27–6.91). There were 499 cases of birth defects reported and 85 cases of childhood cancer in the MEAO population. The unadjusted odds of childhood cancer were slightly higher (OR = 1.7, 95% CI 0.09–3.28) in the MEAO population, and the unadjusted odds of birth defects were lower (OR = 0.52, 95% CI 0.40–0.68). The male:female infant sex ratio of babies born to respondents was 102 (5939 males:5823 females). Conclusions: The MEAO Census Study presents a generally reassuring picture of reproductive health for women serving in the Australian Defence Force with regards to the risk of pregnancy loss and perinatal outcomes. The increased odds of perinatal and neonatal death and stillbirth are worthy of further study and evaluation, as is the increase in likelihood of childhood cancer in the offspring of MEAO veterans.
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Affiliation(s)
- Rachelle Warner
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Jodie C. Avery
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Susan Neuhaus
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Michael J. Davies
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
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Graham K, Searle A, Van Hooff M, Lawrence-Wood E, McFarlane A. The Associations Between Physical and Psychological Symptoms and Traumatic Military Deployment Exposures. J Trauma Stress 2019; 32:957-966. [PMID: 31774592 DOI: 10.1002/jts.22451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 01/08/2023]
Abstract
Current paradigms regarding the effects of traumatic exposures on military personnel do not consider physical symptoms unrelated to injury or illness as independent outcomes of trauma exposure, characteristically dealing with these symptoms as comorbidities of psychological disorders. Our objective was to ascertain the proportions of deployed military personnel who experienced predominantly physical symptoms, predominantly psychological symptoms, and comorbidity of the two and to examine the association between traumatic deployment exposures (TDEs) and these symptomatic profiles. Data were taken from a cross-sectional study of Australian Defence Force personnel who were deployed to the Middle East during 2001-2009 (N = 14,032). Four groups were created based on distributional splits of physical and psychological symptom scales: low-symptom, psychological, physical, and comorbid. Multinomial logistic regression models assessed the probability of symptom group membership, compared with low-symptom, as predicted by self-reported TDEs. Group proportions were: low-symptom, 78.3%; physical, 5.0%; psychological, 9.3%; and comorbid, 7.5%. TDEs were significant predictors of all symptom profiles. For subjective, objective, and human death and degradation exposures, respectively, the largest relative risk ratios (RRRs) were for the comorbid profile, RRRs = 1.47, 1.19, 1.48; followed by the physical profile, RRRs = 1.27, 1.15, 1.40; and the psychological profile, RRRs = 1.22, 1.07, 1.22. Almost half of participants with physical symptoms did not have comorbid psychological symptoms, suggesting that physical symptoms can occur as a discrete outcome trauma exposure. The similar dose-response association between TDEs and the physical and psychological profiles suggests trauma is similarly associated with both outcomes.
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Affiliation(s)
- Kristin Graham
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, Australia
| | - Amelia Searle
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, Australia
| | - Miranda Van Hooff
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, Australia
| | - Ellie Lawrence-Wood
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, Australia
| | - Alexander McFarlane
- Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, Australia
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Porter B, Bonanno GA, Bliese PD, Phillips CJ, Proctor SP. Combat and Trajectories of Physical Health Functioning in U.S. Service Members. Am J Prev Med 2019; 57:637-644. [PMID: 31564607 DOI: 10.1016/j.amepre.2019.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Previous research has demonstrated that different forms of mental health trajectories can be observed in service members, and that these trajectories are related to combat. However, limited research has examined this phenomenon in relation to physical health. This study aims to determine how combat exposure relates to trajectories of physical health functioning in U.S. service members. METHODS This study included 11,950 Millennium Cohort Study participants who had an index deployment between 2001 and 2005. Self-reported physical health functioning was obtained 5 times between 2001 and 2016 (analyzed in 2017), and latent growth mixture modeling was used to identify longitudinal trajectories from these assessments. Differences in the shape and prevalence of physical health functioning trajectories were investigated in relation to participants' self-reported combat exposure over the index deployment. RESULTS Five physical health functioning trajectories were identified (high-stable, delayed-declining, worsening, improving-worsening, and low-stable). Combat exposure did not influence the shape of trajectories (p=0.12) but did influence trajectory membership. Relative to personnel not exposed to combat, participants reporting combat exposure were more likely to be in the delayed-declining, worsening, and low-stable classes and less likely to be in the high-stable class. However, the high-stable class (i.e., the most optimal class) was the most common trajectory class among not exposed (73.0%) and combat-exposed (64.5%) personnel. CONCLUSIONS Combat exposure during military deployment is associated with poorer physical health functioning trajectories spanning more than a decade of follow-up. However, even when exposed to combat, consistently high physical health functioning is the modal response.
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Affiliation(s)
- Ben Porter
- Leidos, Reston, Virginia.; Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, California.
| | | | - Paul D Bliese
- Darla Moore School of Business, University of South Carolina, Columbia, South Carolina
| | - Christopher J Phillips
- Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, California
| | - Susan P Proctor
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts; Research Service, VA Boston Healthcare System, Boston, Massachusetts
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10
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Evaluating measures of combat deployment for U.S. Army personnel using various sources of administrative data. Ann Epidemiol 2019; 35:66-72. [DOI: 10.1016/j.annepidem.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/22/2019] [Accepted: 04/03/2019] [Indexed: 11/22/2022]
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Ketcheson F, Cyr K, King L, Richardson JD. Influence of PTSD and MDD on somatic symptoms in treatment-seeking military members and Veterans. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2018. [DOI: 10.3138/jmvfh.2017-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Felicia Ketcheson
- Operational Stress Injury Clinic, Parkwood Institute, London, Ontario, Canada
| | - Kate Cyr
- Operational Stress Injury Clinic, Parkwood Institute, London, Ontario, Canada
| | - Lisa King
- Operational Stress Injury Clinic, Parkwood Institute, London, Ontario, Canada
| | - J. Don Richardson
- Operational Stress Injury Clinic, Parkwood Institute, London, Ontario, Canada
- Department of Psychiatry, Western University, London, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
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Horyniak D, Bojorquez I, Armenta RF, Davidson PJ. Deportation of non-citizen military veterans: A critical analysis of implications for the right to health. Glob Public Health 2018; 13:1369-1381. [PMID: 29243564 PMCID: PMC6561474 DOI: 10.1080/17441692.2017.1413123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Military personnel are commonly exposed to health-harming conditions during their service, resulting in higher rates of physical and mental health conditions compared with the general population. In an era of mass deportations, it is notable that non-citizen military veterans are not exempt from deportation. We utilised a human rights framework to conduct a critical analysis of potential health consequences of deportation for U.S. military veterans, identifying three ways in which veterans' rights to health may be constrained through deportation. First, honourably discharged deported veterans may be denied access to free or subsidised Veterans Affairs health services to which they would likely otherwise be entitled. Second, availability of and access to healthcare may be limited for reasons including barriers to enrolling in public insurance schemes, challenges navigating unfamiliar health systems and stigma and discrimination towards deported migrants. Finally, quality of available care may be sub-optimal due to limited expertise in service-related health issues and lack of evidence-based treatment for some health conditions (e.g. substance abuse/dependence). Binational multi-sectoral efforts are necessary to ensure that the rights to health of deported military veterans are adequately protected.
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Affiliation(s)
- Danielle Horyniak
- Division of Global Public Health, University of California San Diego, La Jolla, USA
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ietza Bojorquez
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Mexico
| | - Richard F. Armenta
- Division of Epidemiology, University of California San Diego, La Jolla, USA
- Department of Kinesiology, College of Education, Health and Human Services, California State University San Marcos, San Marcos, USA
| | - Peter J. Davidson
- Division of Global Public Health, University of California San Diego, La Jolla, USA
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Is the Military’s Century-Old Frontline Psychiatry Policy Harmful to Veterans and Their Families? Part Three of a Systematic Review. PSYCHOLOGICAL INJURY & LAW 2017. [DOI: 10.1007/s12207-016-9280-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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