James R. Riddle

The physical and mental health of a large military cohort: baseline functional health status of the Millennium Cohort

Background:The US military is currently involved in large, lengthy, and complex combat operations around the world. Effective military operations require optimal health of deployed service members, and both mental and physical health can be affected by military operations.Methods:Baseline data were collected from 77,047 US service members during 2001–2003 as part of a large, longitudinal, population-based military health study (the Millennium Cohort Study). The authors calculated unadjusted, adjusted, and weighted means for the Medical Outcomes Study Short Form 36-item Survey for Veterans physical (PCS) and mental component summary (MCS) scores over a variety of demographic and military characteristics at baseline.Results:The unadjusted mean PCS and MCS scores for this study were 53.4 (95% confidence interval: 53.3–53.4) and 52.8 (95% confidence interval: 52.7–52.9). Average PCS and MCS scores were slightly more favorable in this military sample compared to those of the US general population of the same age and sex. Factors independently associated with more favorable health status included male gender, being married, higher educational attainment, higher military rank, and Air Force service. Combat specialists had similar health status compared to other military occupations. Having been deployed to Southwest Asia, Bosnia, or Kosovo between 1998 and 2000 was not associated with diminished health status.Conclusion:The baseline health status of this large population-based military cohort is better than that of the US general population of the same age and sex distribution over the same time period, especially in older age groups. Deployment experiences during the period of 1998–2001 were not associated with decreased health status. These data will serve as a useful reference for other military health studies and for future longitudinal analyses.

Complementary and alternative medicine use among US Navy and Marine Corps personnel

BackgroundRecently, numerous studies have revealed an increase in complementary and alternative medicine (CAM) use in US civilian populations. In contrast, few studies have examined CAM use within military populations, which have ready access to conventional medicine. Currently, the prevalence and impact of CAM use in US military populations remains unknown.MethodsTo investigate CAM use in US Navy and Marine Corps personnel, the authors surveyed a stratified random sample of 5,000 active duty and Reserve/National Guard members between December 2000 and July 2002. Chi-square tests and multivariable logistic regression were used to assess univariate associations and adjusted odds of CAM use in this population.Results and discussionOf 3,683 service members contacted, 1,446 (39.3%) returned a questionnaire and 1,305 gave complete demographic and survey data suitable for study. Among respondents, more than 37% reported using at least one CAM therapy during the past year. Herbal therapies were among the most commonly reported (15.9%). Most respondents (69.8%) reported their health as being very good or excellent. Modeling revealed that CAM use was most common among personnel who were women, white, and officers. Higher levels of recent physical pain and lower levels of satisfaction with conventional medical care were significantly associated with increased odds of reporting CAM use.ConclusionThese data suggest that CAM use is prevalent in the US military and consistent with patterns in other US civilian populations. Because there is much to be learned about CAM use along with allopathic therapy, US military medical professionals should record CAM therapies when collecting medical history data.

Health impact of US military service in a large population-based military cohort: findings of the Millennium Cohort Study, 2001-2008

BackgroundCombat-intense, lengthy, and multiple deployments in Iraq and Afghanistan have characterized the new millennium. The US militarys all-volunteer force has never been better trained and technologically equipped to engage enemy combatants in multiple theaters of operations. Nonetheless, concerns over potential lasting effects of deployment on long-term health continue to mount and are yet to be elucidated. This report outlines how findings from the first 7 years of the Millennium Cohort Study have helped to address health concerns related to military service including deployments.MethodsThe Millennium Cohort Study was designed in the late 1990s to address veteran and public concerns for the first time using prospectively collected health and behavioral data.ResultsOver 150 000 active-duty, reserve, and National Guard personnel from all service branches have enrolled, and more than 70% of the first 2 enrollment panels submitted at least 1 follow-up survey. Approximately half of the Cohort has deployed in support of operations in Iraq and Afghanistan.ConclusionThe Millennium Cohort Study is providing prospective data that will guide public health policymakers for years to come by exploring associations between military exposures and important health outcomes. Strategic studies aim to identify, reduce, and prevent adverse health outcomes that may be associated with military service, including those related to deployment.

Self-reported mental health among US military personnel prior and subsequent to the terrorist attacks of September 11, 2001.

Learning ObjectivesCompare the prevalence and severity of psychological symptoms reported by US military personnel before and after the terrorist attacks of September 11, 2001 (9/11).Identify any self-reported differences before and after 9/11 in alcohol intake, social functioning, and role limitation cause by emotional problems.Appraise possible mechanisms for the findings in this survey. Abstract There is much concern over the potential for short- and long-term adverse mental health effects caused by the terrorist attacks on September 11, 2001. This analysis used data from the Millennium Cohort Study to identify subgroups of US military members who enrolled in the cohort and reported their mental health status before the traumatic events of September 11 and soon after September 11. While adjusting for confounding, multivariable logistic regression, analysis of variance, and multivariate ordinal, or polychotomous logistic regression were used to compare 18 self-reported mental health measures in US military members who enrolled in the cohort before September 11, 2001 with those military personnel who enrolled after September 11, 2001. In contrast to studies of other populations, military respondents reported fewer mental health problems in the months immediately after September 11, 2001.