Publication year
2012
Citation Title
Injury-related hospital admissions of military dependents compared with similarly aged nonmilitary insured infants, children, and adolescents.
Journal Name
Trauma and Acute Care Surgery
Journal Volume
73
Issue Number
4
Page Numbers
S236-S242
DOI
10.1097/TA.0b013e31827035f2
Summary
In this epidemiological study, researchers examined injury in infants, children, and adolescents of military and nonmilitary parents. Injury-related hospital admissions were approximately 20% higher among military youth than their civilian counterparts. Injury risk for military dependents may be higher and prevention efforts may be important to reduce this risk. Injury risk for military dependents may be higher and prevention efforts may be important to reduce this risk.
Key Findings
Injury-related hospital admissions were 20% higher in military compared to nonmilitary dependents; intracranial injury in very young children was higher in military than nonmilitary dependents.
Compared to nonmilitary dependents, mental health diagnoses (i.e., affective, anxiety, and behavioral disorders) were higher in every age category (0-4 years, 5-9 years, 10-14 years, 15-17 years) of military dependents.
Although the risk difference was small, military adolescents had higher suicide attempts and poisonings from medicinal substances than nonmilitary adolescents.
Compared with nonmilitary teens, military teens aged 15-17 years had a 34% higher rate of alcohol abuse and 15% higher rate of substance abuse.
Implications for Program Leaders
Tailor efforts to meet the unique needs of military families and their dependents dealing with mental health issues
Train service providers in evidence-based practices shown to reduce mental health disorders among military youth
Disseminate information regarding injury prevention and the unique risks among military children
Implications for Policy Makers
Continue to support programs designed to promote public safety among Service members and their families
Encourage the development of programs to include substance abuse prevention information in military youth programming to reduce the risk of substance use
Recommend education to service providers regarding the unique risk factors of military children related to mental and physical health
Methods
Data from the Kid Health Care Cost and Utilization Project 2006 (KID), which contains information on pediatric admissions in 38 states, were used to identify military and nonmilitary dependents.
Mental health diagnoses per 1,000 hospitalizations and mechanisms of injury per 1,000 injury-related hospitalizations were reported.
All patients in the study were non-needs based insurers.
Participants
The sample included 1,660 female service members who gave birth between 2001 and 2008.
The majority of participants were White and born between 1970-1979.
Most female service members who deployed both prior to and after childbirth were enlisted Army or Air Force members.
Limitations
This study did not include information on the branch of service. Hence, the findings may not generalize to all Service members.
The way the data were weighted (national versus state level) may have biased the findings in an unknown direction.
Given the parameters of the dataset, researchers were unable to calculate population-level rates; therefore, the possibility that some differences were influenced by competing causes of injury is increased.
Avenues for Future Research
Explore the effect of demographic (e.g., rank, branch, component) and deployment (e.g., frequency, number, length, stage of deployment cycle) factors on military dependent hospitalization
Examine the effectiveness of health prevention strategies aimed at military families
Utilize randomized trials designed to identify effective, culturally sensitive interventions for public safety could be funded to determine the most appropriate programs for military families
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
BACKGROUND: Military deployment of one or both parents is associated with declines in school performance, behavioral difficulties, and increases in reported mental health conditions, but less is known regarding injury risks in pediatric military dependents. METHODS: Kid Health Care Cost and Utilization Project 2006 (KID) was used to identify military dependents aged 0.1 year to 17 years through expected insurance payer being CHAMPUS, Tricare, or CHAMPVA (n = 12,310) and similarly aged privately insured nonmilitary in CHAMPUS, Tricare, or CHAMPVA states (n = 730,065). Mental health diagnoses per 1,000 hospitalizations and mechanisms of injury per 1,000 injury-related hospitalizations are reported. Unweighted univariate analyses used FisherÕs exact, [chi]2, and analysis of variance tests for significance. Odds ratios are age and sex adjusted with 95% confidence intervals. RESULTS: Injury-related admissions were higher in military than in nonmilitary dependents (15.5% vs. 13.2%, p < 0.0001). Age- and sex-adjusted motor vehicle occupant and pedestrian injuries were significantly lower in all-age military dependents but not in age-stratified categories. Very young military dependents had higher all-cause injury admissions (p < 0.0001), drowning/near drowning (p < 0.0001), and intracranial injury (p < 0.0001) and showed a tendency toward higher suffocation (p = 0.055) and crushing injury (p = 0.065). Military adolescents and teenagers had higher suicide/suicide attempts (p = 0.0001) and poisonings from medicinal substances (p = 0.0001). Mental health diagnoses were significantly higher in every age category of military dependents. All-cause in-hospital mortality tended to be greater in military than in nonmilitary dependents (p = 0.052). CONCLUSION: This study suggests that military dependents are a vulnerable population with special needs and provides clues to areas where injury prevention professionals might begin to address their needs. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level II.
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