Publication year
2011
Citation Title
Risk factors for disability retirement among healthy adults joining the U.S. Army.
Journal Name
Military Medicine
Journal Volume
176
Issue Number
2
Page Numbers
170-175
DOI
10.7205/milmed-d-10-00114
Summary
Risk factors for disability retirement were assessed using 2,453 disability cases compared to controls. Potential risk factors included sex, deployment status, military occupation, disqualification at accession, body mass index, age, education and race/ethnicity. Disability retirement cases differed statistically from control cases on all variables except education.
Key Findings
Disability retirement cases were more likely than controls to be women, older, overweight at accession, and Latino.
Disability retirement cases were less likely to have been deployed to combat zones.
Disability retirement was more common among older Soldiers.
Musculoskeletal conditions, neurological conditions, mental health disorders, respiratory conditions, and eye diseases comprised 79-85% of all disability retirement cases.
Implications for Program Leaders
Develop groups to support Soldiers with longer service histories who may be experiencing compounded stress and fatigue
Provide concrete information on normative versus problematic responses to deployment and strategies to address the deployment-related distress
Enhance education, activities, and curriculum related to coping behaviors and dealing with chronic medical conditions
Implications for Policy Makers
Encourage the development and continuation of programs that can promote resilience in Service members, their partners, and children
Encourage collaboration among DoD programs and community-based organizations to support a smooth transition for departing Service members
Recommend culturally relevant physical and mental support services targeted to at-risk groups
Methods
The Army Physical Disability Agency provided data on disability retirees.
Variables of interest included: sex, deployment status, military occupation, permanent or temporary disqualification, body mass index, age, education, and race/ethnicity.
Statistical analyses compared men deployed to combat theaters to those specializing in combat support.
Participants
Participants were Soldiers who entered the Army between 1997-2004 and were receiving disability retirement between 1997-2006.
Two thousand four hundred fifty-three disability retirement cases were compared to 12,265 controls.
Disability retirement cases included individuals with 30% disability rating or greater, and included temporary disability cases.
The study population was primarily White, male, and under age 25 years.
Limitations
No deployment information is available prior to 2001, which limits the range of time to use in comparisons.
Observed sex differences among deployed Soldiers may result from other factors like exposure to gender-based violence or physical conditions more prevalent among certain sexes (e.g., breast cancer).
Analyses were restricted to Veterans with 30% disability or greater, limiting the generalizability of the findings.
Avenues for Future Research
Examine the relationship between age, gender, and disability retirement
Collect longitudinal data from Service members regarding disability condition and deployment
Explore family variables (e.g., marital status) that may impact disability status and functioning among Service members
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: From 2001 to 2006, the Army deployed over 717,000 personnel to Iraq and Afghanistan, with over 15,000 troops wounded. Little is known about the impact of military and demographic factors, particularly deployment, occupation, and pre-existing medical status, on disability retirement. Methods: A nested case–control study of first time, active duty personnel entering from 1997 to 2004. Cases, individuals granted a medical disability retirement from 1997 to 2006, were identified by the Army Physical Disability Agency. Five controls were matched by year of entrance to each case. Results: Several factors were associated with increased risk of disability retirement, including sex, age, Hispanic ethnicity, body mass index, and military occupation; deployment was associated with a lower risk. Conclusions: The reasons for increased risk among some groups are unknown. The decreased risk associated with deployment probably reflects a “healthy warrior effect,” whereas the increased risk for combat arms may reflect combat exposures among the deployed and more rigorous training among the nondeployed.
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