All-Cause Mortality and 1990-1991 Gulf War Service within the Millennium Cohort Study (2001-2021).

Although 1990-1991 Gulf War deployment has been linked to worse health outcomes such as chronic multisymptom illness (CMI), often referred to as Gulf War Illness, among deployed Gulf War Veterans, less is known regarding Gulf War service and mortality. Using 20 years of longitudinal data from Gulf War Veteran and Era personnel from the Millennium Cohort Study (2001-2021; n=45381), Cox proportional hazard models estimated the relative effects of Gulf War service status, CMI, and their corresponding interaction on all-cause mortality. Although age- and sex-adjusted mortality ratios suggested that Gulf War Veterans had higher mortality rates than Era personnel, no association was observed between Gulf War service status and mortality risk.

Utilizing machine learning to predict participant response to follow-up health surveys in the Millennium Cohort Study.

The Millennium Cohort Study is a longitudinal study which collects self-reported data from surveys to examine the long-term effects of military service. Participant nonresponse to follow-up surveys presents a potential threat to the validity and generalizability of study findings. In recent years, predictive analytics has emerged as a promising tool to identify predictors of nonresponse.

Factors Associated With Mental Healthcare Utilization Among United States Military Personnel With Posttraumatic Stress Disorder or Depression Symptoms.

Introduction: Although posttraumatic stress disorder (PTSD) and depression are prominent mental health conditions affecting United States service members, only a subset of individuals with these conditions utilize mental healthcare services. Identifying factors associated with mental healthcare utilization may elucidate military subgroups with unmet mental healthcare needs.

Methods: Cross-sectional survey data from the 2019-2021 Millennium Cohort Study assessment were used to examine correlates of unmet mental healthcare needs among military personnel who screened positive for PTSD or depression symptoms (n=18,420) using modified Poisson regression models.

All-cause mortality among United States military personnel: Findings from the Millennium Cohort Study, 2001-2021.

Purpose: The goal of this study was to estimate all-cause mortality among Operations Enduring Freedom, Iraqi Freedom, and New Dawn era service members and veterans and to identify protective and risk factors for mortality.

Methods: Using 20 years of longitudinal data from the Millennium Cohort Study (2001-2021), sequential Cox proportional hazard models were conducted to examine demographic, military, and health-related characteristics associated with all-cause mortality among service members and veterans.

Results: Among 201,619 participants, 3806 (1.

Bidirectional Associations between Probable Eating Disorders and Mental Health Conditions Among Military Service Members and Veterans.

Although prior research has examined the prevalence of eating disorders (EDs) such as binge eating disorder (BED) and bulimia nervosa (BN) among military personnel, less is known regarding temporal associations between EDs and other mental health conditions. Using longitudinal data from 179,694 service members and veterans from the Millennium Cohort Study, temporal associations between EDs (BN, BED) and mental health conditions (posttraumatic stress disorder, anxiety, depression, and problem drinking) were investigated using a cross-lagged panel model approach. Results indicated consistent bidirectional associations between most mental health conditions and EDs; however, the magnitude of these cross-lagged associations varied across BN and BED.

Risk of Traumatic Brain Injury in Deployment and Nondeployment Settings Among Members of the Millennium Cohort Study.

Objective: To describe and quantify the prevalence and risk of deployment and nondeployment service-related traumatic brain injury (TBI) among participants of the Millennium Cohort Study.

Setting: Survey data.

Participants: 28 759 Millennium Cohort Study participants who were active duty, Reserves, or National Guard at the time of the survey.

Racial, Ethnic, and Sex Differences in Eating Disorder Onset Among U.S. Military Service Members.

Bulimia nervosa (BN) and binge eating disorder (BED) are the most prevalent eating disorders (EDs) among military personnel. Although sex differences are noted in ED prevalence in military and civilian samples, mixed findings have emerged when evaluating racial and ethnic differences. The present study examined independent associations and interactions between sex, race, ethnicity, and probable BED and BN onset.

Posttraumatic stress disorder, Veterans Health Administration use, and care-seeking among recent-era U.S. veterans.

The current study investigated the associations among probable posttraumatic stress disorder (PTSD), recent Veterans Health Administration (VHA) health care use, and care-seeking for PTSD in U.S. military veterans.

Racial, Ethnic, and Sex Disparities in Mental Health Among US Service Members and Veterans: Findings From the Millennium Cohort Study.

Although disparities in mental health occur within racially, ethnically, and sex-diverse civilian populations, it is unclear whether these disparities persist within US military populations. Using cross-sectional data from the Millennium Cohort Study (2014-2016; n = 103,184; 70.3% male; 75.

Survey response over 15 years of follow-up in the Millennium Cohort Study.

Background: Patterns of survey response and the characteristics associated with response over time in longitudinal studies are important to discern for the development of tailored retention efforts aimed at minimizing response bias. The Millennium Cohort Study, the largest and longest running cohort study of military personnel and veterans, is designed to examine the long-term health effects of military service and experiences and thus relies on continued participant survey responses over time. Here, we describe the response rates for follow-up survey data collected over 15 years and identify characteristics associated with follow-up survey response and mode of response (paper vs.

Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation.

Introduction: Although previous research suggests that overpressure exposure from either high-level blast (HLB) or low-level blast (LLB) are harmful to health, to date no large-scale studies with representative samples of military personnel have utilized prospective designs and self-reported measures to examine the relationships between blast exposure and health conditions. To address these limitations, this analysis of data from the Millennium Cohort Study (MCS), the largest and longest running study of U.S.

Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001-2018).

Background: Prior research linking military factors with cancer-specific mortality has shown inconsistent findings, with few studies examining these associations among U.S. service members and veterans who served in Operation Iraqi Freedom/Operation Enduring Freedom conflicts.

Identifying at-risk marines: A person-centered approach to adverse childhood experiences, mental health, and social support.

Background: Previous research indicates an association between adverse childhood experiences (ACES) and health outcomes; however, most of these studies rely on variable-centered techniques. This study implemented a person-centered approach to provide a more nuanced understanding of these relations.

Methods: The sample consisted of 3611 male Marines who completed two surveys, one prior to service and another during or after service.

Contribution of post-trauma insomnia to depression and posttraumatic stress disorder in women service members: findings from the Millennium Cohort Study.

Study Objectives: We examined whether women service members and veterans who reported recent combat and/or sexual trauma experiences had a greater risk of insomnia compared with women who did not report these recent experiences, and whether insomnia would be associated with a greater risk of mental health outcomes.

Methods: We analyzed two waves of survey data (2011-2013, Time 1 [T1] and 2014-2016, Time 2 [T2]) from 26 443 current and former women service members from the Millennium Cohort Study. We assessed recent traumas in the past 3 years, and probable insomnia at T1 and probable post-traumatic stress disorder (PTSD) and depression at T2.

The relative impact of injury and deployment on mental and physical quality of life among military service members.

US service members injured in the recent conflicts in Iraq and Afghanistan were more likely to survive than those in previous conflicts because of advances in medicine and protective gear. However, there is limited research examining the long-term impact of injuries while deployed on physical and mental quality of life (QOL) among service members. We used data from two time-points with an average follow-up period of 4.

Health Disparities Among Lesbian, Gay, and Bisexual Service Members and Veterans.

Introduction: This study investigated whether health disparities exist among lesbian, gay, and bisexual individuals serving in the U.S. military by examining the associations of sexual orientation with mental, physical, and behavioral health among a population-based sample of service members and veterans.

Combat exposure and behavioral health in U.S. Army Special Forces.

Although combat has been found to be associated with adverse health outcomes, little is known about the impact of specific combat exposures, particularly among specialized personnel. This study examined the association of different types of combat exposures with behavioral health outcomes, and whether these associations differed by Army occupational specialization: General Purpose Forces infantrymen (n = 5,361), Ranger Qualified infantrymen (n = 308), and Special Forces personnel (n = 593). Multivariable regression models estimated the association of combat severity, type of combat event (fighting, killing, threat to oneself, death/injury of others), and type of killing with mental health disorders, trouble sleeping, and problem drinking.

Association of deployment with maintenance of healthy weight among active duty service members in the Millennium Cohort Study.

Objective: Understanding body size in relation to deployment readiness can inform Department of Defense fitness policies. This study examined longitudinal associations between deployment and changes in body mass index (BMI) among active duty service members.

Methods: Service branch-specific changes in BMI post-deployment were examined using logistic regression models among active duty Millennium Cohort Study participants without obesity at baseline ( = 22,995).

A temporal analysis of mental health symptoms relative to separation from the military.

Background: The transition from military to civilian life is a dramatic change that is often stressful for veterans. However, little is known regarding how mental health symptoms fluctuate in the period leading up to and following separation from the military.

Methods: The current study examined posttraumatic stress disorder and depression symptoms reported on surveys completed within 1 year of military separation from 23,887 active duty Millennium Cohort Study participants.