By V. Hauschild, MPH, Defense Centers for Public Health-Aberdeen
ABERDEEN PROVING GROUND, Md. – For more than a decade, military medical surveillance data analyzed by the Army Public Health Center, now Defense Centers for Public Health–Aberdeen, identified the same two leading reasons for Soldiers’ seeking medical care:
• Outpatient visits for injuries, especially overuse injuries to the bone and soft tissues of the musculoskeletal system, and
• Health encounters for behavioral health conditions that include adjustment disorders, depressive disorders, substance abuse, posttraumatic stress disorder, anxiety disorders and sleep disorders.
[Figure 1]
Army data repeatedly show the number of Soldiers affected by injuries and behavioral health conditions exceeds that for all other groups of medical conditions combined.
“These conditions not only require many clinical visits for treatment but also result in profiles for more days of limited duty than all other medical conditions,” says Dr. Bruce Jones, a medical doctor and retired Army colonel, now the senior injury scientist with the DCPH-A. “The temporary profiles for injuries and behavioral health conditions can affect readiness to deploy.”
Army data show approximately one out of five Soldiers may not be mission ready due to temporary medical profiles resulting from either injuries or behavioral health conditions.
The Army’s 2020 Health of the Force report, also known as the HoF, found musculoskeletal, or MSK, injuries such as overuse injuries resulted in an average of over two months of lost or limited duty time per injury. Behavioral health conditions required an average of almost three months of lost or restricted duty per Soldier receiving care.
“Reducing the severity or impact of overuse injuries and behavioral conditions on Soldiers’ health may enhance a unit’s medical readiness and fighting capability,” says Army Col. Mark Reynolds, director of the DCPH-A Clinical and Epidemiology Directorate.
Reynolds and other CPHE health experts advise commanders and leaders to optimize their unit’s health with the following tips:
TIP 1. Be a More Proactive and Engaged Leader
Leading by example and staying in touch with Soldiers is the first step toward maximizing unit strength.
According to a 2016 APHC study, less than one half of Soldiers surveyed felt leadership prioritized injury prevention and kept them informed of key injuries and risk factors. They felt many leaders were unaware of the magnitude of the adverse impacts of injury to the Army, and/or did not recognize what they as leaders can do to reduce these injuries.
According to one respondent noted in the report, “Changing the mentality of injury is a must within the military. … It starts with the drill sergeants not wanting to look weak in front of their trainees and extends up through the [Chain of Command].”
Another respondent, a medical provider, noted “Leaders … play a direct role in helping the junior Soldiers prevent and recover from injury…For example, I am treating a patient with an ankle fracture. He is in a cast and on crutches yet was made to walk for PT.”
Inconsistent leadership support or awareness
