Chronic Diseases and Military Readiness
Preventing and controlling chronic diseases is a matter of national security.
- Nearly 1 in 4 young adults is too heavy to serve in the US military.
- Active duty military members (service members) with obesity are more likely to be injured. New recruits with less physical fitness are more likely to get injured during basic training.
- The US Department of Defense (DoD) spends about $1.5 billion a year in obesity-related health care costs for current and former service members and their families.
- Service members who use tobacco are more likely to become sick, get injured, drop out of basic training, and leave military service during the first year.
- Binge drinking among service members increased from 35% in 1998 to 47% in 2008.
Increasing the Availability of Healthy Foods
CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) began offering a fellowship for DoD personnel in May 2016. This partnership led to increased opportunities and expertise for providing healthier foods and beverages on military bases and in the surrounding communities. These fellows helped create an infographic Cdc-pdf[PDF – 850 KB] on how obesity is affecting national security and promoted the use of food service guidelines in DoD facilities.
DNPAO staff are also helping the Jacksonville Public Health Naval Hospital in Jacksonville, Florida, create a food environment where healthy choices are easy to make—including setting up a healthy “micromarket,” which provides automated access to food and beverages 24 hours a day. CDC is helping the Navy determine how to set up micromarkets that make it easier for people to get and choose healthier foods.
DNPAO staff led the update of the 2017 Food Service Guidelines for Federal Facilities Cdc-pdf[PDF – 3.4 MB] in collaboration with nine federal agencies, including DoD. In addition, DNPAO, DoD, and other partners participate in the Food Service Guidelines collaborative, which facilitates the purchasing and selling of healthier foods and beverages in government facilities, military bases, worksites, hospitals, universities, and other institutional settings.
Reducing Tobacco Use
Cigarette smoking is the leading cause of death and disease in the United States. Over 16 million Americans have at least one disease from smoking, and 480,000 Americans die from smoking-related diseases each year. Tobacco use harms military preparedness by reducing service members’ physical fitness and strength. Service members who use tobacco are more likely to become sick, get injured, drop out of basic training, and leave military service during the first year. Tobacco use also costs DoD an estimated $1.7 billion in additional annual medical costs (2014 data).
The percentage of service members who smoke cigarettes has historically been higher than that of the general adult population but has been dropping in recent years, along with declines in smoking in the general population. The percentage of service members who use smokeless tobacco (chewing tobacco, snuff, dip, or snus) is also higher than in the general population. In addition, e-cigarette use is increasing among service members. During 2010–2015, almost 3 in 10 US veterans were current users of any tobacco products.
Helping Service Members and Veterans Quit
CDC’s Tips From Former Smokers® (Tips®) campaign focuses on motivating US adults who smoke to try to quit. Tips features real people—not actors—who are living with serious health conditions caused by smoking and secondhand smoke exposure. It connects people who smoke with resources to help them quit, including 1-800-QUIT-NOW, which directs people to free services available from their state quitlines.
CDC’s Office on Smoking and Health (OSH) worked with DoD and the US Department of Veterans Affairs (VA) to develop a military-focused ad for the 2016 Tips campaign. The Tips website includes tailored content on dedicated cessation resources to help service members and veterans quit.
The VA features Tips campaign materials, including Brian’s Ad and James’ Ad, on the Tobacco and Health section of its website. The VA also includes five Tips ads tagged with the 1-855-QUIT-VET number on its YouTube channel, and staff at its outpatient clinics can air any of these ads in patient waiting areas.
Publishing Research on Tobacco Use Among Veterans
OSH worked with partners at the VA on a Morbidity and Mortality Weekly Report article about tobacco product use among military veterans, which highlighted cessation resources. Analysis of data from the 2010–2015 National Survey on Drug Use and Health showed that 29.2% of veterans reported current tobacco product use. Current use was highest for cigarettes (21.6%), followed by cigars (6.2%), smokeless tobacco (5.2%), roll-your-own tobacco (3.0%), and pipes (1.5%).
Creating a Facebook Event for Tobacco Users
OSH collaborated with DoD, the VA, and the National Cancer Institute to host a 30 Tobacco Free Days Facebook event in November 2018. The event focused on service members and veterans who use tobacco products, including regular cigarettes, e-cigarettes, and smokeless tobacco. Facebook posts offered encouragement and tools to help participants quit using tobacco products and stay tobacco-free. As part of this event, DoD and OSH experts provided practical advice and information on quitting tobacco use.
Preventing Binge Drinking
Excessive alcohol use contributes to 88,000 deaths in the United States each year, including 1 in 10 deaths among working-age adults. Binge drinking (at least 5 drinks on an occasion for males or 4 drinks on an occasion for females) is responsible for over half of these deaths. Binge drinking is also related to a variety of health and social problems, including alcohol-impaired driving, violence, and unintended pregnancy.
Drinking too much lowers service members’ military readiness by impairing cognitive and motor function, including response time, decision making, and other critical combat skills, as well as workplace productivity. A 2013 report from the Institute of Medicine found that excessive alcohol use among service members “adversely affect[s] military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense.”
Binge drinking among service members increased from 35% in 1998 to 47% in 2008, according to DoD health behavior surveys. Another study found that, in 2005, 43% of service members reported past-month binge drinking. About 29% of this group also reported one or more alcohol-attributable problems related to their job performance in the past year, including being drunk while working.
The Community Preventive Services Task ForceExternal recommends the following measures to reduce excessive alcohol use and related harms in communities:
- Regulating the density of alcohol outlets.
- Increasing alcohol taxes.
- Having commercial host (dram shop) liability laws.
- Enforcing laws preventing alcohol sales to minors.
- Electronic screening and brief intervention for excessive alcohol use.
Connecting Military Communities With State and Local Public Health Resources
DNPAO and OSH are collaborating with DoD (Personnel and Readiness), the National Guard Bureau, and the National Association for Chronic Disease Directors to support DoD’s Total Force Fitness (TFF) framework. One TFF initiative is Building Healthy Military Communities (BHMC), which is working to coordinate and integrate DoD, federal, state, regional, and local efforts in support of service members and their families in seven states.
In October 2018, DNPAO and OSH provided funding to the National Association for Chronic Disease Directors to:
- Connect military communities in BHMC pilot states with local and state support to prevent chronic disease associated with poor nutrition, lack of physical activity, obesity, and tobacco use.
- Identify opportunities to implement strategies that can help prevent health risk behaviors among service members and their families.