2022 Army Health of the Force report continues focus on impact of COVID-19, substance abuse, female Soldier-unique health needs

By Douglas Holl, Defense Centers for Public Health-Aberdeen Public AffairsJune 8, 2023

2022 Army Health of the Force report continues focus on impact of COVID-19, substance abuse, female Soldier-unique health needs
The Defense Centers for Public Health – Aberdeen recently released the eighth annual Health of the Force (HOF). The HOF makes Soldier health and readiness information accessible to a wide array of stakeholders, including military medical professionals, Soldiers, and the larger community (Defense Centers for Public Health-Aberdeen graphic illustration by Jason Embry) (Photo Credit: Courtesy) VIEW ORIGINAL

ABERDEEN PROVING GROUND, Md. – The Defense Centers for Public Health – Aberdeen recently released the eighth annual Health of the Force (HOF). The report focuses on Active Component Soldiers and presents Army-wide and installation-level data for more than 20 medical, wellness, and environmental indicators.

“The 2022 Health of the Force report was produced by a talented team of subject matter experts from a wide variety of disciplines within Defense Centers for Public Health – Aberdeen,” said Shaina Zobel, HOF product manager. “This diverse team consisted of epidemiologists, health scientists, environmental scientists, entomologists, graphic designers, editors, and public health communicators and were advised by an internal steering committee as well as external partners throughout the Public Health Enterprise.”

The report benefits Soldiers by examining what determines medical readiness, characterizing environmental exposures, underscoring the importance of wellness domains, and empowering leaders with the necessary data to advance programs and strategies that improve performance and reduce illness and injury, said Zobel.

The 2022 HOF report continues the discussion on the unique health needs of female Soldiers and introduces a focus on potential disparities in substance use among sexual minority Soldiers.

“More work is needed to draw definitive conclusions, but data highlight a potential issue about the need for all Soldiers, including sexual minorities, to have equitable access to resources and treatment,” said Dr. Erin Anderson Goodell, HOF editor-in-chief.

The report highlights several findings around the COVID-19 pandemic’s impact on Soldiers, including enlisted Soldiers reporting higher rates of COVID-19 compared to officers and warrant officers. According to the report, the relationship between rank and COVID-19 incidence was consistent, even within Soldiers of the same age group, race and ethnicity. The differences in rates of COVID-19 among rank groups were largest among Soldiers under 35.

“One of the main differences between enlisted Soldiers and officers that may explain the disparities in COVID-19 incidence is the requirement for unmarried, junior enlisted Soldiers to live in barracks,” said Anderson Goodell. “These communal living spaces may make social distancing difficult. Another explanation may be that younger Soldiers have more training requirements than senior-ranking Soldiers, and in training environments, the likelihood of transmission may be increased because of close contact and, again, limited opportunity for social distancing.”

The report also makes some recommendations for limiting transmission or spread of airborne viruses like SARS-CoV-2.

“One of the highlighted recommendations for reducing transmission is focusing closely on air quality, since the SARS-CoV-2 virus is primarily spread through respiratory droplets from person to person,” said Anderson Goodell. “Strategies include ventilation and air filtration of indoor spaces and monitoring of CO2 levels, since high levels indicate poor ventilation. Focusing on air quality in addition to continuing to utilize other prevention methods like vaccination, masking and distancing can help minimize transmission of COVID-19.”

Soldier behavioral health was another focus of this year’s report, which found behavioral health diagnoses were higher among female Soldiers relative to male Soldiers in all age and race categories. According to the HOF report, more than a quarter of female Soldiers had a behavioral health diagnosis, compared to 15 percent of male Soldiers. For adjustment disorder, anxiety disorder and mood disorder, the proportions of affected female Soldiers was double that of male Soldiers. The one exception where the prevalence of male Soldiers exceeded female Soldiers was for substance use disorder.

“Behavioral health disorder diagnoses increased in 2021 compared to 2020, which may be the result of Soldiers seeking care following limited access to behavioral health care during the first year of the COVID-19 pandemic,” said Dr. Lisa Ruth, HOF program manager. “This increase in diagnoses may also have impacted the number of temporary behavioral health-related profiles. Early identification and treatment of behavioral health concerns among Soldiers can reduce the risk of experiencing negative outcomes and elements of decreased readiness.”

One of the HOF report’s vignettes recommends the benefits of nonclinical support services, including community-based counseling, spiritual support and psycho-educational training to address behavioral health issues.

“These services are beneficial for addressing personal and social life challenges and stressors that service members may be experiencing,” said Anderson Goodell. “Such services can also help curb the chance that general distress develops into a behavioral health syndrome and reduce some of the burden that is currently being experienced by overextended behavioral health clinical service providers.”

Also spotlighted in the report were leader recommendations related to food insecurity experienced by some service members and their families.

“According to recent surveys, almost one-quarter of active-duty service members and spouses may experience food insecurity,” said Ruth. “With that in mind, recommendations for leaders include being aware of service members and families who may be struggling, and helping them identify resources related to healthy food availability and affordability, such as the Supplemental Nutrition Assistance Program (SNAP); Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); Army Community Service; and local civilian food pantry offerings.”

Looking ahead to next year’s report, the HOF’s focus will expand to include the other Services.

“The Health of the Force team is excited to expand the scope of reporting to also include Air Force, Navy, and Marine Corps service member data,” said Zobel. “Metrics and spotlight narratives are being developed that will identify strengths and challenges in the Joint Force and will support efforts to reduce disparities and optimize health promotion.”

The calendar year 2021 data from the 2022 Health of the Force report will be available on the complementary online data platform, HOF Online, later this summer. Users will be able to dynamically display health outcomes, compare populations, and examine trends in data over time.

Read the 2022 Health of the Force report here.

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