The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.
| Title | Publication | Date/Location |
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| Hearing Loss Associated with US Military Combat Deployment | Noise and Health | 2015 Jan-Feb; 74(17): 34-42 |
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Wells TS, Seelig AD, Ryan MAK, Jones JM, Hooper TI, Jacobson IG, Boyko EJ This study investigated hearing loss among Service members and Veterans. New-onset hearing loss was associated with combat deployment. Among those who had deployed, new-onset hearing loss was also associated with proximity to improvised explosive devices and experiencing a combat-related head injury. These findings have implications for health care and disability planning, as well as for prevention programs. |
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| Post-Traumatic Stress Disorder Predicts Future Weight Change in the Millennium Cohort Study | Obesity | 2015 Apr;23(4):886-92 |
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LeardMann CA, Woodall KA, Littman AJ, Jacobson IG, Boyko EJ, Smith B, Wells TS, Crum-Cianflone NF Data from Millennium Cohort Study participants (2001-2008), consisting of US Service members and Veterans, were used to prospectively examine the association between posttraumatic stress disorder (PTSD) and weight change. A significant and consistent association of PTSD with subsequent three-year weight gain and the development of obesity was found in adjusted models. Given these findings, weight gain and development of obesity should be considered important comorbidities for PTSD; existing screening and treatment programs should make sure to address these associated conditions. |
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| Obesity and Associated Adverse Health Outcomes Among US Military Members: Findings from the Millennium Cohort Study | Obesity | 2016 Jul;24(7):1582-1589 |
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Rush T, LeardMann CA, Crum-Cianflone NF This study examined body weight among Service members and Veterans over time (2001-2007), finding a doubling of the prevalence of obesity. Obesity rates were significantly higher among veterans, including among those recently discharged from service. The study found that military personnel, even during service time, experienced weight gain and the development of obesity. Individuals with obesity had higher rates of adverse physical, mental, and functional health, suggesting that weight control should be a DoD and national priority. |
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| Association of deployment with maintenance of healthy weight among active duty service members in the Millennium Cohort Study | Obesity Science and Practice | 2022 Apr;8(2):247-253 |
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Carey FR, Jacobson IG, Roenfeldt KA, Rull RP Understanding changes in weight in relation to deployment readiness can inform Department of Defense fitness policies. This study examined longitudinal associations between deployment and service branch-specific changes in body mass index (BMI) among active duty participants without obesity (BMI< 30kg/m2) at baseline (n=22,995). Service members, particularly Army and Marine Corps personnel, with longer deployments were less likely to maintain a healthy weight (BMI < 30) than those with shorter deployment lengths. Conversely, each additional deployment increased the likelihood of maintaining a healthy weight post-deployment for personnel in the Army, Marine Corps, and within the pooled population. These results indicate that multiple deployments may support healthy weight maintenance and longer deployments may adversely impact weight maintenance. Fitness policies designed to optimize service member readiness should consider modifiable behaviors related to weight gain among those who are deployed for long periods of time. |
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| The Impact of Prior Deployment Experience on Civilian Employment After Military Service | Occupational and Environmental Medicine | 2013; 70: 408-417 |
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Horton JL, Jacobson IG, Wong CA, Wells TS, Boyko EJ, Smith B, Ryan MA, and Smith TC Employment after military service, in particular after stressful deployment experiences, is a concern for many veterans and policymakers. Among this large cohort of veterans, we found that prior deployment and PTSD were not significantly associated with job status post-service; in contrast, depression, panic/anxiety disorder, and poor physical health increased the risk of unemployment among certain groups. These findings may guide policy for veterans most in need of post-military employment support. |
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| Mental Health, Physical Health, and Health-Related Behaviors of U.S. Army Special Forces | PLOS One | 2020 Jun 3;15(6):e023356 |
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Cooper AD, Warner SG, Rivera AC, Rull RP, Adler AB, Faix DJ, Neff RR, Deagle EA, Caserta RJ, LeardMann CA, for the Millennium Cohort Study Team Using prospective data, Army Special Forces personnel and Ranger Qualified infantrymen reported fewer mental health problems, multiple somatic symptoms, and unhealthy behaviors than General Purpose Forces infantrymen. Findings indicate that the adoption of healthy behaviors, such as adequate sleep and physical activity, may be an efficient and cost-effective approach for preventing adverse health outcomes, regardless of occupational specialization or prior health status. |
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| Cigarette smoking patterns among U.S. military service members before and after separation from the military | PLoS One | 2021 Oct 4;16(10):e0257539 |
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Nieh C, Mancuso JD, Powell TM, Welsh MM, Gackstetter GD, Hooper TI. Millennium Cohort Study data were used to examine smoking behavior at enrollment into the study and through their first follow-up survey, approximately 3 years later. Time remaining in service from baseline until separation or the first follow-up survey was the main exposure of interest. The baseline prevalence of smoking in the Cohort was higher among those who eventually separated (20.1%) than among those who remained on active service (17.4%), but the overall prevalence of current smokers significantly declined over the observation period. Factors significantly associated with greater likelihood of smoking at follow-up were baseline smoking, non-White Hispanic individuals, being non-married, enlisted rank, underweight or healthy BMI, active duty component, any alcohol consumption, experiencing two or more stressful life events, and screening positive for either PTSD or depression. Including smoking prevention and/or cessation programs in pre-separation counseling sessions and developing smoking screening and cessation programs targeting high-risk subgroups may reduce smoking among Service members and veterans. |
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| Combat exposure and behavioral health in U.S. Army Special Forces | PLoS One | 2022 Jun 28 | doi: 10.1371/journal.pone.0270515 |
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Rivera AC, LeardMann CA, Rull RP, Cooper A, Warner S, Faix D, Deagle E, Neff R, Caserta R, Adler AB, Millennium Cohort Study Team In this cross-sectional study using Millennium Cohort Study data, various types of combat, such as combat severity, fighting, threat to oneself, and killing noncombatants, were consistently associated with mental health disorders, trouble sleeping, and problem drinking among all three Army occupational specialization investigated (General Purpose Forces infantrymen, Ranger Qualified infantrymen, and Special Forces personnel). However, with few exceptions, Special Forces personnel and Ranger Qualified infantrymen had lower prevalence of these adverse outcomes. Findings suggest that even elite personnel may be negatively impacted by experiencing combat, thus trainings and interventions focused on moral conflict reasoning and resolution may help to mitigate some of these adverse behavioral outcomes. |
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| The relative impact of injury and deployment on mental and physical quality of life among military service members | PLoS One | 2022 Sep 29 | doi: 10.1371/journal.pone.0274973 |
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Kolaja CA, Castañeda SF, Woodruff SI, Rull RP, Armenta RF Deployment and injury status was associated with poorer mental and physical quality of life (QOL) with clinically significant decreases in physical QOL observed for those who deployed and were injured, either in battle or nonbattle settings, compared with uninjured deployers. |
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| Early Mortality Experience in a Large Military Cohort and a Comparison of Data Sources Used for Mortality Ascertainment | Population Health Metrics | 2010 May;8(1):15 |
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Hooper TI, Gackstetter GD, LeardMann CA, Boyko EJ, Pearse LA, Smith B, Amoroso PA, Smith TC, for the Millennium Cohort Study Team This study assessed the ability of four different mortality data sources to document the early mortality experience of the Cohort. The strengths and limitations of each data source are described and support continued use of multiple sources for future mortality assessment. |
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