Publications

The following manuscripts have been published or are currently in press. Listings are in chronological order, unless otherwise noted.

Research Publication 2
Title Publication Date/Location
Racial, Ethnic, and Sex Disparities in Mental Health Among U.S. Service Members and Veterans: Findings from the Millennium Cohort Study American Journal of Epidemiology 2024 Feb 5 | doi: 10.1093/aje/kwad221

Sharifian N, Kolaja CA, LeardMann CA, Castañeda SF, Carey FR, Seay JS, Carlton KN, Rull RP, Millennium Cohort Study Team

Racial, ethnic, and sex disparities in mental health among service members and veterans persist, even after accounting for sociodemographic, military, health-related and social support factors. Despite increased availability to care among military populations, culturally relevant and targeted outreach are still needed to address these disparities.

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Epidemiology of Inflammatory Bowel Disease Among Participants of the Millennium Cohort: Incidence, Deployment-Related Risk Factors, and Antecedent Episodes of Infectious Gastroenteritis Alimentary Pharmacology & Therapeutics 2017 Apr;45(8):1115-1127

Porter CK, Welsh M, Riddle MS, Nieh C, BoykoEJ, Gackstetter GD, Hooper TI

This study describes the incidence of and risk factors for two pathotypes of inflammable bowel disease (IBD), Crohn’s Disease (CD) and ulcerative colitis (UC) among Millennium Cohort Study participants using survey responses as well as data from post-deployment health assessments and medical encounters in the Military Health System. We observed that CD risk predictors included current smoking, two life stressors (vs. none), and prior irritable bowel syndrome. For UC, a dose-response relationship between the risk of UC and an increasing number of life stressors was observed. Antecedent infectious gastroenteritis was associated with an almost three-fold increase in risk in UC, but was not associated with CD. Stressful conditions along with infectious gastroenteritis are usual features of any deployment operation and may play a role in the development of IBD. However, observed differences in risk factors for UC and CD warrant further investigation.

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Smokeless Tobacco Use Related to Military Deployment, Cigarettes, and Mental Health Symptoms in a Large, Prospective Cohort Study Among US Service Members Addiction 2012 May;107(5):983-994

Hermes ED, Wells TS, Smith B, Boyko EJ, Gackstetter GD, Miller SC, Smith TC, for the Millennium Cohort Study Team

Chronic use of smokeless tobacco has been linked to poor military training performance, early discharge, and a host of medical problems from cancer to heart disease. Smokeless tobacco initiation occurred in 1.9% and persistent use in 8.9% of Millennium Cohort participants. The study showed that deployment, combat exposure, smoking, and symptoms of posttraumatic stress disorder increased the risk for smokeless tobacco initiation, while deployment and combat exposure increased the risk for persistent use.

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Prospective Comparison of Risk Factors for Firearm Suicide and Non-Firearm Suicide in a Large Population-Based Cohort of Current and Former US Service Members: Findings from the Millennium Cohort Study The Lancet Regional Health – Americas 2024 August | doi.org/10.1016/j.lana.2024.100802

LeardMann CA, Sharifian N, Warner S, Boyko EJ, Boparai SK, Powell TM, Rull RP, Reger MA, Hoge CW, for the Millennium Cohort Study Team

In this prospective study of over 200,000 US current and former service members, risk factors were similar between firearm and non-firearm suicides. Suicide prevention and intervention strategies may benefit those at risk and may not need to be differentiated by specific demographic, military, or health factors.

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The Effect of Combat Exposure on Financial Problems International Review of Economics and Finance 2022 May | doi: 10.1016/j.iref.2022.02.042

Ackerman A, Porter, B

This paper examined whether combat exposure led to new-onset financial problems and financial stress among 64,508 veterans using 2001-2016 data from the Millennium Cohort Study. The average predicted probability of developing a new major financial problem (such as bankruptcy) and greater financial stress increased 0.44% (21% relative to the mean probability) following a single combat exposure and increased 0.90% (43% relative to the mean probability) following multiple combat exposures. The likelihood of financial decline resulting from combat exposure were greater for veterans with poorer pre-deployment mental or physical health, veterans in enlisted ranks, and younger veterans between the ages of 26 and 36. These results translate to a crude cost estimate of lost productivity of at least $41 million and up to 3,629 bankruptcies for the 2.7 million veterans (1.34 per 1,000) deployed from 2001 through 2016.

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Report to the Committees on Armed Services of the Senate and House of Representatives. (July 2020). Section 748 of the National Defense Authorization Actfor Fiscal Year 2020 (Public Law 116-92)Initial Report on Millennium Cohort Study Relating to Women of the Armed Forces

This report is in response to the section 748 of the National Defense Authorization Act (NOAA) for Fiscal Year (FY) 2020 (Public Law 116-92) requirement for the Secretary of Defense to submit a report on "Millennium Cohort Study Relating to Women Members of the Armed Forces" to the Committees on Armed Services of the Senate and the House of Representatives, within 180 days of enactment and annual reports thereafter through January 31, 2022. This initial report describes findings of the Millennium Cohort Study relating to the gynecological and perinatal health of women members of the Armed Forces

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