Publications
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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| Report to the Committees on Armed Services of the Senate and House of Representatives. (July 2020). Section 748 of the National Defense Authorization Act for Fiscal Year 2020 (Public Law 116-92) Initial Report on Millennium Cohort Study Relating to Women of the Armed Forces | ||
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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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| The Effect of Combat Exposure on Financial Problems | International Review of Economics and Finance | 2022 May | doi: 10.1016/j.iref.2022.02.042 |
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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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| 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: 10.1016/j.lana.2024.100802 |
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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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| 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 |
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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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| 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 |
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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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| Chronic Multisymptom Illness: A Comparison of Iraq and Afghanistan Deployers with 1991 Gulf War Veterans | American Journal of Epidemiology | 2014;180(12):1176-1187 |
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Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD These data highlight a difference in CMI reporting when comparing deployed to non-deployed military members. While symptom reporting in this contemporary Cohort occurred less frequently than in the historical 1991 GW cohort, increased CMI reporting was noted among deployed compared to non-deployed contemporary Cohort members. |
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| Longitudinal Associations Among PTSD, Disordered Eating, and Weight Gain in Military Men and Women | American Journal of Epidemiology | 2016 Jul 1;184(1):33-47 |
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Mitchell KS, Porter B, Boyko EJ, Field AE This study examined longitudinal associations between PTSD, disordered eating, and weight change in Millennium Cohort data from U.S. military Service members who completed the baseline survey and first and second follow-up surveys. The association between PTSD and weight change from time 2 to time 3 was partially mediated by disordered eating symptoms measured at time 2, specifically compensatory behaviors (vomiting, laxative use, fasting, over-exercise). In stratified models, the association between PTSD and weight gain via compensatory behaviors was significant for men and for non-Hispanic white participants only. Results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military Service members. |
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| A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure | American Journal of Epidemiology | 15 December 2017;186(12):1310–1318. |
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Donoho CJ, Bonanno GA, Porter B, Kearney L, Powell TM Using survey data collected at four different time points over a 10-year study period, four distinct patterns of PTSD symptoms were observed among deployed personnel. More than 85% of participants were found to be resilient with almost no PTSD symptoms. Despite similarity in pre-deployment symptoms, those experiencing combat-related trauma had higher PTSD symptom levels following deployment across every trajectory compared with those not exposed to combat-related trauma. These findings suggest the clinical course of PTSD symptoms has a heterogeneous pattern of development, but that combat exposure is uniformly associated with poorer mental health. |
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| New-Onset Asthma and Combat Deployment: Findings from the Millennium Cohort Study | American Journal of Epidemiology | 2018 Oct 1;187(10):2136-2144 |
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Rivera AC, Powell TM, Boyko EJ, Lee RU, Faix DJ, Luxton DD, and Rull RP New-onset asthma developed in 2.7% of men and 4.6% of women during the follow-up period, among participants without a prior diagnosis of asthma at baseline. Compared with those who did not deploy, those who deployed with combat experience were 24-30% more likely to develop asthma, even after controlling for smoking status and other covariates. No elevated risk was observed for deployers who did not experience combat. Additional risk factors for asthma among both men and women included Hispanic ethnicity, overweight or obesity, Army service, stressful life events, PTSD, and health care or other technical occupations. |
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| When Epidemiology Meets the Internet: Web-Based Surveys in the Millennium Cohort Study | American Journal of Epidemiology | 2007 Nov;166(11):1345-54 |
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Smith B, Smith TC, Gray GC, Ryan MAK, for the Millennium Cohort Study Team Optimal use of the Internet - with minimal response bias, maximum cost-savings, and improved data - is highlighted. |
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