Using various machine learning algorithms, patterns in response to prior surveys among Millennium Cohort Study participants improved the ability to predict future response to a follow-up survey.

Between 2001 and 2016, approximately 2% of 49,323 post-9/11 era Veterans experienced homelessness after military separation. Notable risk factors for homelessness in this population included identifying as non-Hispanic Black, identifying as gay, lesbian, or bisexual, not having a college degree, enlisted pay grade, or receiving a general or other than honorable discharge status.

Previous history of deployment, female sex, and Hispanic ethnicity were protective for mortality, while combat exposure, enlisted rank, being in the Army, and health factors (e.g., stressful life events, smoking, alcohol use) were risk factors for mortality among OEF/OIF/OND service members and veterans over a 20 year period.

The risk of traumatic brain injury (TBI) was higher among service members in deployment settings compared to those in nondeployment settings. Risk reduction strategies and education are needed to reduce the occurrence of TBI based on deployment status and history.

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.

Among 4,953 active-duty naval personnel who completed the 2014-2016 Millennium Cohort survey, sleep metrics (e.g., fatigue, short sleep duration) and sleep-related health outcomes (e.g., PTSD, depression) were similar between sailors with recent sea and shore duty, while sailors with recent shore duty had poorer physical health (e.g., type 2 diabetes, bodily pain) compared with those with recent sea duty.

TBI was associated with greater risk of post-concussive symptoms (e.g., fatigue, poor concentration, memory loss) among active-duty service members with risk being greater as number of lifetime TBIs increased.

Veterans with probable PTSD were more likely to use Veterans Health Administration (VHA) services than veterans without probable PTSD. Among these veterans with probable PTSD, those with recent VHA use were more likely to have reported seeking care for PTSD compared to those who did not use VHA services in the past year.

Given the prevalence of problematic anger and its association with adverse outcomes, it is vital to develop a very brief measure that can be easily included in research and clinical contexts. Using data from two large military samples with current and former service members in Australia and the US, this study reported on a newly developed 3-item Dimensions of Anger Reactions (DAR-3) scale. The DAR-3 assesses anger intensity, frequency, and duration. Results were consistent across the samples in terms of the scales reliability, validity, and cut-off score. The DAR-3 has practical utility for military and veteran populations.

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.

Experiencing recent sexual trauma was associated with PTSD, depression, and multiple somatic symptoms (e.g. physical complaints, bodily distress). These associations remained relatively stable across demographic and military factors but varied in the presence of protective (e.g., social support) and risk factors (e.g., childhood trauma). These findings underscore the complex interplay of trauma and resilience in understanding adverse health outcomes.

Across a 3-15 year follow-up period, the average response rate among almost 198,833 Millennium Cohort Study participants was 60%. Factors associated with follow-up survey response over time included increased educational attainment, married status, female sex, older age, military deployment, greater life stress, and poorer mental/physical health status.

This paper provides an update to the original cohort profile paper published a decade ago. The Study includes 260,228 military personnel enrolled across 5 panels between 2001 and 2021 (baseline age range: 25-35 years), where participants are surveyed every 3-5 years through 2068. Longitudinal survey data are linked to administrative and medical data from DoD, VA, and external sources. The breadth of research topics has expanded over the past decade with the continued aim of contributing to policies and programs that improve service member and Veteran health and wellbeing.

This study examined whether single and repeated high-level blast exposure (e.g., from incoming munitions) and low-level blast exposure (e.g., from outgoing munitions) were associated with 45 different self-reported diagnoses of illness and injury. Outcomes examined included PTSD, depression, hearing loss, tinnitus, chronic fatigue syndrome, and migraines. Findings suggest that blast exposure elevated risks for more than 20 different diagnoses and that repeated exposure was associated with worse outcomes.

U.S. military and veteran populations are challenging to retain in longitudinal studies as they span the globe, frequently move, and are heavily surveyed. This study tested the effectiveness of multiple pre-incentives ($2 bill, $5 gift card, magnet, and Apple iPad lottery entry) on increasing the response rate to the 2014 survey of the Millennium Cohort Study. Findings suggest that providing participants a monetary pre-incentive was an effective way to increase response rates and participant retention as well as re-engage participants who did not respond to a previous follow-up survey.

In a sample of male Marines (n=3,881), five subgroups based on adverse childhood experiences were identified. One in five Marines reported moderate to elevated levels of childhood adversity. A history of varying types of childhood adversity characterized by parental absence was associated with greater PTSD and depression symptomology and lower levels of social support. When attempting to identify Marines most at-risk for mental health concerns, the identification of specific patterns of childhood adversity, particularly regarding parental absence, may be more valuable.

Post-trauma insomnia contributed to the development of depression and PTSD among women service members and veterans; screening for insomnia may help mitigate the development of posttraumatic mental health conditions.

This longitudinal study used data from the Millennium Cohort Study (2001-2018) to examine risk and protective factors for cancer mortality among service members and veterans. Compared with those who deployed without combat experiences, non-deployers were more likely to die from cancer, consistent with the healthy deployer effect.

Study findings indicate a bi-directional relationship between the development of sleep disorders and PTSD. Military-related factors associated with new onset PTSD or sleep disorders, such as combat deployment, recent military separation, and rank, should be considered in prevention efforts for sleep disorders and PTSD.

This study examined whether differences in mental, physical, and behavioral health exist by sexual orientation among active duty and Reserve/National Guard service members and veterans (N=96,930). Lesbian, gay, and bisexual (LGB) individuals (3.6% of the sample) were more likely to screen positive for post-traumatic stress disorder, depression, anxiety, binge eating, problematic anger, multiple somatic symptoms, and insomnia than heterosexual individuals. LGB women reported more adverse health outcomes (overweight and obesity, smoking, problem/risky drinking) than heterosexual women. Gay and bisexual men reported some adverse health outcomes (e.g., smoking and problem drinking) but better physical health (e.g., less overweight/obesity) than heterosexual men. These results suggest that LGB service members experience health disparities, despite many having equal eligibility for health care, highlighting the need for improved equity initiatives that promote cultural responsiveness, acceptance, and approaches to support the healthcare needs of LGB military members.