The Millennium Cohort Study: The first 20 years of research dedicated to understanding the long-term health of US Service Members and Veterans

Belding, Jennifer N.; Castañeda, Sheila F.; Jacobson, Isabel G.; LeardMann, Cynthia A.; Porter, Ben; Powell, Teresa M.; Kolaja, Claire A.; Seelig, Amber D.; Matsuno, Rayna K.; Carey, Felicia R.; Rivera, Anna C.; Trone, Daniel W.; Sheppard, Beverly; Walstrom, Jennifer L.; Boyko, Edward J.; Rull, Rudolph P.

doi:10.1016/j.annepidem.2021.12.002

Cited by 24 publications

(14 citation statements)

References 134 publications

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“…The Millennium Cohort Study is the largest and longest-running prospective health study of members of the U.S. Armed Forces ( 24 , 25 ) and was designed to investigate the long-term effects of military service on service member and veteran health ( 25 ). Thorough descriptions of the Study are available elsewhere ( 26 , 27 ).…”

Section: Methodsmentioning

confidence: 99%

Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation

Belding

Kolaja²,

Rull³

et al. 2023

Front. Neurol.

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IntroductionAlthough previous research suggests that overpressure exposure from either high-level blast (HLB) or low-level blast (LLB) are harmful to health, to date no large-scale studies with representative samples of military personnel have utilized prospective designs and self-reported measures to examine the relationships between blast exposure and health conditions. To address these limitations, this analysis of data from the Millennium Cohort Study (MCS), the largest and longest running study of U.S. service members and veterans, examined (1) whether single or repeated HLB exposure is associated with self-reported diagnoses of illness and injury, (2) whether repeated HLB is associated with greater risk than single HLB, (3) potential adverse consequences of LLB exposure using military occupation as a proxy, and (4) the combined effects of single or repeated HLB and LLB exposure.MethodMCS participants who completed the 2011–2013 survey (N = 138,949) were classified as having been exposed to “no,” “single,” or “repeated” HLB exposure, and into low or high risk of exposure to LLB based on occupation. Participants self-reported diagnosis of 45 medical conditions; newly reported diagnoses were regressed on single and repeated (vs. no) HLB, occupational risk of LLB, and relevant interactions using logistic regression.ResultsSingle and repeated HLB were associated with new onset of 25 and 29 diagnoses, respectively; repeated HLB exposure was associated with greater risk than single HLB exposure for five diagnoses (e.g., PTSD, depression). Occupational risk of LLB was associated with 11 diagnoses (e.g., PTSD, significant hearing loss). Additionally, 14 significant interactions were detected across 11 diagnoses.DiscussionFindings suggest that overpressure exposure (including single HLB, repeated HLB, and occupational risk of LLB) may increase the risks of self-reporting clinical diagnoses of PTSD, hearing loss, chronic fatigue syndrome, neuropathy-caused reduced sensation in the hands and feet, depression, vision loss, sinusitis, reflux, and anemia. Furthermore, the combination of HLB and LLB exposure may be associated with greater risk of migraines, PTSD, and impaired fecundity. These findings provide further evidence of the potential adverse consequences associated with overpressure exposure and underscore the necessity of public health surveillance initiatives for blast exposure and/or safety recommendations for training and operational environments.

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Section: Methodsmentioning

confidence: 99%

Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation

Belding

Kolaja²,

Rull³

et al. 2023

Front. Neurol.

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“…Data were drawn from the Millennium Cohort Study, the largest and longest running prospective cohort study of U.S. service members and veterans. Between 2001 and 2013, 4 separate cohorts of service members (referred to as “panels”) were randomly selected from active military rosters and invited to enroll in the Millennium Cohort Study, with over-sampling of certain subgroups such as women and reservists ( 18 ). A total of 201,619 participants completed a baseline survey at the time of enrollment and additional follow-up surveys every 3 to 5 years thereafter (waves).…”

Section: Methodsmentioning

confidence: 99%

Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)

Sharifian

Carey

Seay

et al. 2023

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Prior research linking military factors with cancer-specific mortality has shown inconsistent findings, with few studies examining these associations among United States service members and veterans who served in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) conflicts. Methods: Cancer mortality between 2001-2018 was ascertained from the Department of Defense Medical Mortality Registry and National Death Index for 194,689 Millennium Cohort Study participants. Cause-specific Cox proportional hazard models were used to examine links between military characteristics and cancer mortality [overall, early (<45 years), and lung]. Results: Compared with individuals who deployed with no combat experiences, non-deployers had a greater risk of overall (HR=1.34, 95% CI=1.01, 1.77) and early cancer mortality (HR=1.80, 95% CI=1.06, 3.04). Enlisted individuals had a greater risk of lung cancer mortality compared with officers (HR=2.65, 95% CI=1.27, 5.53). No associations by service component, branch, or military occupation and cancer mortality were observed. Higher education was associated with reduced overall, early and lung cancer mortality risk and smoking and life stressors were associated with elevated overall and lung cancer mortality risk. Conclusions: These findings are consistent with the healthy deployer effect in which military personnel who were deployed tend to be healthier than those who did not deploy. Further, these findings highlight the importance of considering socioeconomic factors, such as military rank, that may have long-term implications for health. Impact: These findings highlight military occupational factors that may predict long-term health outcomes. Additional work is necessary to investigate more nuanced environmental and occupational military exposures and cancer mortality.

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“…The initial panel was selected from the entire military, whereas subsequent panels were selected from new accessions (Chesbrough et al, 2002; Ryan et al, 2007). Each panel was selected to ensure adequate sample size to examine differences among underrepresented populations in the military (e.g., females, Marines) or characteristics of interest (e.g., 1998–2000 deployments, married); a complete list of oversampled groups are published elsewhere (Belding et al, 2021). This analysis examined 23,887 active duty service members enrolled in the Millennium Cohort Study who completed a survey within a year of separating from the military and entering civilian life (i.e., not transitioning to the Reserves or National Guard).…”

Section: Methodsmentioning

confidence: 99%

A temporal analysis of mental health symptoms relative to separation from the military

Porter

Carey

Roenfeldt

et al. 2022

Depression and Anxiety

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Background: The transition from military to civilian life is a dramatic change that is often stressful for veterans. However, little is known regarding how mental health symptoms fluctuate in the period leading up to and following separation from the military.Methods: The current study examined posttraumatic stress disorder and depression symptoms reported on surveys completed within 1 year of military separation from 23,887 active duty Millennium Cohort Study participants. A series of general linear models and graphs stratified by demographic and military characteristics examined the association between time until/since separation and mental health symptoms.Results: Character of discharge had the most striking relationship between time until/since separation and mental health. Personnel with Honorable discharges did not differ in their level of mental health symptoms across the study period. In contrast, personnel with Other than Honorable/General discharges reported normal levels of mental health symptoms 1 year-prior to separation but reported progressively greater symptoms leading to separation which persisted through the remainder of study period.Conclusions: This study suggests that additional outreach is needed for personnel with Other than Honorable/General discharges. However, for most other personnel, increased mental health symptomatology around military separation is not a normative phenomenon and any instance should be treated promptly.

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The Millennium Cohort Study: The first 20 years of research dedicated to understanding the long-term health of US Service Members and Veterans

Cited by 24 publications

References 134 publications

Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation

Single and repeated high-level blast, low-level blast, and new-onset self-reported health conditions in the U.S. Millennium Cohort Study: An exploratory investigation

Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)

A temporal analysis of mental health symptoms relative to separation from the military

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