153075 Temporal changes in U.S. Army disability rates, benefits and reasons for discharge from 1980 to 2005

Tuesday, November 6, 2007: 9:00 AM

Carolyn E. Schwartz, ScD , Social Sectors Development Strategies, Concord, MA
Tom Harford, PhD , Social and Behavioral Sciences, Boston University School of Public Health, Portsmouth, NH
Ilyssa Hollander, MPH , SSDS, Inc, Boston, MA
Paul J. Amoroso, MD, MPH , Madigan Army Medical Center, Tacoma, WA
Nicole Bell, ScD , SSDS, Inc, Boston, MA
Objective: Disability is a growing problem among U.S. military and civilian populations. We evaluated the relative contribution of changes in the Army's demographic composition to observed increases in disability discharges and compensation patterns. Methods: Time-series and logistic regression models were used to study 108,617 active-duty Army Soldiers discharged with permanent disabilities between 1980 and 2005. Overall disability rates and disability disposition compensation patterns were evaluated. Disposition compensation is based upon both the proportion of the disabling condition resulting from, or aggravated by, active-duty military service, and military tenure. Results: While the number of Soldiers discharged from the Army declined over the study period, the rate of permanent disabilities increased. Factors associated with disability discharge include female gender, minority race, younger age, and shorter tenure (Time Trend=-0.008, -0.003, -0.003, -0.022, respectively). Most prevalent causes of disability were musculoskeletal (70%), neurological (6%), mental health (5%), cardiovascular (4%), and respiratory conditions (4%). Factors associated with receipt of greater benefits include older age (OR range 1.10-2.18), Hispanic ethnicity (OR=1.22), having completed some college education (OR=1.27), median intelligence (1.08), higher-rank (OR range 1.51-2.38), and Soldiers with longer tenure (OR=1.25). Risk factors for receiving fewer benefits include male gender (OR=0.90), African-American race (OR=0.91), unmarried (OR range=0.81-0.95), and more recent disability discharge date (OR=0.94). Soldiers discharged with musculoskeletal and mental health disorders also received fewer benefits, whereas Soldiers with cardiovascular and neurological conditions received more benefits (OR=0.85, 0.22, 2.06, 1.32, respectively). Conclusions: Demographic changes in the Army may partially explain patterns of disability discharge and compensation.

Learning Objectives:
1. Describe how changes in demographic characteristics of Army Soldiers have affected rates of disability discharges. 2. Describe the most prevalent causes of disability discharges from the Army. 3. Articulate how different demographic and medical factors relate to the benefits assigned to a Soldier upon disability discharge.

Keywords: Disability, Risk Factors

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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