The Changing Profile of Disability in the U.S. Army-A Study: Costs, Seeking Causes, and Hoping to Positively Impact Change
Caroff, Maria, The Exceptional Parent
Disability in both the military and civilian communities is growing more costly, with billions of dollars spent annually in both communities. The costs are felt not only financially, with dollars spent on healthcare, the loss of trained and expert personnel, and lost income, but in a variety of other ways, including reduced ability to engage fully in day-to-day activities and subsequent overall decreased quality of life. A research group has undertaken a study of disability in the United States Army, funded by a grant from the U.S. Army Medical Research and Materiel Command. This first of five planned studies has been published in Disability and Health Journal, January 2008. The group analyzed disability data spanning 25 years, from 1981-2005. Excerpts of the study appear here, followed by an interview EP conducted with Dr. Nicole Bell, a co-author of the study. A full copy of the report can be found at the Disability and Health Journal Web site (http://www.disabilityandhealthjnl.com).
Background: We sought to provide a profile of U.S. Army soldiers discharged with a permanent disability and to clarify whether underlying demographic changes explain increasing risks.
Results: Disability risk has increased seven-fold over the past 25 years. In 2005, there were 1,262 disability discharges per 100,000 active-duty soldiers. Risk factors include female gender, lower rank, married or formerly married, high school education or less, and age 40 or younger. Army population demographics changed during this time; the average age and tenure of soldiers increased, and the proportion of soldiers who were officers, women, and college educated grew. Adjusting for these demographic changes did not explain the rapidly increasing risk of disability. Time-series models revealed that disability among women is increasing independently of the increasing number of women in the Army; disability is also increasing at a faster pace for younger, lower-ranked, enlisted, and shorter-tenured soldiers.
Conclusion: Disability is costly and growing in the Army. Temporal changes in underlying Army population demographics do not explain overall disability increases. Disability is increasing most rapidly among female, junior enlisted, and younger soldiers.
Between 1981 and 2002, the number of active-duty Army personnel fell by 37 percent as part of an overall downsizing effort. At the same time, soldiers reported poorer physical and mental health and increased levels of stress, depression, anxiety, and occupational stress compared with their civilian peers; these factors may be associated with increased risk for subsequent disability.
DoD (Department of Defense) Directive 1332.18 and 10 U.S. Code, Ch. 61 outline the requirements and procedures for separations due to a physical disability with the primary requirement being that the soldier must be unfit to carry out duties of his or her rank, office, or grade due to a physically disabling condition that substantially limits or precludes fulfillment of the purpose of their active-duty employment.
Causes or major types of disability are defined in the Veterans Administration Schedule for Rating Disabilities (VASRD). They fall into the following categories: musculoskeletal conditions; neurological conditions; mental health disorders; cardiovascular conditions; respiratory conditions; endocrine disorders; digestive conditions; diseases of the eye; skin disorders; genitourinary conditions; infectious diseases, immune disorders, and nutritional disease; hemic and lymphatic disorders; diseases of the ear; diseases of other sensory organs; gynecological conditions; and dental and oral conditions.
Musculoskeletal-related disability is the fastest growing category of disability, increasing from 70 per 100,000 in 1981 to 950 per 100,000 by 2005.
Disability discharge risks are 7 times higher today than they were 25 years ago. …