Veterans leaving military service face many challenges transitioning back to civilian life. More than a quarter of veterans report struggling with the return to civilian life, according a Pew Research Poll. Some challenges are psychological; a considerable body of research has linked veteran status with mental health concerns. Other challenges, however, can be physical. Civilian life lacks the structure and routine of the military, making it hard to maintain fitness goals.
For those on active duty, the military maintains high standards for physical conditioning. Being a civilian myself, I was curious about those standards, so I looked up the physical fitness test for three of the five branches of the Armed Forces. The Naval Physical Readiness Test (PRT) consists of push-ups, curl-ups (sit-ups) and a 1.5-mile run. The Army just recently piloted a new set of physical conditioning exercises, replacing their old Army Readiness Fitness Test, which resembles the Navy’s PRT. The Army’s new physical assessments were meant to better mirror job functions. The Air Force employs two tiers: one intended to reduce health risks and promote an overall fitness culture within the Air Force and another to ensure (link [PDF]) are intended to ensure that Airmen are ready for physically demanding jobs. The former is similar to the Navy and Army’s, while the latter is quite extensive and involves a lot of swimming!
The goal of all of these physical standards is, obviously, to ensure a fit military population as well as combat readiness. It serves another purpose though: keeping down rates of obesity and other important cardiovascular disease (CVD) risk factors. Active duty men and women have much lower rates of obesity (but higher overweight) and metabolic syndrome than the general US population. Active duty members in the Air Force have significantly lower rates of dyslipidemia and diabetes.
What, then, happens when the military service is over? Does it impart long-term health benefits, even for those who can’t maintain the high levels of conditioning during civilian life? Do the CVD risk reductions experienced during active duty carry over to civilian life?
An article published ahead-of-print last week in Medical Care suggests that it does not. Two CVD risk factors, obesity and hypertension, were found to be much higher among veterans than in the general population, suggesting no long-term protective effect of military service. Diabetes prevalence was similar to that of the general population. Although, as the authors note, there are differences in the comparisons of veterans and the general population that are hard to control for.
The study, conducted by Dr. Sally G. Haskell and colleagues, included 267,305 veterans whose date of last deployment was between 2001 and 2014. They used electronic health record data from the Veterans Health Administration to identify newly diagnosed hypertension, obesity, dyslipidemia, and diabetes.
There are nuances to the results: women veterans were less likely to develop risk factors, save for obesity, than their male counterparts. The rate of developing at least one risk factor (or coronary artery disease) was 240 and 151 per 1000 person-years for men and women veterans, respectively. Race also played a role: Black/African American women veterans had higher rates of hypertension and obesity than white women veterans.
This study draws attention to a population that could use attention as they return to civilian life. Let’s honor our troops — and ourselves — by engaging in some physical activity!