Assessing the Health Readiness of Air National Guard Members

Assessing the Health Readiness of Air National Guard Members: Results from Air National Guard Respondents to the HRBS

DoD Health Related Behaviors Survey for reserve component service members

Weight and Sleep Issues

• 67.0% were overweight or obese, according to body mass index
• 50.8% met age-appropriate sleep quantity requirements
• 13.4% were moderately or severely bothered by sleep-related lack of energy
• 5.3% took sleep medications to help them sleep at least three times weekly

Substance Use

Alcohol, Tobacco, Illicit Drugs, and Prescription Drugs

• 24.9% had engaged in binge drinking in the past 30 days (five or more drinks for men or four or more for women on one occasion)
• 4.9% were heavy drinkers (binge drinking at least one or two days a week in the past 30 days)
• 20.3% viewed military culture as supportive of drinking
• 25.0% reported any current tobacco or nicotine use
• 8.8% were current cigarette smokers
• 9.3% were current smokeless tobacco users
• 8.0% were current e-cigarette users
• 0.6% reported illicit drug use (mostly marijuana or synthetic cannabis) in the past 12 months
• 0.7% reported prescription drug misuse in the past 12 months (use without a prescription or use in greater amounts, more frequently, or for longer than prescribed)

Mental and Emotional Health

• 2.9% met criteria for serious psychological distress in the past 30 days
• 5.4% met criteria for serious psychological distress in the past 12 months
• 5.9% met criteria for probable posttraumatic stress disorder (PTSD) in the past 30 days
• 2.8% had thought about attempting suicide in the past 12 months
• 0.3% reported a suicide attempt in the past 12 months
• 3.1% needed mental health services in the past 12 months but did not receive them
• 15.9% reported mental health service use in the past 12 months
• 31.2% said that seeking military mental health treatment damages one's military career

Physical Health and Functional Limitations

• 32.0% reported one or more chronic medical conditions (e.g., high blood pressure) in the past 12 months
• 15.3% reported that pain (including headaches) had bothered them a lot over the past 30 days
• 3.0% screened positive for mild traumatic brain injury

Sexual Behavior and Health

• 11.7% had more than one sexual partner in the past 12 months
• 28.8% had sex with a new partner without using a condom in the past 12 months
• 2.1% reported contracting a sexually transmitted infection in the past 12 months
• 13.7% were at high risk for human immunodeficiency virus (HIV)
• 19.1% of those not expecting or trying to conceive a child did not use birth control during their most recent vaginal sex in the past 12 months
• 1.5% reported having or causing an unintended pregnancy in the past 12 months

Sexual Orientation, Identity, and Health

3.8% identified as lesbian, gay, or bisexual (LGB)

Significantly greater percentages of LGB personnel than non-LGB personnel reported serious psychological distress and probable PTSD ; suicidal thoughts and attempts; binge and heavy drinking; cigarette, e-cigarette, and smokeless tobacco use; illicit drug use; unwanted sexual contact;* and having been physically assaulted. These results are not specific to the Air National Guard.

* Unwanted sexual contact in the HRBS is a broader construct than sexual assault, and these survey responses do not represent official reports of sexual assault.

Deployment Experiences and Health

67.1% reported at least one prior combat or noncombat deployment

Among those who had ever deployed:

• 76.2% reported at least one lifetime combat deployment
• 21.0% reported past exposure to combat trauma (e.g., knowing someone wounded in combat)
• 40.8% reported a deployment in the past 12 months

The Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense's (DoD's) flagship survey for understanding the health, health-related behaviors, and well-being of service members.

• The HRBS allows leadership to better understand the health-related readiness of the force.
• The HRBS is used to facilitate benchmarking in combination with Healthy People benchmarks (designed for the general U.S. population).
• Results are weighted to represent the 2018 reserve component.

Comparison with the U.S. General Population

Air National Guard members reported health and health behaviors that were comparable to the general population in some areas but that were concerning in others.

Air National Guard members were comparable to the general population and Healthy People 2020 goals for body weight. Their rate of binge drinking was also comparable to the general population and the Healthy People 2020 goal, while their rate of heavy drinking was less than that of the general population. Their average amount of sleep was below Healthy People 2020 goals.

Higher percentages of Air National Guard members than of the general population reported any current tobacco and nicotine use, as well as use of e-cigarettes and smokeless tobacco. Air National Guard members did not meet the Healthy People 2020 goal for smokeless tobacco use, but their rate of cigarette smoking did meet the Healthy People 2020 goal and was below the general population rate.

Psychological distress was about as prevalent among Air National Guard members as it is among the general population. Probable PTSD was more prevalent among Air National Guard members than the general population, while suicidal ideation and attempts were less prevalent.

Development of military-appropriate population benchmarks, especially by service branch, could facilitate goal-setting, command visibility, and incremental improvements in health-related readiness.

Limitations

A low overall response rate (16.6 percent for the Air National Guard and 9.4 percent across all services) suggests that the results should be interpreted with caution and in conjunction with other existing data. Use of targeted incentives, modules administered to subsets of respondents, or a service member panel survey could help improve response rates and representation. The above comparisons with the general adult population do not control for demographic differences between the two populations.

Adapted from 2018 Department of Defense Health Related Behaviors Survey (HRBS): Results for the Reserve Component, by Sarah O. Meadows, Charles C. Engel, Rebecca L. Collins, Robin L. Beckman, Joshua Breslau, Erika Litvin Bloom, Michael Stephen Dunbar, Mary Lou Gilbert, David Grant, Jennifer Hawes-Dawson, Stephanie Brooks Holliday, Sarah MacCarthy, Eric R. Pedersen, Michael W. Robbins, Adam J. Rose, Jamie Ryan, Terry L. Schell, and Molly M. Simmons, Santa Monica, Calif.: RAND Corporation, RR-4228-OSD, 2021. The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. For the complete report detailing these and other findings, visit www.rand.org/t/RR4228.

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