Spatiotemporal Trends in Vision Impairment, Hearing Loss, and Executive Dysfunction Among Active Duty Military Personnel, United States, 2015-2019

Abstract

ABSTRACT Introduction Non-Department of Defense (DoD)-curated health surveillance data on military personnel is limited and that which is generated by sources other than the DoD is rarely analyzed for the purposes of disseminating intelligence about health trends in this population. The purpose of this study was to determine spatiotemporal variations in the prevalence of certain conditions (i.e., hearing loss, vision impairment, and executive dysfunction) among active duty and National Guard/Reserve (NGR) military personnel. Materials and Methods We obtained person-level data from the 2015–2019 United States Census Bureau’s American Community Survey on active duty military personnel (N = 44,503) and NGRs (N = 146,488). We estimated survey-weighted logistic regression models to determine spatiotemporal differences in hearing loss, vision impairment, and executive dysfunction. Results Results showed that when aggregated across time and stratified by military service status, hearing loss was most prevalent (1.71%, 95% CI = 1.55, 1.89), followed by executive dysfunction (1.48%, 95% CI = 1.34, 1.64) and vision impairment (0.65%, 95% CI = 0.55, 0.77), among active duty service members. Among the NGR sample, hearing loss was most prevalent (9.99%, 95% CI = 9.80, 10.18), followed by executive dysfunction (5.35%, 95% CI = 5.20, 5.50) and vision impairment (3.43%, 95% CI = 3.31, 3.55). Overall, disability rates were higher among individuals in the NGR than among those on active duty. Results showed that risk for the aforementioned disabilities varied between 2015 and 2019 and was dependent on the rural location of the respondent’s residence. Specifically, limiting condition prevalence increased from 2015 to 2019 for all types—except for hearing loss among NGRs—among active duty members and NGRs living in rural areas. Conclusions Proper surveillance, education, treatment/rehabilitation, and prevention are essential components of mitigating these impairments to help assure the health, wellness, and combat readiness of our military personnel. Recommendations for future military health surveillance activities and health care services are provided.