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Assessing Fitness for Military Enlistment: Physical, Medical, and Mental Health Standards
Injuries and Attrition
Two recommendations concern reducing injury and attrition: (1) develop a standardized fitness test for use in the recruiting process and (2) tailor the demands of basic training to the fitness levels of recruits. Recommendations aimed primarily at reducing attrition involve obtaining better information about recruits’ mental health status via the use of a brief self-report of mental symptoms at the military entrance processing station, accompanied by a brief mental status exam by a physician.
Increasing the Pool of Eligible Youth
Three recommendations concern increasing the proportion of the youth population eligible for entry into military service: (1) do not use BMI as a proxy for fitness, (2) do not use a BMI standard for retention that is more stringent than a BMI standard for entry, and (3) do not require documentation or further medical reviews for self-reported mood and anxiety disorders that occur before the 13th birthday.
Developing Databases and Procedures
Five recommendations concern developing databases and administrative procedures to permit a broader and more probing inquiry into the relationship between standards and outcomes than is possible in light of data available today: (1) maintain data from the medical history form completed by recruits at the recruiting station, (2) develop a common core of physical strength and fitness measures across the Services, (3) collect data permitting the linkage between medical standards and outcomes, (4) increase the specificity of the single mental health item on the medical history prescreen administered at the military entrance processing station, and (5) collect and retain mental health data from recruitment through length of service.
Identifying Needed Research
Six recommendations concern substantive research studies needed prior to recommending changes in a current standard or in implementing a new one: (1) analyze the physical requirements of the set of common military tasks across military occupational specialties to obtain a clearer picture of the physical demands of these tasks, (2) study prebasic training fitness interventions to determine whether they are a viable and cost-effective route to reduced injury and attrition, (3) examine the causes of increased injury and attrition in women, (4) compare attrition rates of