Assessing Fitness for Military Enlistment Physical, Medical, and Mental Health Standards (2006) / Chapter Skim
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8 Summary Conclusions and Recommendations
8 Summary Conclusions and Recommendations
Pages 177-196
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From page 177... ...
Note that each Service has it own BMI standards. The second is at the military entrance processing stations (MEPS)
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From page 178... ...
Physical Demands of Military Service Studies show that technology is increasing the physical demands of some jobs and decreasing the demands of others. This leads to the question of whether it is feasible or advisable to set differing physical and medical standards for different military occupational specialties (MOSs)
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From page 179... ...
While the research we recommend would provide a scientific underpinning for specifying the physical requirements for combat-readiness, the current annual fitness testing standards serve as the Services' current operational definition of the physical requirements of military service. We note that the use of different fitness measures by the Services makes it difficult to assess fitness across the Services.
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From page 180... ...
Conclusion: Application of the cost trade-off model requires valid data on enlistee health and fitness throughout the tour of duty, as well as the ability to link health and fitness measures to such outcomes as lost work time and attrition. This requires ready access to and linkage between health and personnel databases.
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From page 181... ...
Individual Factors, Training Demands, and Injury and Attrition Musculoskeletal Injury Research has identified several risk factors for musculoskeletal injury, including individual characteristics, physical demands, and psychosocial demands. Individual characteristics include age, gender, race, physical structure, previous injury, previous physical activity, and physical fitness.
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From page 182... ...
, and changes in basic training protocols (e.g., modification of physical training during basic military training) that would provide important benefits.
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From page 183... ...
The psychosocial environment thus merits consideration in designing interventions aimed at reducing musculoskeletal injury. Gender and Musculoskeletal Injury Since the injury rates of female recruits in basic training are higher than those for male recruits, time lost from training for these injuries is also higher, and attrition rates are higher, consideration should be given to designing different training regimens for women.
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From page 184... ...
Conclusion: Although training outcomes are the result of several interrelated factors, preliminary, direct evidence suggests that imposing limited physical demands at entry to military training and increasing physical training demands as fitness levels increase could produce comparable levels of physical fitness to current training regimes, with markedly reduced injury rates. This approach should be considered when redesigning basic training.
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From page 185... ...
The committee reviewed research examining the relationship between BMI and a direct fitness measure and injuries. Although there is a systematic relationship between fitness and injury for both men and women, there is virtually no relationship between BMI and injury rates for men, and the small relationship observed for women reflects a slightly higher injury rate for low BMI (i.e., very lean)
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From page 186... ...
That research is generally pessimistic about the prospects for long-term weight reduction. Although a relatively small number of individuals with high motivation and high self-control can lose weight and retain that weight loss through diet and high levels of physical activity, such results are not the norm, and research has not identified programs that have a high likelihood of success for achieving long-term substantial, sustainable weight loss.
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From page 187... ...
Currently, asthma at any level of severity precludes participation in the military without a waiver. Available data indicate little difference after basic training between military personnel with and without asthma.
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From page 188... ...
. Mental Health Enlistment Standards DoD has recently revised the mental health disorders that are causes for rejection for enlistment into the military service.
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From page 189... ...
The current DoD fitness standards exclude any individual who has a history of a mood disorder, including depression, who received outpatient treatment for longer than six months from a physician or mental health professional. The committee's determination of a reasonable cutoff was based on clinical evidence from the civilian youth population.
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From page 190... ...
after the age of 13, anxiety disorders after the age of 13, exposure to trauma, attention deficit hyperactivity disorder with medication treatment in the past year, schizophrenia and psychotic disorders, and hospitalization for mental illness care. A positive response to this screening question would require open ended amplification regarding the specific diagnosis.
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From page 191... ...
These data should be ob tained for all Services and should create an accurate picture of the impact of mental illness on military personnel from recruitment through separation, with a particular focus on the outcome of recruits who request and receive mental illness waivers for specific diagnoses, as well as the rates and diagnoses leading to attrition during training and active duty. Further studies using complete data sets should be designed to determine whether there are any differences in retention and performance between recruits with and without a history of psychiatric disorders, such as depression and anxiety disorders.
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From page 192... ...
On one hand, it is not clear whether these elevated rates would justify changes in the waiver policy; the longer persons stay in the Service past 12 months (the maximum length of most training periods) , the more likely they are to repay the initial training investment.
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From page 193... ...
Additional research found that recruits who required some form of enlistment waiver were approximately 1.5 times more likely than their counterparts without a waiver to have smoked before entering military service. A subsequent Air Force study found that preservice smokers were approximately 1.8 times more likely to be discharged during the first year of service than were nonsmokers.
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From page 194... ...
Smoking before entry is associated with injury during basic training, probably arising from its adverse effects on numerous physiological characteristics. Studies across the Services show elevated attrition rates for smokers, although the degree of elevation differs appreciably among the Services, perhaps due to different definitions of the frequency and quantity of smoking.
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From page 195... ...
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.
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From page 196... ...
Due to the prevalence of asthma, the committee carefully reviewed the literature on the relationship between asthma and outcomes of interest to the Services and concluded that the current standard and waiver process are appropriate. The committee concluded its earlier study of the role of youth attitudes toward the military and of aptitude and educational standards by noting that recruiting is a complex process, with no single route toward achieving recruiting goals.
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