4

Military Life Opportunities and Challenges

To build a clearer picture of military families and gain insights into both their strengths and their needs, in this chapter we build on Chapter 3 by examining the real-life experiences of active and reserve component military personnel and their families. By highlighting the opportunities and challenges of military life at different stages of service and for different subgroups, this chapter offers insights into how major and minor life stressors accumulate and converge to wear down service members and their families, as well as insights into features that mitigate their impact or help provide a safety net, such as a sense of community and opportunities for personal and professional growth.

This chapter is not intended to be a complete listing of all of the major opportunities and challenges of military life. The sponsor of this study will be familiar with these general topics, since understanding what attracts individuals to military service, what supports or impedes performance and deployability, and why personnel leave the military are all key to managing the all-volunteer force. Nevertheless, the challenges highlighted here are likely experienced and managed quite differently by today’s military families compared to those who served as recently as 2000.

Military families encounter opportunities and challenges in life, just like any family does, and the life-course of military families is similar to the life-course of their civilian counterparts. However, some experiences are particular to military life or are experienced differently because of the military context in which they occur. Moreover, there is great variability in military experiences across individuals and families.

An extensive body of research has emerged since the terrorist attacks of September 11, 2001 (9/11), which raises questions as to whether and how the experiences of service members and their families have changed with the times, and whether or how these experiences relate to family, such as well-being, resilience, readiness, and retention. Taken individually, the studies each face limitations such as: cross-sectional rather than longitudinal data, difficulties recruiting participations (particularly family members and junior enlisted personnel), relying on parents for insights about children, inability to weight samples to unknown characteristics, sample sizes that limit analyses of small subgroups, and restrictions on access to military populations, datasets, and findings not released to the public. As a body of research, however, considered alongside testimonials, news articles, and DoD-reported facts and figures, there are a number of prominent themes that emerge and questions they invite. The literature echoes most of the significant demands on military personnel and their families as well as influential societal trends that Segal (1986) described more than 30 years ago. However, in light of recent, rapid societal changes (discussed below) and ongoing military efforts to support service members and their families, we must continue to seek to understand how today’s families experience and respond to military life.

Recent research has paid particular attention to acute stressors that can be associated with military life, such as combat exposure, traumatic brain injury, family separations during deployment, and post-deployment family reintegration (see Chapters 5 and 6). There are also the daily and chronic stressors that can take a toll on individual or family well-being when they are experienced by particularly vulnerable populations or when they become cumulative, either through the same stressor chronically recurring or through multiple stressors occurring simultaneously. Military families must manage a wide range of stressors, of course, not just those that are particular to military life. At the same time, one should not overlook the aspects of military life that service members and their families may find attractive and beneficial.

This chapter highlights broad categories of opportunities and challenges of military life for active or reserve component¹ military personnel and their families. Several overarching themes frequently appear across reports that convey input from service members and spouses, whether that input is qualitative or quantitative, based on large or small samples, based on opportunity or probabilistic samples, or originate from inside or outside

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¹ As noted in Chapter 1, for the reserve component, the committee focuses on the Selected Reserves, which refers to the prioritized reserve personnel who typically drill and train one weekend a month and two additional weeks each year to prepare to support military operations.

of the Department of Defense (DoD). We chose to spotlight the following seven issue areas, which the chapter addresses in turn, because of their prominence and implications for family well-being:

1. Transition into the military
2. Pay and benefits
3. Geographic assignment and relocation
4. Deployments, sea duty, training away from home
5. National Guard and Reserve issues
6. Diversity and inclusion issues
7. Transition out of the military.

These issue areas are all interrelated: we call them out separately to better highlight their contributions or roles as military opportunities or stressors.

OPPORTUNITIES OR CHALLENGES?

In this chapter, the committee has not categorized events or features of military families’ lives according to whether they are opportunities or challenges, nor does it presume that all challenges are stressors, for these reasons:

• Some experiences could be opportunities, challenges, and stressors—such as job promotion.
• Circumstances may influence how one individual appraises an experience. For example, someone may be eager for a permanent change of station (mandatory moves known as PCS) and to move away from one assignment or town, but then be reluctant to have to move away from another.
• Different individuals have different preferences. For example, some personnel may welcome the opportunity to deploy multiple times, while others may prefer never to deploy.

Nevertheless, some aspects of military life are generally positive, such as opportunities to develop one’s skills and to receive steady pay and benefits; others may be generally negative, such as being passed over for promotion; and a few may be potentially catastrophic, such as a service-related permanent disability or the death of a loved one. Figure 4-1 depicts how challenges and opportunities, such as the examples discussed in this chapter, can contribute to or rely upon individual, family, and external resources, such as the ability to cope, social networks, and community organizations. That process can result in positive or negative well-being

and readiness outcomes. Managing challenges or opportunities can be an iterative process, one that involves multiple engagements with resources and potentially strengthens or drains resilience factors. These well-being and readiness outcomes can themselves contribute to new challenges or opportunities. This model builds upon a previously proposed Military Family Fitness model (discussed in detail in Bowles et al., 2015), and similarly provides illustrative examples rather than a complete listing in every category.

Military families, particularly those who choose to and are able to remain in the military, can be very adaptable and resilient and can develop healthy coping strategies for the stressors of military life such as moves and deployments (Easterbrooks et al., 2013; Meadows et al., 2016). Military families can develop their own norms and rhythms for the process of managing family separations or moves and for finding out about the right networks, programs, and services available for their particular needs. Children’s responses to the opportunities and strains of military family life are likely to depend on parental and family maturity and the individual child’s developmental stage, temperament, and social capacity. Based on individual differences within the same family, one child can thrive and another struggle.

The impact of the challenges and opportunities of military life can be shaped by the duration and timing of these events as well. For example, a deployment can be a short mission to transport equipment, supplies,

or personnel overseas and back, or it can require service members to live and operate in a combat zone for a year or longer. On the positive side, longer deployments can offer greater opportunities to hone leadership and occupational skills, enhance the ability to compete for promotion or key assignments, and increase service-member income through special pays and tax benefits. However, longer duration deployments can also increase service members’ exposure to hazardous environments (e.g., chemical, biological, climatic); present greater risk of war-related injury, death, or exposure to traumatic events; lengthen family separations; and cause service members to miss major milestones such as births and holidays. Individual family members are developing throughout their lives, and the timing of particular events relative to individual development may be consequential.

Early experiences can shape responses to later—sometimes much later—events (Wilmoth and London, 2013). For example, service members’ exposure to adverse events such as abuse or violence prior to joining the military can affect their likelihood of later post-traumatic stress disorder (PTSD) or suicide (Carroll et al., 2017). Military service typically begins during the transition to adulthood, with the possibility of enhancing or disrupting the trajectories of individuals’ later work and family lives. Service members’ military experiences may alter the career trajectories of their spouses or partners (Kleykamp, 2013). An individual could become a military spouse or partner well before their own careers have been established, or long afterward. That timing could result in differing processes for managing the demands of military life, differing levels of resilience resources, and differing types of need for support. Timing is particularly salient in childhood, when development happens so rapidly. For example, children’s experiences with relocations may affect later school performance (Lyle, 2006; Moeller et al., 2015). Effects of the content and timing of life experiences can cascade across developmental domains, such that early difficulties at school might lead to later difficulties in relationships with peers (Masten, 2013; Masten and Cicchetti, 2010).

These long-term effects of military experiences may be positive, as the “military-as-turning-point” perspective attests; they may be neutral; or they may be negative, as expressed in the “life-course disruption” perspective (Segal et al., 2015; Wilmoth and London, 2013). The impact of life events and transitions is conditioned by their characteristics, such as how expected, how abrupt, or how traumatic they are (Boss, 2002). In addition, both risks and resilience factors can accumulate to create mutually reinforcing ‘caravans’ that move together over time, accelerating positive or negative effects (Layne et al., 2014).

Timing also refers to the historical and social context of military service. MacLean and Elder (2007), for example, documented how the effects of military service varied substantially across conflicts during the 20th century,

as societal perceptions of those conflicts shifted. Historical changes in military compensation and educational benefits can also shape both the attractiveness and the consequences of military service. Attitudes of the public toward service members and their families can be powerful influences on the consequences of military service, leading to both positive consequences, such as special efforts to employ veterans, and negative ones, such as society’s failure to seek out military and veteran families as assets to their communities (MacLean and Elder, 2007).

THE CONTEXT OF MILITARY FAMILY LIFE: YESTERDAY VERSUS TODAY

The context of military service is dramatically different today from what it was when the all-volunteer force was designed. Today, U.S. forces increasingly serve in diverse missions, including combat, peacekeeping, disaster relief, public health and humanitarian efforts, and homeland security. Many missions, such as those that involve technology or long-term engagement with local populations overseas, require expert knowledge and advanced skills that take years to develop. Today’s armed forces prepare for and carry out missions not only in the air, on the land, and on the sea, but through space and cyberspace. Unlike during the Cold War era, today the military is focused not on a single main adversary but on ever-changing threats from state and nonstate actors around the globe. In addition, the National Guard and the Reserves have been called up like never before in our nation’s military history (Commission on the National Guard and Reserves, 2008).

As discussed in chapters 2 and 3, today’s military personnel and military families are more diverse than ever (DoD, 2017a; Hawkins et al., 2018). The proportions of military personnel who are women, who are dual-military couples, and who are racial and ethnic minorities have all grown. As of 2011, gay, lesbian, and bisexual service members have been allowed to serve openly, and now dependent benefits extend to same-sex spouses. Occupations and units that had been closed to women have gradually opened, and by 2016 the policies that had excluded them from the remaining combat positions were lifted. Also, as discussed in Chapter 3, in 2016, the secretary of defense ended the ban on transgender service (DoD, 2015), which was reversed effective April 2019, with certain exemptions for those diagnosed with gender dysphoria after the ban was lifted (DoD, 2019). There is no ban on transgender military dependents, however, and these dependents have been increasingly seeking gender affirming care through the military health system since it became available in 2016 (Klein et al., 2019; Van Donge et al., 2019).

The number of military dependents continues to outnumber service members by increasingly large margins, and survey data suggest that there

are also significant numbers of unmarried partners of personnel in long-term relationships (see Chapter 3) (DoD, 2018). The younger generations have grown up with smartphones, computer tablets, ubiquitous Internet access, GPS-based location and mapping services, online search engines, and the use of social media to create and share content with others (e.g., Facebook, Twitter, Instagram, Snapchat, Reddit, YouTube). Another important development is that today’s military and veteran family populations are more likely than those of past wars to include individuals with physical and mental wounds and challenges, because service members who historically would have died of battlefield wounds, illnesses, or injuries have survived in recent wars due to advances in military medicine, in training, and in aeromedical evacuations.²

Geographic distribution has shifted as well. Today’s military families do not necessarily live near other military families or installation-based support services. Instead, they live across communities that are more geographically dispersed, rather than being concentrated in specific neighborhoods, as the active component has shifted from living primarily on military installations to living primarily off-installation (DoD, 2017a). Some families do live in regions with a greater concentration than average of military and veteran families, as noted in Chapter 3. One way in which active component military personnel have become less diverse is that they are increasingly likely to have come from the South and least likely to come from the Northeast (Maley and Hawkins, 2018). Recent analyses find that these regional differences are largely explained by differences in demographic characteristics, such as race, education, and religious adherence (Maley and Hawkins, 2018). Nevertheless, the armed forces still bring together individuals from diverse communities across the United States who work and sometimes live together but who are also immersed in nonmilitary communities.

The structure of DoD’s personnel system has important implications for service member and family retention and readiness. To compete with civilian job market opportunities and mitigate the impacts of the demands of military life, particularly post-9/11, support programs for military personnel and their families have grown enormously. However, decades of research continue to show that other one-size-fits-all legacy aspects of the military personnel system, such as the up-or-out policy of promotion, frequent relocation, lack of individual and family control over placements and timing, and the standardization of career pathways, can often negatively impact service members and their families; moreover, they can also increase the military’s expenses and limit its ability to develop, assign, and retain the optimal staffing for its needs (Carter et al., 2017; Task Force on Defense

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² For further details, see health.mil/Reference-Center/Publications/2016/09/01/Advances-in-Army-Medicine-since-9-11.

Personnel, 2017). Turnover is highest among women (DACOWITS, 2017) and among the junior ranks, where DoD has invested heavily in training and support but has not yet seen the yield of those costs (GAO, 2017).

The widespread access to the internet and the rise of social media and smartphone use can facilitate information sharing, communication with friends and loved ones, self-expression, education, access to services, social networking, mentoring, translation, job and housing searches, and staying in touch with “battle buddies” after moves and deployments. But these digital developments can also be new channels for deception, inappropriate content, misinformation, information overload, abuse and harassment (e.g., cyberbullying, revenge porn, trolling), and distractions from real-world obligations and face-to-face interactions. Additionally, for many members of the American public the news media is the primary or sole source of information about U.S. military members, veterans, and their families, and this in turn can contribute to stereotyping, both positive and negative (Kleykamp and Hipes, 2015; Parrott et al., 2018; Substance Abuse and Mental Health Services Administration, 2013).

The Pew Research Center estimates that U.S. internet use among adults has grown from 52 percent in 2000 to 89 percent in 2018 (Pew Research Center, 2018a). Social media use among adults has grown from 5 percent in 2005 (when Pew first began to collect estimates) to 69 percent in 2018 (Pew Research Center, 2018b). Smartphone ownership among adults rose from 35 percent in 2011 to 77 percent in 2018 (Pew Research Center, 2018c). Usage rates are even higher among younger adults; for example, 94 percent of those ages 18 to 29 had a smartphone in 2018, compared to 73 percent of adults ages 50 to 64 (Pew Research Center, 2018c).

Given these rapid changes over the past decade and a half—in military life, deployments, societal views, family arrangements, and digital access—to the extent possible we have relied in this study on the most recent literature, highlighting where there is still significant work to be done as well as where new developments may call for new strategies or new perspectives on perennial issues. We emphasize that many of the stressors of military life are not inevitable, inherent features, but policies that could be adapted to allow for greater flexibility for the preferences and needs of the diverse individuals and families DoD needs to attract and retain in order to meet the demands of the current and anticipated future national security environment.

TRANSITION INTO THE MILITARY

The military invests significant resources to attract quality recruits and transform them into disciplined and skilled military personnel. Most young Americans do not meet military recruitment standards because of their weight, drug or alcohol abuse, physical or mental health conditions,

criminal record, or other such issues. Among youths ages 17 to 24, only about 29 percent (9.6 million) meet all the core eligibility requirements and would be able to enlist without a waiver (JAMRS, 2016, p. 5). Narrowed further to youths who are not enrolled in college and able to score average or better on the Armed Forces Qualification Test, the pool drops to 13 percent of youths (4.4 million) (JAMRS, 2016, p. 5). That figure does not account for individuals’ interest in serving in the military or reflect that the military must compete with other organizations with similar employment criteria, such as law enforcement agencies, fire departments, and the Department of Homeland Security.

The estimated cost to recruit, screen, and train each new enlistee is approximately $75,000 (GAO, 2017). Rapid and successful adaptation to military life is key to military family readiness as well as to reducing attrition (failure to complete the first term of service) and increasing the retention of quality personnel beyond the first term of service. First terms of enlistment are typically 4 to 6 years long, but in fiscal year 2011 approximately 27 percent active component enlistees had separated from the military before they had completed 4 years of service, and close to 10 percent of new enlistees had attritted within just 6 months of service (GAO, 2017, p. 12). The recorded indicators of why service members attrite provide little insight, since the leading documented reason was the catch-all “unqualified for active duty, other” (GAO, 2017, p. 14).³

This section considers some of the benefits and challenges that new service members may encounter as they transition into the service and into their first duty stations. Prominent examples from the literature and other sources (e.g., testimonials) discussed here are summarized in Box 4-1. As noted earlier in this chapter, the committee does not sort issues into positive and negative categories, because characterization may depend upon the context and circumstances, the time at which they occur, individuals’ own vulnerabilities and interpretations, and other factors. Also, even positive changes can serve as stressors, and both positive and negative experiences can result in individual growth and enhanced resilience. The issues discussed in this section apply to both active and reserve component individuals, and many of them extend throughout the military life course.

For most service members, transitioning from civilian life into military service is typically simultaneous with the transition to adulthood (Kelty et al., 2010). Some military spouses and partners are also experiencing this transition. As discussed in Chapter 3, 40 percent of service members and

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³ Less common reasons for attrition, in order of occurrence (specific numbers not provided), were drug abuse; disability, severance pay; failure to meet weight or body fat standards; character or behavior disorder; temporary disability retirement; pregnancy; permanent disability retirement; fraudulent entry; and alcoholism (GAO, 2017, p. 14).

19 percent of military spouses are age 25 or younger (DoD, 2017c, pp. 8, 125). Military service often begins with geographic separation from friends and family, as service and occupational entry-level training typically take even members of the National Guard and Reserves away from their hometowns. After initial entry training, reserve component personnel may return to their hometowns and be able to put down roots, but geographic separation from friends and family will be an ongoing feature of military life for many service members.

Especially for those not raised in a military family, entering service can require quite an adjustment to elements of military life. Military jargon, acronyms, organization, culture, and rules and regulations may present a steep learning curve. The loss of a certain degree of privacy—not just of physical space but also potentially loss of privacy of health records if deemed a military necessity—may also require an adjustment.

Military service can also provide a range of intangible benefits. Service members and families alike may greatly enjoy a sense of belonging, a sense of community, camaraderie and esprit de corps. Of course, not everyone who values those qualities feels valued and fully included in their military community. Being ostracized, socially excluded, or otherwise rejected in a tight-knit community can be physically and psychologically painful; DoD policy prohibits such treatment but only when it takes the form of retaliation for reporting crimes (McGraw, 2016; Williams, 2007). In such environments, members may consider the risks of exclusion, ostracization, or other retaliation when

reporting misconduct or criminal behavior within the community, or revealing anything that may be stigmatized in that particular community.

New service members may be in a particularly vulnerable position in the organization given their relative unfamiliarity with the rules, regulations, and acceptable norms, and given the power imbalance between them and authority figures who have significant influence over their careers. This may put them at greater risk for abuse, such as sexual harassment or sexual assault (Davis et al., 2017) and hazing rituals (Office of Diversity Management and Equal Opportunity, 2017).

At the same time, it may not be long into a military career before a new service member gains the opportunity to hold a level of responsibility, authority, or power that someone their age and background might rarely experience in a civilian job. For example, recent college graduates (young military officers) can be sent to military operations or battlefields overseas, be held responsible for the lives of their charges, operate multimillion-dollar equipment, control weapons that could cause major loss of life and damage to infrastructure, and be expected to maintain the peace on the ground in an area of heightened tensions.

Related to the hierarchical structure of the organization and the stakes of military missions, the military forbids certain types of relationships. Fraternization refers to Service and DoD policies prohibiting certain relationships that can compromise or appear to compromise the chain of command. Although the term is often used to refer to romantic or sexual relationships, it can also refer to friendships, business partnerships, or other relationships that may indicate a supervisor or commander who is unable to be fair or impartial, who is using rank or position for personal gain or to take advantage of subordinates, or who would not have the ability to exert their authority properly. An example is officers who are too informal with and too often socialize with their subordinates outside of official settings and then find they cannot command effectively in military operations.

Military work can be challenging in both growth-enhancing and negative ways. Less desirable challenges include too-heavy work demands, particularly if they are seemingly relentless, are related to tasks that do not seem essential, or are perceived as being the consequence of poor leadership or organizational management. Examples might include long hours, understaffing, stressful work, or being frequently called away from home for temporary duty (TDY), training, unaccompanied tours, or deployments. As the next chapters will discuss further, traumatic military experiences can include participation in or exposure to combat or its aftermath, being taken a prisoner of war, and being physically or sexually abused, harassed, or assaulted by fellow DoD personnel or contractors.

Military service, awards, and promotions can become a source of pride. On the other end of the spectrum, disciplinary action can be a risk to well-being,

and family members may feel the brunt of the consequences economically or by reputation if their service member is confined, docked pay, demoted, required to perform additional duties, denied reenlistment, or discharged.

Officer and enlisted transitions into the military are not equivalent. Officers obtain a college degree prior to obtaining their commission, and thus on average are older and have a higher level of education. Poorer family well-being has been consistently correlated with lower rank (Hawkins et al., 2018, Key Findings, p. ES-8). In addition, there is evidence that enlisted ranks may be at higher risk of developing or reporting post-traumatic stress disorder (PTSD) (Hawkins et al., 2018, p. 31; Lester et al., 2010). Service members in the lower enlisted ranks and their spouses experience more isolation than officers and their families, and officers’ children have been reported to use more effective coping skills than those of lower-ranked parents (Hawkins et al., 2018, p. 4; Lucier-Greer et al., 2016). Not surprisingly, military families with lower incomes (such as those with members in the junior enlisted ranks) experience less financial stability and more strain than those with higher incomes. For married or partnered service members, unemployment or underemployment of nonmilitary spouses and disruption of their career progression are often by-products of aspects of the military lifestyle, and these consequences are further affected by a spouse’s gender and by the service member’s paygrade (Shiffer, et al., 2017).

PAY AND BENEFITS

Service members and their families can benefit from various levels of military pay, health care, housing or housing allowances, education and training (or financial assistance to support it), subsidized child care, and recreational activities, facilities, and discounts. Eligibility can vary by active and reserve component military status, as noted in the examples summarized in Box 4-2). More benefits are available to service members on active duty status, as they are full-time military personnel. Members of the active component and the Reserves always serve under federal control (Title 10), and that is true regardless of whether members of the Reserves are on active duty or reserve status. Members of the National Guard serve under federal control when they are called up for a federal mission, which could include being mobilized for war or providing domestic assistance during national emergencies. When not on Title 10 orders, however, National Guard members work for their states. Responding to natural disasters or accidents as well as homeland security missions could fall under either federal (Title 10) or state (Title 32) control.⁴

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⁴ For more information on National Guard domestic operations and authorities, see U.S. Departments of the Army and the Air Force (2008).

Because military service offers the promise of financial stability and upward mobility for many families, service members who come from lower socioeconomic backgrounds are over-represented in the forces (Kelty and Segal, 2013) and within the enlisted ranks, although they are by no means the only socioeconomic class of individuals to join the all-volunteer force. Military service offers opportunities for overcoming structural and cumulative disadvantage among those who have been raised in poorer families and communities and received low-quality education, including among racial and ethnic minority groups (Bennett and McDonald, 2013).

Youth from disadvantaged backgrounds often have relatively few options for accessing jobs that provide living wages and skill development

or higher education. Thus, military service offers the potential for socioeconomic advancement through competitive wages, educational achievement, including a pathway to college, housing, and health benefits (Bennett and McDonald, 2013, p. 138). In addition, service members have the flexibility to use their service to acquire needed training and skills for later entry into the civilian labor market or may stay in the military through retirement. Military employment opportunities can appeal to the middle class as well, for reasons such as the cost of financing a college education or vocational training, alternative entry-level employment for American youths looking for benefits and on-the-job training, and employment opportunities during economic downturns such as the Great Recession of 2008.

Pay

Among the major benefits of military service are steady earnings and employment for service members. For active duty service, those earnings include paid leave and pay when sick or off-duty recovering from injuries. Some personnel will qualify for bonuses or special pays based on the military’s need, their specialized skills, or their duty conditions (e.g., enlistment and re-enlistment bonuses, pays for critical skills, hazardous duty incentive pay, flight pay, family separation allowance, tax breaks).⁵ Increases in active and reserve component base pay correspond to increasing rank and years of service, regardless of age, gender, race, ethnicity, or sexual orientation. However, there is not proportional representation across ranks and occupations by gender, race, or ethnicity. We cannot determine representation across ranks and occupations in terms of lesbian, gay, bisexual, or transgender (LGBT) service members due to limited systematic data. In the past, the military’s pay structure has resulted in a significantly smaller, though still present, wage gap between African American and White service members (Booth and Segal, 2005).

Over time, there have been fluctuations in approved pay, incentives, and the design of the retirement system. One of the most significant recent changes is the new Blended Retirement System, which took effect January 1, 2018. This now provides options to the military’s legacy system, which had previously allowed only personnel who had served 20 years or more to receive retirement benefits, and those were in the form of monthly payments. The new system includes a Thrift Savings Plan (similar to a 401(k) retirement savings plan), a pay bonus for those who continue beyond 12 years of service, and an annuity payment calculated with a

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⁵ For military pay charts, see https://www.dfas.mil/militarymembers/payentitlements/PayTables.html.

2 percent multiplier (rather than 2.5% multiplier under the legacy system).⁶ The preferences of service members and their families, and the impact of their choices (e.g., lump sum instead of monthly payout, Thrift Savings Plan option), remain to be seen.

In periods of downsizing, service members can be incentivized to leave voluntarily before their term of service ends, or involuntarily “let go” even if they have not done anything wrong. So a military term of service is not without uncertainties; however, such unexpected discharges tend to be less common than in the civilian sector. Service members serve under a contract or commitment for length of service: although some young adults might find it daunting to make a 4- to 6-year commitment to a job and an employer, especially not knowing what it will be like, where they will be serving, or what their boss or co-workers will be like, others may find the job security reassuring.

Financial Stress and Food Insecurity

Although service members receive steady pay and benefits, they may still struggle financially. Varied sources of data, including the 2013 Status of Forces Survey of Active Duty Members, indicate that junior enlisted families with children are the most vulnerable to experiencing food insecurity, although systematic data on the proportion or characteristics of military families who are food insecure is limited (GAO, 2016). Analyses of nationally representative data on veterans have found that veterans serving during the all-volunteer era have had significantly higher odds of food insecurity when compared to either veterans serving during the previous era or to civilian households (Miller et al., 2016). There are 18 federal programs for food assistance, such as the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and free and reduced-lunch programs, all of which have different eligibility criteria and access points (GAO, 2016). Military personnel are not ineligible for these programs. In 2015, 24 percent of children in Department of Defense Education Activity (DoDEA) schools qualified for reduced lunch, and another 21 percent qualified for free lunch (GAO, 2016).

Due to limited systematic data from these benefit providers, DoD does not have a comprehensive picture of the extent to which service members need or use food assistance programs (GAO, 2016, p. 13). Nevertheless, the use of SNAP among service members, while hard to measure exactly,

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⁶ For an overview of the new system in a reader-friendly format, see https://militarypay.defense.gov/Portals/3/Documents/BlendedRetirementDocuments/A%20Guide%20to%20the%20Uniformed%20Services%20BRS%20December%202017.pdf.

indicates that food insecurity is significant. According to estimates from a 2013 Census Bureau survey, approximately 23,000 active duty service members utilized SNAP in the previous 12 months (GAO, 2016). London and Heflin (2015) examined SNAP use by active duty, veteran, and reservist participants in the American Community Survey from 2008 to 2012 and reported that use was low but “non-trivial” among the active duty respondents (2.2%), while use was 9 percent among surveyed reservists, and about 7 percent among veterans. More recently, service members on active duty spent over $21 million in food stamp benefits at military commissaries from September 2014 through August 2015 (GAO, 2016).

As is the case for people struggling financially in the civilian sector, service members and their families face both logistical challenges and stigma in seeking food assistance (GAO, 2016, p. 21). Specifically, military families may have limited awareness of assistance programs and may assume that they do not qualify or may fear being stigmatized for using the services.

Health Care

Particularly relevant to the well-being of military families is free military health care, a benefit that extends to service members and their legal dependents. The military health care system covers preventive care, maternity care, hospitalization, outpatient procedures, mental health care, prescription medications, catastrophic illnesses, and preexisting conditions. This system is discussed more thoroughly in subsequent chapters, but it may be worth noting here that critiques of it include long wait times, poor care quality, limited access to specialists, and limited access for members of the National Guard and Reserves who are not serving on Title 10 active duty orders.

Supplemental to the military mental health care system are confidential, short-term nonmedical counseling options, akin to employee assistance program offerings, that help families with issues such as coping with a loss, stress management, work-life balance, managing deployment issues, and parenting and relationship challenges. These options, available through Military OneSource and the Military and Family Life Counseling Program, have been positively rated by most participants; however, these limited sessions alone are not likely to be able to resolve complex or severe problems, and awareness of this benefit may be limited among military families (Trail et al., 2017).

Housing

For active component personnel, military service includes on-installation housing or a housing allowance adjusted to the local housing market and intended to cover the cost of housing in the local economy.

Military housing varies from installation to installation in terms of modernization, configuration, and location relative to other buildings, but regardless of this, housing options will vary based on personnel’s rank group and dependent status. DoD sets minimum configuration and privacy standards for housing, so that higher-ranking personnel have more space and more privacy than lower-ranking personnel. For example, all senior noncommissioned officers (NCOs) (pay grades E-7 to E-9), warrant officers, and commissioned officers unaccompanied by military dependents must have a private housing unit with a private bedroom, bathroom, kitchen, and living room; junior NCOs (pay grades E-5 to E-6) may live in a shared unit, but must have at least a private bedroom and a bathroom shared with not more than one other person; and junior enlisted personnel (E-1 to E-4) may live in a shared unit with a bedroom and bathroom shared with one other person (DoD, 2010, p. 25). Thus, junior enlisted and junior NCO housing may resemble shared college dormitory or shared apartment living, but even the most junior officers without dependents will have private housing.

Family housing on installations accommodates service members accompanied by dependents, and families are not required to share a unit with another family. DoD guidance is for commanders to make reasonable attempts, based on the inventory and need, to provide family housing that will allow each dependent to have a bedroom, or at least share it with no more than one other “unless the installation commander determines the bedroom is large enough to accommodate more” (DoD, 2010, p. 14). Generally, family housing is separate from unaccompanied housing, and unaccompanied housing units are grouped by whether they house junior enlisted members, NCOs, or officers.

Over the last several decades, there has been a major shift among active component personnel and their spouses and children, from living primarily on installations to living primarily off of them and not necessarily even living close to their assigned installations. This shift in residence offers benefits to service members, including greater privacy, greater opportunities for single service members to meet potential partners, opportunities to live with nonmarital partners or others of one’s choosing, more control over the choice of neighborhood and housing, and more choice over how the home is kept and decorated.

The downsides of this shift include a more dispersed military community, neighbors who may know little about the military or even be hostile to it, additional time taken out of every work day to commute and get through the morning line at the gate to the installation (and potentially the need for a car where one otherwise would not have existed), the possibility of choosing housing that is more expensive than one can responsibly afford, and greater challenges for leadership and service providers in identifying families that are isolated or in trouble.

Education and Training

In addition to entry-level, on-the-job, and more advanced occupational training, the military can support other types of service member education. The military service academies are highly competitive colleges that provide a full-time, 4-year college degree, plus room and board, educational expenses, and military and other training opportunities at no expense to the students or their families, in exchange for a minimum service commitment once the graduate is commissioned as a military officer. Under competitive Reserve Officer Training Corps (ROTC) scholarships, students receive full or partial scholarships for tuition, books, and fees at a civilian university, along with military training, in exchange for a minimum service commitment (also as an officer). Enlisted personnel are also able to compete to attend the academies or receive an ROTC scholarship.

The military also sponsors relevant graduate degrees for selected officers. Graduate degrees may help officers prepare for military careers. For example, the Uniformed Services University of the Health Sciences provides a tuition-free medical school education plus a salary of $64,000 or more for selected service members to pursue their degree and obtain leadership training, in exchange for an additional service commitment after graduation.⁷ Some officers may have opportunities to earn PhDs in graduate schooling sponsored by the military, but this is not the norm. More commonly, during the course of officers’ careers there are often opportunities to obtain military-sponsored master’s degrees at military graduate schools, such as the Air Force Institute of Technology, Marine Corps University, National Defense University, Naval Postgraduate School, and the U.S. Army War College, or occasionally at civilian institutions. Some families are geographically separated while officers attend graduate programs in-residence for a year, and then reunite through a permanent change of station (PCS) to the next duty station. For this reason, among others, graduate study can therefore be both an opportunity and a stressor.

As enlisted personnel move up the organizational hierarchy, professional military education helps prepare them for the leadership and management duties that noncommissioned officers must take on. As is the case for officers, these professional development opportunities for selected enlisted personnel will be paid for by the military. Enlisted personnel and officers alike may take advantage of Defense Voluntary Education benefits, including education counseling services, testing services, academic skills training, tuition assistance, and college credit exams. Through use of a Joint Services Transcript, they can also have their military training translated into

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⁷ See https://www.usuhs.edu/medschool/admissions.

equivalent civilian college credits. The 2008 Post-9/11 GI Bill⁸ offers service members postsecondary education tuition assistance, a living allowance, and related expenses, and personnel with a minimum number of years of service can transfer some or all of these benefits to a spouse or child(ren). In less than a decade, more than one million service members and veterans and more than 200,000 dependents utilized this benefit (Wenger et.al., 2017, p. xii).

Service members may take college classes on their own time, and enlisted personnel may earn an associate’s degree, bachelor’s degree, or license or certificate beyond their military training. Some civilian colleges and universities even offer courses located on military installations, and of course many schools today offer courses online, which can provide opportunities for military families that lack the transportation or travel time to attend school on-campus.

Local installations typically offer classes to service members, and in some cases their families, for recreation, well-being, or self-improvement. Examples from the wide range of class subjects include stress management, anger management, communication, time management, financial management and budgeting, auto repair and maintenance, scuba, arts and crafts, yoga, nutrition, healthy cooking, smoking cessation, disease management (e.g., asthma, diabetes), parenting, job search skills, and English as a second language.

Child Care

A key benefit of active component military service is access to quality affordable child care. As outlined in Chapter 3, the military is a young force with many young families. Indeed, the average age of the active component force is 28 years old (DoD, 2017c, p. iv). More than one-half of all active component members are married, and 43 percent of spouses are age 30 or younger. Nearly 41 percent of active component personnel have children; almost 38 percent of these children are age 5 or younger, and 69 percent are age 11 or younger.

DoD is the provider of the nation’s largest employer-sponsored child care system, serving approximately 180,000 children ranging in age from birth to age 12 (DoD, 2016a). More than 700 DoD child development centers and child care facilities are located across more than 230 installations worldwide (DoD 2017b, pp. 3–4).

In terms of both cost and quality, DoD’s child development program is viewed as a model of child care for the nation. The quality of DoD child care is upheld through national accreditation standards; 97 percent of DoD

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⁸ Title 38 U.S.C., Chapter 33, Sections 3301 to 3324 – Post-9/11 Educational Assistance.

child development centers are accredited (DoD, 2017b). More broadly, one report notes that, “Nationally, only 11 percent of child care establishments are accredited by the National Association for the Education of the Young Child or the National Association for Family Child Care” (Schulte and Durana, 2016). The affordability of DoD’s child development program for service members and their families is assured by appropriated funding. The National Defense Authorization Act (NDAA) of 1996 required that the amount appropriated by Congress for child development centers must equal or exceed what service members pay in fees. On average, these subsidies cover about 64 percent of the cost of military installation child care, which for each child includes 50 hours of care a week and two meals and two snacks per day, with all families paying some fees based on an income scale (Floyd and Phillips, 2013, p. 85). Free respite care provides a temporary break in caregiving to spouses whose service member is deployed overseas or to families with children with special needs.

However, civilian child care for infants and toddlers is costly, so demand for subsidized military child care for this age group is high and child care spaces are limited. In 2016, at 32 percent of installations the wait lists for child care exceeded 3 months—in particular, areas with large military populations and a high cost of living, such as San Diego (California), Hawaii, the Tidewater Region of Virginia, and the National Capitol Region (DoD, 2016b).

Limited access to child care and lengthy wait times are key concerns for many military families. In a 2017 Blue Star Families survey, 67 percent of military family respondents indicated they are not always able to obtain the childcare they need. The survey found that the top employment obstacles reported by military spouse respondents who wanted to be working but were not, were service member job demands (55%), child care (53%), and family commitments (43%), rather than lack of job skills or opportunities (Shiffer et al., 2017). Moreover, 67 percent of female service members and 33 percent of male service members reported they could not find child care that worked with their schedules (Shiffer et al., 2017). That finding was reinforced by focus groups that also emphasized the mismatch between the hours military child care is available and the needs of service women (DACOWITS, 2017). Although the survey and focus groups may not be representative samples, it is clear from these and numerous sources over recent decades that there is a high demand for more affordable, quality child care and that DoD’s capacity still has not yet been able to fully meet the need (DACOWITS, 2017; Hawkins et al., 2018; Huffman et al., 2017; Zellman et al., 2009).

By DoD’s own metrics, in fiscal year 2015 it was only able to meet 78 percent of the child care needs of military families, rather than its

goal of 80 percent, and was reaching into the civilian community to expand child care, as well as building new child care facilities while repairing or replacing aging ones (DoD 2017b, p. 5). Additionally, as part of a secretary of defense initiative, in 2016 installations began offering extended child care hours to better align with service member schedules. Some child development centers faced hurdles in recruiting and hiring providers, however, which Congress addressed in the fiscal year 2018 NDAA by modifying the hiring authorities (Kamarck, 2018). Time will tell how much headway these reforms will be able to contribute toward better meeting the child care needs of military families with children. DoD may need to increase its goal for how much of the child care need it aims to meet, although not all eligible parents of military children needing child care services will likely wish to use DoD’s.

Activities, Facilities, and Discounts

Other benefits of military service include free or low-cost recreational facilities, such as installation pools, fitness centers, movie theaters, golf courses and hobby shops; rental of outdoor equipment, such as kayaks, bikes, and camping gear; ticketing services for activities, such as concerts, festivals, amusement parks, and comedy shows; and free or discounted flight opportunities. Additionally, some businesses and organizations offer discounts to military personnel and their families, such as free or discounted admission to zoos, parks, and museums. Many of these benefits provide access to venues through which community and family bonds are built and reinforced, and the subsidies and discounts go far to keeping such activities affordable for military families.

DoD policy for Morale, Welfare and Recreation Programs specifically states that these offerings by DoD are an integral part of the military and benefits package, that they build healthy families and communities, and that their purpose is to maintain individual, family, and mission readiness (DoD, 2009). A 2018 GAO study, however, found that from 2012 to 2017 the Services had not been consistently meeting funding targets for some of these resources, and noted DoD recognition that, “extended engagement in overseas conflicts and constrained budgets have resulted in an operating environment that is substantially different from the peacetime setting in which the targets were first established” more than 20 years ago (GAO, 2018c, p. 13). Thus, the GAO concluded that we cannot be certain that even meeting those funding targets would be adequate for today’s operating environment. DoD concurred with the GAO’s recommendation to evaluate the funding targets and develop measurable goals and performance measures for these programs (GAO, 2018c).

GEOGRAPHIC ASSIGNMENT AND RELOCATION

As shown in the summary in Box 4-3, many of the challenges related to military assignments and relocations are primarily associated with the active component, as reserve component members can typically choose where to live and are not required to keep moving to new locations throughout their military careers.

Location

Military families’ geographic location can play a significant role in their satisfaction with military life, their ability to access military resources, and their ability to interact with other military families or their own family members. Families may prefer to live near other family members, in either rural or urban areas, or in particular climates or regions of the country. Life in remote and isolated areas can present difficulties, however even for families who otherwise enjoy rural or small-town life. For example, in such areas there may be few opportunities for civilian employment or education for members of the National Guard or Reserves or for military spouses or partners, and only limited opportunities for single service members to meet potential romantic partners. Remote areas also provide more limited access to specialists who can examine and treat those with particular medical needs. Because remote and isolated locations offer fewer local nonmilitary opportunities for socializing, fitness, and recreation, additional appropriated fund spending on morale, welfare, and recreation is permitted at installations in such locations (DoD, 2009).

Foreign assignments can present multiple advantages, such as the opportunity to experience new cultures and learn new languages, as well as an appreciation of taken-for-granted advantages back home. They can also introduce difficulties. Some service members or their family members may be uncomfortable venturing off of installations, spouses may face limited opportunities for employment, and the distance and differences in time zones can make communication and contact with family and friends at home particularly challenging. Those who have difficulty adapting to overseas assignments can experience poor mental and physical health as a result (Burrell et al., 2006).

Reactions to a foreign assignment may depend in part on timing. For example, a 2012 survey of 1,036 adolescents with at least one active-duty parent found differences between those living in the United States and those living in Europe (Lucier-Greer et al., 2016). Among adolescents ages 11 to 14, foreign residence was associated with being more likely to turn to their family as a means of coping along with lower levels of self-reliance/optimism, and among adolescents ages 15 to 18 it was associated with higher levels of self-reliance but more depressive symptoms (Lucier-Greer et al., 2016).

Relocation: PCS Moves

Active component personnel typically experience frequent PCS moves approximately every 2 to 3 years. These can be welcome opportunities to move to a more desirable area (with “desirable” being self-defined), to see other parts of the country or world, to take advantage of new career

opportunities at another location, or to reunite with friends and family. However, PCS moves can be stressors even when desired, because of the process of packing, moving, finding a new home (for some, selling the current home), transferring schools, changing medical providers, and so on (Tong et al., 2018). PCS moves can be undesired as well, as they can disrupt social networks, children’s education, spouses’ employment and career and educational advancement, the families’ ability to build home equity, and continuity of health care, especially for military families that include members with special needs. For LGBT service members and racial or ethnic minorities, PCS moves may create specific stressors when the new location offers fewer protections or is less welcoming within the local social and cultural contexts.

Moreover, PCS moves can split families, such as when dual-military couples cannot co-locate, when a family decides it is better for the spouse/partner or children to remain behind until the spouse can find a new job, or when a significant milestone passes, such as a newborn reaching a certain age, a child graduating, or a family member in a vulnerable state stabilizing or recovering. Unfortunately, the literature is lacking evidence on the extent to which families relocate together or in staggered fashion or remain separated, or the effect of the adopted strategy on PCS-related disruptions (Tong et al., 2018).

PCS Moves and Children

Mobility and geographic transitions were once considered a key benefit of military service. While that mobility continues to be an inducement for military service, PCS moves can have a harmful impact on the education of military children. On average, military children move and change schools six to nine times from the start of kindergarten to high school graduation, which is three times more often than their civilian peers. School-age military children are especially vulnerable to the stress related to frequent transitions, as they must simultaneously cope with normal developmental stressors, such as establishing peer relationships, conflict in parent/child relationships, and increased academic demands (Ruff and Keim, 2014). Although many PCS moves occur during the summer months, some families must move during the school year.

Frequent moves can cause military children to suffer academically, lose connections with others, and miss out on opportunities for extracurricular activities (because of the timing of the move) and, among children with special needs, experience gaps in services, continuity of care, and educational plans (Bronfenbrenner Center for Translational Research, 2013; Hawkins et al., 2018). These are issues that any child who moves may face, not just military children. Across various studies of military children, relocation

has been associated with reduced grades, increased depression and anxiety symptoms, skipping class, violence and weapon carrying, gang membership, and early sexual activity, although the overall prevalence is quite low (Hawkins et al., 2018). Evidence is limited regarding the impact of single relocations vs. accumulations of relocations over time.

However, there is evidence suggesting that for some children, frequent relocations may promote resiliency and the development of coping behaviors, and PCS moves can become normative in some military families (Spencer et al., 2016). Having experienced a number of military moves, these children have a better sense of what is involved, and some look forward to the excitement of new opportunities in a new location.

The Interstate Compact on Educational Opportunity for Military Children aims to address what it identifies as the major challenges for children in public schools, including:

• Enrollment requirements for educational records and immunizations
• Waiver of course requirements for graduation if similar classes were completed
• Similar course placement (e.g., honors, vocational) and flexibility in waiving prerequisites
• Excusing absences so children can spend time with service members on leave from or immediately returned from a deployment
• Special education services
• Flexibility with application deadlines for extracurricular activities (Military Interstate Children’s Compact Commission, 2018).

Families with children may also rely on social supports offered by the military and civilian communities in dealing with PCS moves (MCEC, 2009). DoD has stated their commitment to serve military children by providing youth programming for children ages 6 to 18 on installations and in communities where military families live. Part of this effort includes establishing approximately 140 youth and teen centers worldwide that serve more than 1 million school-age children of active duty and reserve component members annually. Centers provide educational and recreational programs designed around character and leadership development, career development, health and life skills, and the arts, among others (DoD, 2016a).

DoD has also recognized researchers’ recommendations to align the formal supports of a military installation with the informal supports of the nonmilitary community to support families (Huebner et al., 2009). DoD has partnered and/or contracted with federal and nonfederal youth-serving organizations, such as Boys & Girls Clubs of America (BGCA), Big Brothers Big Sisters, 4-H, Young Men’s Christian Association (YMCA), the Department of Labor summer employment program, and other local

and national youth organizations to provide programming to military youth on and off installations. Programs that have resulted from partnerships with national youth serving organizations, such as the USA Girl Scouts Overseas⁹ and BGCA-affiliated Youth Centers,¹⁰ often identify their goal to positively influence well-being, resiliency, and academic success and provide a sense of security, stability, and continuity as families transition to new locations. DoD has stated its intention to continue to building “strong partnerships with national youth-serving organizations that augment and offer valued resources” (DoD, 2016, p. 5). Given that a significant proportion of the current military population comprises reserve component service members, the expansion of formal support systems to include agencies and organizations located outside of the military installations is key (Easterbrooks et al., 2013; Huebner et al., 2009).

PCS Moves and Family Financial Well-Being

PCS moves every 2 to 3 years can disrupt the pursuit by spouses and partners of higher education, as well as partner eligibility for in-state tuition. Moves can also disrupt their employment, leading to loss of seniority, employment gaps, and underemployment. All of these effects can hurt the financial well-being of a military family.

In a representative longitudinal DoD-wide survey of active component civilian spouses conducted by the Defense Manpower Data Center (DMDC), 6,412 spouses participated in all three waves of the 2010, 2011, and 2012 surveys. The study provided self-reported evidence that PCS moves had a negative impact on spouses’ pursuit of higher education or training, on their employment, and on families’ financial condition (DMDC, 2015). Another study of the earnings of active component spouses who were not in the active component themselves also found evidence of a family financial disruption associated with a PCS move. Based on an analysis of DoD administrative data and Social Security Administration earnings data between 2000 and 2012, it found that a PCS move was associated with a 14 percent decline in average spousal earnings during the year of the move (Burke and Miller, 2018, p. 1261).

The impact of these moves on the financial well-being and satisfaction of service member families is likely more widespread than has been estimated, given that in the 2017 Status of Forces surveys nearly 10 percent of active component and 17 percent of reserve component personnel indicated they are in a long-term relationship that has lasted a year or longer (DoD, 2018). Those unmarried partners of service members may also have experienced

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⁹ For more information, see http://www.usagso.org/en/our-council/who-we-are.html.

¹⁰ For more information, see https://www.bgca.org/about-us/military.

a disruption to their education and earnings, but they would have been ineligible for assistance to spouses provided by DoD. For example, Military Community and Family Policy’s (MC&FP’s) Spouse Education and Career Opportunities Program offers career counseling and tuition assistance in the form of My Career Advancement Account [MyCAA] Scholarships for spouses of early-career service members to support occupationally focused education and training in portable career fields. Through these initiatives, DoD helps spouses select and prepare for portable careers likely to be in demand wherever their service member is stationed, so that the spouse’s employment and earnings trajectory will be better able to weather frequent military moves. Unmarried partners are not eligible for this support, nor are they eligible for state benefits for military spouses negotiated by the DoD State Liaison Office, such as unemployment compensation eligibility after following their service member for a PCS move, or accommodations to support the portability of occupational licenses and credentials across state lines.¹¹

TRAINING, SEA DUTY, AND DEPLOYMENTS

Deployments and sea duty¹² can provide service members with a number of desirable opportunities and benefits, such as

• Employing or developing their skills in real-world settings
• Making a difference in the world
• Developing strong bonds with others
• Earning financial bonuses through special pays and tax advantages, and
• Learning about other parts of the world.

Training and field exercises can also confer some of these advantages and help prepare service members to succeed in military operations.

Personnel tempo, commonly referred to as perstempo, refers to the amount of time individuals serve away from their home duty station, whether for deployments, sea duty, exercises, unit training, or individual training. Although a 2013 DoD policy is supposed to limit the amount of time service members spend away from home, a 2018 GAO assessment found that DoD perstempo data are incomplete and unreliable and that the Services do not have or do not enforce perstempo thresholds (GAO, 2018a). Thus, GAO found, DoD lacks the ability to gauge the amount of stress

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¹¹ For more information, see https://statepolicy.militaryonesource.mil.

¹²Sea duty refers to Navy personnel assignments to ships or submarines. It contrasts with shore duty, or land-based assignments. For more information, see http://www.public.navy.mil/bupers-npc/reference/milpersman/1000/1300Assignment/Documents/1306-102.pdf.

perstempo rates place on the force and any associated impacts on military readiness (GAO, 2018a).

Much of the literature has focused on the stressors of these family separations, which can have a negative impact on individuals, relationships, and the family as a unit. Examples include service members worrying about their families while geographically separated and trying to manage family problems from afar; relationship problems (e.g., couples growing apart, infidelity, or the end of a relationship); and missing major life events (e.g., births, weddings, funerals, childhood “firsts,” graduations, holidays, and family reunions). Other challenging life events associated with military separations include traumatic experiences, such as combat participation or exposure to dead bodies, violence, atrocities, or abhorrent living conditions (discussed further in subsequent chapters); family members’ fear of death, injury, or illness (physical or psychological) of their service member serving in a hostile area; and post-absence readjustment/reintegration between/among family members, including the service member’s adjustment to “routine” life upon returning. Family difficulties can be created or exacerbated due to communication challenges, such as connectivity problems, time zones, military-implemented blackouts (e.g., before a secret raid or after major casualties), and even the well-intentioned withholding of information among family members about problems or dangers (Carter and Renshaw, 2016). Box 4-4 provides a brief overview of examples of opportunities and challenges of these types of duties away from personnel’s home duty station. As a reminder, these are not sorted into positive and negative categories, as that interpretation can depend on the context and timing, individuals’ experiences, and other factors, and some can have both positive and negative aspects.

Deployments

More than two million military service members and their families have been impacted by deployments since the inception of combat operations in 2001, and some families have faced five or more such separations and reunions. The effects of combat deployments on military families can be complex (Cozza and Lerner, 2013). Combat deployments have been associated with increased rates of interpersonal conflict (Milliken et al., 2007), impaired parenting (Davis et al., 2015), and child maltreatment (Gibbs et al., 2007; McCarroll et al., 2008; Rentz et al., 2007). Military spouses have demonstrated increased distress (Lester et al., 2010) and utilization of mental health treatment (Mansfield et al., 2011) associated with deployments. Military children have similarly demonstrated negative deployment-related effects, including emotional and behavioral problems, increased mental health utilization, and suicidal behaviors (Chandra et al., 2010; Flake et al., 2009; Gilreath et al., 2015; Lester et al., 2010; Mansfield et al., 2011).

Combat deployment is associated with increased anxiety in military children, which is highly associated with distress in both civilian and active duty parents (Lester et al., 2010). Additionally, deployment has a cumulative effect on children, which can continue even upon return of the deployed parent. Thus, effects in children may be sustained beyond the actual threat to the deployed service member’s safety, potentially reflecting elevated anxiety and distress in highly deployed communities where children witness cycling deployments of adults in their lives. Importantly, children’s anxiety reflects the broader distress within their parents and family as a whole.

Many of these studies involved cross-sectional designs to examine associations between deployment and effects within families and were limited by the lack of longer-term outcomes. The few longitudinal studies that have been conducted provide a more nuanced picture of deployment’s impact on families (e.g., Balderrama-Durbin et al., 2015; Erbes et al., 2017; Gewirtz et al., 2010; Snyder et al., 2016). For example, one study using DoD data found that an increase in cumulative time deployed was associated with a greater risk of divorce and that this risk was greater for women service members, those who served on hostile deployments, and those who married before 9/11 (when there may have been less of an expectation of deployments as frequent events) (Negrusa et al., 2013). A similar study, focusing on Army soldiers, found that in addition to time spent in deployment, self-reported mental health symptoms consistent with PTSD further increased the risk of divorce (Negrusa and Negrusa, 2014).

The Deployment Life Study, conducted by the RAND Corporation (Meadows et al., 2016), assessed military family members at different times during the deployment cycle (before, during, and after deployment), focusing on the health of family, marital, and parental relationships, the physical and psychological health of adults and children within the family, and attitudes toward the military. The study found that changes in marital satisfaction across the deployment cycle were no different than those experienced by matched controls. However, service members’ exposure to physical injury or psychological trauma (but not combat exposure) was associated with increased physical and psychological aggression after deployment, as reported by spouses. Any perceived negative effects of deployment on family satisfaction and parenting were confined to the deployment period, although the presence of psychological trauma and stress contributed to negative post-deployment consequences for families. The researchers found no long-term psychological or behavioral effects of deployment on service members or spouses, except when deployment trauma was experienced. Similarly, child and teen responses to deployment appeared to be contained within the deployment period, except when deployment-related trauma (e.g., injury or post-deployment mental health problems) was involved.¹³ These findings resonate with results from other studies showing that a service member’s psychological functioning as a result of combat exposure during deployments (i.e., PTSD, traumatic brain injury [TBI], and related symptoms) appears to influence family functioning more than the physical characteristics of the deployments, such as their length or number (Gewirtz et al., 2018).

Military deployments add an additional stress to military families in addition to frequent moves, changing schools, and the challenge of integrating

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¹³ For a summary of these findings, see Meadows et al. (2016).

into new communities. The deployment of a parent requires the child to manage stress related to separation from a loved one and the impending sense of danger that accompanies a deployment and combat operations. Spouses or partners who are parents can find themselves needing to function as single parents. These additional demands while their service member is away can present conflicts for those who are employed or seeking employment, and spouses or partners may need to scale back their hours or even give up their jobs if they cannot obtain work schedules allowing them to fulfill household and child responsibilities. This can in turn have a negative impact on the financial well-being of the family. Some spouses and partners are fortunate to live in communities that offer support to families of deployed personnel, such as help with lawn care, maintenance tasks, and transportation to appointments.

Research indicates that a caregiver’s emotional well-being is related to the child’s emotional well-being. In one study (Chandra et al., 2011), caregivers who reported poorer emotional well-being also reported that their children had greater emotional, social, and academic difficulties. Further, if a caregiver’s emotional health difficulties persisted or increased on average over the study period, youth difficulties remained higher when compared with youth whose caregivers reported fewer emotional difficulties. In the same study, it was found that families that experienced more total months of parental deployment also reported more emotional difficulties among the youth, and these difficulties did not diminish over the study period. Families in the study with more months of deployment reported more problems both during deployment and during reintegration. Caregivers in the study with partners in the reserve component (National Guard or Reserves) reported having more challenges than their counterparts in the active component. In particular, National Guard and Reserve caregivers in the study reported more difficulties with emotional well-being, as well as more challenges during and after deployment (Chandra et al., 2011).

Deployments also take a toll on the psychological health of military children of all ages. Studies have shown that preschoolers with a deployed parent are more likely than other preschoolers to exhibit behavioral problems and that school-age children and adolescents with a deployed parent show moderately higher levels of emotional and behavioral distress (Chartrand et al., 2008). School-age children and adolescents with a deployed parent have also displayed increased problems with peer relationships, increased depression and suicidal thoughts, and higher use of mental health services. It has also been found that children with a deployed parent are more likely to be maltreated or neglected, especially in families with younger parents and young children (Lester and Flake, 2013). Again, although there may be increased risks for these negative outcomes, overall these effects are not the norm.

Research has also shown that a parent’s deployment can affect how military children perform academically. Studies of military children, caregivers, and schools have shown that deployments have a modest negative effect on performance. Children with a deployed parent have shown falling grades, increased absence, and lower homework completion (Lester and Flake, 2013, p. 129). A recent study of military children in North Carolina and Washington State whose parents have deployed 19 months or more since 2001 demonstrates that they have modestly lower (and statistically different) achievement scores than those who have experienced less or no parental deployment. This last study suggests that rather than developing resilience, children appear to struggle more with more cumulative months of deployment. Further, the study found that some of the challenges observed by teachers and counselors are ones that stem from the high mobility of this population, which could be amplified during deployment (Moeller et al., 2015; Richardson et al., 2011).

Understanding the effects of deployments on children is challenging, in part because it is difficult to distinguish factors related to deployment and military service. Furthermore, it is difficult to know whether military and civilian children differ. There are currently no publicly available large-scale studies presenting well-controlled comparisons of military and civilian families regarding parenting beliefs or practices, or other family behavior. Well-controlled comparisons of child outcomes among military and civilian children also are rare. The largest source of information about how child outcomes might differ comes from the Youth Risk Behavior Survey program administered by the Centers for Disease Control and Prevention, through which all youth in selected middle and high schools in every state throughout the United States are asked to complete a mostly standard set of items. A few states have incorporated a military identifier, providing the best comparisons to date of military and civilian youth (for more detail, see Box 3-1 in Chapter 3). Due to slight variations in items across states, some of the data sets include children whose parents have left military service as well as those who continue to serve, some data sets include children whose siblings served, and some include children whose military parents have not deployed or who deployed several years ago rather than recently. As a result, it is possible to identify differences indexed by military service alone vs. military service and deployment, and whether it was a parent or sibling who served.

Across the available data, calculations suggest that children with family members who served but were not deployed were more likely to report higher levels of a variety of kinds of risky behaviors or adverse experiences than nonmilitary children, including more use of cigarettes or other substances, and more experiences of violence and harassment, carrying a knife or gun to school, or having suicidal thoughts. These differences were larger

for children whose parents (vs. siblings) had served. Military and civilian children did not differ in rates of ever having used alcohol.

With regard to children whose military parents had deployed, reports of risky behaviors or adverse experiences were more common than among children whose parents had served but not deployed. Thus, military service and deployment each were associated with increments. For example, increments in the rate of ever having used alcohol were 9 percent each for military service and for deployment. Among military children whose parents had deployed, reports of suicidal thoughts were 34 percent higher and reports of having carried a knife or gun to school were about double those of children whose parents had not been deployed and about 80 percent higher than those of civilian children.

It is important to point out that these data come from self-reports by children, which may be subject to biases and memory errors. The differences for some of these experiences or activities, while large on a percentage basis, are small in terms of percentage points. Finally, patterns about exposures to violence may reflect mistreatment of military children as much as they do military children’s behavior. The committee notes that the degree to which stresses faced by military families during combat deployments are attributable simply to family separations, sudden single parenthood, or fear regarding the safe return of the service member has not been disentangled.

There are positive aspects to deployments as well. Deployments can present opportunities for service members to apply their training, improve their skills, take pride in a sense of accomplishment from overcoming hardships and living in austere conditions, and derive satisfaction from feeling that their work makes a difference in the world. The last aspect may particularly hold true for humanitarian and disaster relief missions. Additionally, during military operations overseas, service members can forge close bonds with their unit members and form lasting friendships. Service members and families can financially benefit in significant ways, through tax benefits and additional pays associated with serving in a combat zone, re-enlisting while deployed, and family separation pays. These deployments can thus provide opportunities to pay off debt, invest in property, help relatives, or improve one’s standard of living. Deployments can also help service members subsequently be competitive for promotion or choice assignments.

Several researchers have postulated resilient pathways for children facing combat deployments (e.g., Easterbrooks et al., 2013), including the seven C’s model of positive development, where attributes such as competence, confidence, contribution, and control may all have relevance in providing positive opportunities for military children through such challenging experiences, resulting in pride and growth. However, the committee notes that these pathways of resilience have not been tested in military children.

NATIONAL GUARD AND RESERVE SERVICE

Although members of the National Guard and Reserves and their families experience many of the other opportunities and challenges described throughout this chapter, there are certain experiences particular to the reserve component. We consider those experiences here and summarize them in Box 4-5.

National Guard and Reserve service can be appealing to some families because of the geographic choice and residential stability affords. Unlike active component personnel, guard and reserve personnel do not face frequent, mandatory geographic relocation, and some move from the active component to the reserve component precisely for this reason. If National Guard members choose to move, they can request an interstate transfer. However, National Guard and Reserve members who do not live near their units are responsible for their own transportation expenses for travel to and from duty. Additionally, those who move may face challenges, in that the unit near their new home may not have a vacancy for their same occupation and pay grade.

There is evidence that for military children, friendships with other military children and participation in military-sponsored activities can be beneficial for their well-being (Bradshaw et al., 2010; Lucier-Greer et al., 2014). Children of members in the reserve component (as well as active component children who live far from military installations) may have few opportunities for face-to-face interactions with others who would have a basic shared understanding of life as a military dependent.

Because the National Guard and Reserves are both part of the “reserve component,” clarifying what aspects of their service differ from service in the active component is critical to having a comprehensive picture of the military. National Guard members usually apply to enlist and work at the unit closest to their home, although they do not necessarily live close to that unit’s headquarters or facilities. Recall that they work for their states (under Title 32), unless they are mobilized to work under the federal government (under Title 10), as they would be for an overseas military deployment. Moreover, for the National Guard and Reserves the job requirements, eligibility for programs and services, health care system, and more can vary depending on whether the member’s current orders fall under Title 32 or Title 10. Reservists work for the federal government only, but like National Guard members they traditionally train one weekend a month and two weeks in the summer, although they may also be called to full-time active duty service. We are unaware of any tool that would assist National Guard and Reserve families in understanding what they are eligible for at any point based on their service member’s current status or upcoming change in status.

Deployment for National Guard and Reserve personnel is typically preceded by mobilization and followed by demobilization, and thus can have deployment cycles that are lengthier than their active component counterparts. When they are mobilized for federal service, they are not necessarily mobilized with their National Guard or Reserve unit as a whole. Individuals may be called up to augment other units that could be located quite far from their homes. Thus, even for those who do live near their own unit, they and their family members may not be near the deploying unit and thus not have easy access to predeployment briefings, activities, or support groups, nor would they already be on the distribution list for unit or spouse network email announcements or newsletters. Similarly, those families may be distant from programs and services designed to aid with post-deployment family reintegration. During demobilization, National Guard and Reserve members usually return to their hometowns and civilian jobs, which may not be close to any fellow unit members or military resources that can assist them with their transition or post-deployment issues.

Mobilizations as Disruptions to Service Member and Spouse Employment

The Uniform Services Employment and Reemployment Rights Act of 1994¹⁴ requires that civilian employers not discriminate against reservists in their hiring practices, allow reservists time away from work to fulfill their federal military duties, and hold their position for them until they

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¹⁴ For more information, see https://www.dol.gov/vets/programs/userra/userra_fs.htm.

return and at that time compensate them as though they had been working continuously the entire time (e.g., with regard to pay rate, position, and benefits terms and eligibility). This can present challenges to employers, and despite these legal protections, reservists may still face employers hesitant to hire them. Since 9/11, National Guard and Reserve members have been mobilized at unprecedented levels (Figinski, 2017; Werber et al., 2013). Due to the large numbers of reservists mobilized for long deployments to Iraq and Afghanistan, there were dramatic increases in the number of veterans receiving unemployment benefits, as more reservists were eligible for the benefits and long deployments made it more difficult to return to civilian employment (Loughran and Klerman, 2008). Some reservists also work as DoD civilian employees, which makes them “military technicians” who work under somewhat different employment terms than their civilian employee or reservist counterparts.¹⁵ For example, a condition of their DoD civilian employment is that they maintain their membership in the Selected Reserve, although an exception may be made if they receive combat-related disability but are still able to perform their DoD civilian job.

Changes to Pay, Benefits, Programs and Services

Members of the National Guard and Reserves mobilized since 9/11 have encountered pay and allowance delays, underpayments, and over-payments that the military later sought to recoup, all due to lack of integrated pay and personnel status systems (Flores, 2009). Eligibility for benefits and services can be complicated for members of the National Guard and Reserves and their families. Exactly what they are eligible for and under what conditions varies across programs and services and can be based upon whether they are or have recently been on active duty status and whether that was under Title 32 or Title 10 orders. Perhaps most notably, reserve component families are eligible for health care benefits under TRICARE only while their service members are on active duty for more than 30 days or are mobilized for a contingency operation. Otherwise, when their service member is on reserve status or during shorter periods of active duty, the service members and their family are responsible for their own health care insurance, and the service members are responsible for ensuring that they are medically ready to deploy should they be called up.

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¹⁵ The terms are specified under Section 10216 of Title 10 in the U.S. Code.

DIVERSITY AND INCLUSION

DoD has been implementing institutional policies and practices designed to reduce barriers to service and promote equitable and respectful treatment of all service members (DoD, 2017a, p. 10). According to Lutz (2013), the core training at the Defense Equal Opportunity Management Institute (DEOMI) aims to achieve total force readiness through a focus on the American identity of service members. This legacy of legal inclusivity has continued into the 21st century with the repeal of the so-called Don’t Ask Don’t Tell policy (2011), extension of family benefits with the implementation of legal same-sex marriage (2015), and most recently the lifting of blanket restrictions on the service of military women (2016). This section will highlight some examples of diversity- and inclusion-related issues, summarized in Box 4-6, but as is the case with this chapter more generally, this high-level review is by no means complete. Furthermore, it does not capture the complexity of the issues represented in the literature that a deeper dive on any one of these topics could provide.

Variability Across and Within Groups

As discussed in Chapter 2, ecological and family systems theories emphasize the embeddedness of individuals within multiple, reciprocal, and interacting contexts. As helpful as these frameworks are in identifying interactions that influence individual and family development, they do not capture systematic or structural inequity, such as race- and gender-based discrimination and attitudes, which may affect military families who are members of marginalized groups. An intersectional lens can serve as an organizing framework for understanding how overlapping social statuses, including gender, race, sexual orientation, and socioeconomic status, connect individual service member and family experiences to structural (macro) realities (Bogard et al., 2017; Bowleg, 2012).

Each military service member and each family member is positioned within a unique social location and occupies multiple social statuses, which helps to explain the tremendous diversity in individual service members’ responses to what appear to be similar military and life experiences. Minority stress theory (Meyer 2003) spotlights minority group members’

unique experiences of chronic stresses stemming from social institutions in addition to their everyday experiences of racial bias. When applied to sexual minorities, analysis tends to focus on stresses related to heteronormative bias and anti-LGBT experiences.

Discrimination or even suspected discrimination in promotion, job assignments, assigned duties within a position,¹⁶ opportunities for promotion and career development, and the enforcement of rules and regulations can be a detrimental stressor to the well-being of service members. Intersectionality is also a useful concept in understanding “the intersectional nature of resilience” (Santos and Toomey, 2018, p. 9), which reflects the ability

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¹⁶ For example, a women truck driver being tasked with handling the unit’s administrative work, or Black or Hispanic personnel being assigned the dirty or heavy manual labor.

of military service members and their families to function well in spite of significant disadvantages, stresses, or experiences of inequity.

Taken together, ecological, life-course, and intersectional models of individual and family well-being all indicate that what is most effective at supporting military families is not a one-size-fits-all approach but rather a variety of approaches that seek to align programs with the diverse needs of service members, diverse family constellations, and local social contexts (Lerner, 2007). Of course, this is not meant to imply that a custom program must be developed for each military family. The point is that DoD and local service providers cannot make assumptions based on one or two characteristics at a given point in time (e.g., single newly enlisted service member, deployed parent, Latinx Marine) about what is most important to military personnel and military family members, what they need, or what is the best way to support them. Instead, they must take into account the perceptions, priorities, and preferences of service members and their families; provide a range of types of support from which to draw (e.g., mode of communication, military vs. nonmilitary); and ensure that the support networks contain providers with knowledge about and sensitivity to the needs of different subgroups (e.g., noncitizens and immigrants, male sexual assault victims, religious minorities).

Servicewomen in the Military

Women make up one-half of the U.S. population but only 17.5 percent of the total force (DoD, 2017c, p. 6). Notably, relatively few servicewomen occupy leadership positions at the officer ranks of colonel and admiral/general (DACOWITS, 2015). Findings from the most recent (2017) DACOWITS report indicate that women often identify different reasons for joining the military than men do, that they are more likely than men to be married to another service member (both within and across services), and that they separate from the military earlier in their careers than do men. Key factors in servicewomen’s decisions to leave the military relate to the challenges of geographic separation from family, both because of deployment and inability to co-locate with a service member spouse; pressure to prioritize one’s military career among dual- military service members; and difficulties with work-life-family balance. In addition, servicewomen are more likely than men to separate from the military prior to starting a family (Clever and Segal, 2013).

Globally, 74 foreign militaries allow or require women to serve, including 13 in which combat roles are open to servicewomen (DACOWITS 2017). Among militaries that have successfully integrated women, policies to support servicewomen include flexible parental leave policies, co-location and geographic stability, and comprehensive and affordable child care that can

accommodate long shifts, nontraditional working hours, and care for ill children. DACOWITS (2017) presented recommendations to increase DoD’s ability to attract and retain servicewomen that similarly emphasize policies supporting families with children, educational initiatives to address unhelpful perceptions related to gender roles, and protocols for appropriate physical training for women. Findings also indicate that servicewomen are disproportionately affected by findings of noncompliance with family care plans, indicating a need for more appropriate application of these protocols.

There is very little research on motherhood in the military, and almost no research on the impact on families of a military mother’s deployment to war (see, e.g., Barnes et al., 2016). A series of studies of Navy mothers during the Gulf War indicated that anxiety and distress increased among the children of those who were deployed more than among children of the nondeployed (Kelley et al., 2001). Among deployed Navy mothers, length of separation from families and perceptions of social support both contributed to psychological adjustment (Kelley et al., 2002). More recent research on a sample of mothers who deployed to Iraq and Afghanistan reported that reintegrating mothers experienced more adverse past-year life events, and more depression and PTSD symptoms, than nondeployed mothers (of deployed spouses), but this research did not report worse parenting, couple functioning, or child adjustment (Gewirtz et al., 2014). More research is needed to examine the adjustment of deployed mothers, how programs and policies may affect them (Goodman et al., 2013), and other factors that may affect these mothers, such as societal norms that stigmatize a mother’s leaving her children for war as “non-maternal” behavior (Gewirtz et al., 2014).

Segal and Lane (2016) bring attention to contextual factors within military culture and everyday life that likely affect servicewomen’s well-being. Specifically, they identify “leadership behaviors” that set the tone for how women are treated by their male peers and commanders as well as social isolation that can result from being ostracized within a unit. As part of the 2017 DACOWITS research, focus group participants similarly indicated that servicewomen may be disadvantaged by cultural attitudes based on traditional gender roles, especially as women begin to move into previously closed combat and leadership roles. Segal and Lane (2016) bring to light gender-based sexual harassment, ranging from inappropriate behavior—such as sexual comments, jokes, offensive pictures or posters, and gestures—to criminal-level assault. Recent estimates find that servicewomen report and experience sexual harassment and sexual assault at higher rates than male service members (Davis et al., 2017; Galovski and Sanders, 2018) and that sexual trauma is likely underreported due to concerns about safety, stigma, avoidance, and shame (Galovski and Sanders, 2018). Relatedly, servicewomen are more likely than servicemen to be harassed or stalked online and through social media (DACOWITS, 2017, p. 76). The psy-

chological impact of sexual trauma on servicewomen can be especially disruptive to fulfilling service roles, family functioning, parenting, and child outcomes (Kimerling et al., 2010; Millegan et al., 2015; Rosellini et al., 2017; Suris et al., 2013).

Segal and Lane (2016) assert that women’s gynecological, contraceptive, and pregnancy-related needs are not fully and universally accessible across settings, including deployment environments. Pregnancy, new motherhood, and maternity leave can disadvantage servicewomen in several ways. Pregnancies do not always occur only and precisely when desired, and their timing can make it more difficult to manage work demands and attract harmful stigma, such as accusations of having become pregnant to avoid sea duty or deployment. Added to this, pregnancies and new motherhood can involve new physical and emotional health challenges, such as problematic pregnancies, problems at birth, difficulties breastfeeding, managing post-pregnancy physical fitness and weight requirements, and suffering from post-partum depression (Appolinio and Fingerhut, 2008).

However, the committee notes that in recent years, granting of parental leave for service members has become more common in order to increase recruitment and retention in the Armed Forces. Recent changes to military parental leave mandated in the FY 2017 National Defense Authorization Act (Section 521 of the enacted bill) authorize

More research will be needed to examine the consequences of these policy changes for service members, as well as their impact on family well-being.

Finally, with the full integration of women into combat roles, attention has turned to women’s physiology and ability to meet the military’s physical standards for combat and related roles. DACOWITS (2017) reports that because of physiological differences between women and men, physical training and nutritional protocols designed for men, such as “large field training” and cardio focus, may not be most efficient for women, and point to sports science and human performance approaches (pp. 55–57) to prepare all service members.

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¹⁷ See https://fas.org/sgp/crs/natsec/R44577.pdf, pg. 19, Sec. 521.

LGBT Status

The history of military policy related to sexual orientation, gender identity, and military service has developed in tandem with broader changes in social attitudes and evolving state and federal legislation in the post-9/11 period. Three pieces of legislation during the Obama administration represented a sea change in federal and military policy: (1) the 2009 Matthew Shepard and James Byrd Jr., Hate Crimes Prevention Act; (2) the 2011 repeal of Don’t Ask Don’t Tell (DADT); and (3) the 2015 legalization of same-sex marriage by the U.S. Supreme Court (Obergefell v. Hodges). Additionally, in 2016 the secretary of defense ended the ban on transgender service (although as noted in Chapter 3, those advances have been rolled back effective April 2019).

LGBT service members enlist at higher rates than heterosexual people and identify diverse reasons for joining (Ramirez and Bloeser, 2018) that extend beyond patriotism, altruism, and commitment to public service. For example, given the troubling rates of family rejection of LGBT youth (Zimmerman et al., 2015), some LGB service members enlist as a mechanism to escape fraught home environments (Legate et al., 2012). For some men, the hypermasculine culture of the military may be appealing, while for lesbian women, the military allows a laser focus on career and mission rather than gender-bound heteronormative roles of motherhood and marriage (Ramirez and Bloeser, 2018).

In population health research, sexual minorities have been found to be at risk for multiple health and mental health burdens when compared to heterosexuals (Hatzenbuehler, 2009). Minority stress theory (Meyer, 2003) articulates that members of sexual minorities experience excess and accumulated stress, including stigma, prejudice, and discrimination, and often expend significant energy to remain vigilant to environmental and interpersonal threats, safety, and disclosure of sexuality. In addition, for LGBT recruits, self-awareness regarding sexual orientation or the decision to live as their gender rather than birth sex and the coming out process often coincide with socialization into military culture.

Until the federal legalization of same-sex marriage, military policy and practice under DADT also interfered with lesbian, gay, and bisexual service members’ family functioning and well-being (Kelty and Segal, 2013) by requiring concealment, excluding same-sex partners and children from receiving benefits, and limiting same-sex partners from participating in family roles.¹⁸ In addition, concerns about being outed and career repercussions

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¹⁸ Testimony of Ashley Broadway-Mack, president of the American Military Partner Association, at Voices from the Field, a public information-gathering session held at the National Academies of Sciences, Engineering, and Medicine on April 24, 2018.

prevented many sexual minority service members from seeking help and support under DADT (Mount et al., 2015).

With the legalization of same-sex marriage in 2015, DoD began immediate efforts to extend benefits to spouses and children of sexual minority service members, and in 2016 new health care and service options became available for transgender service members. However, because these important policy changes are very recent, we still know little about LGBT service members, couples, parents, and families. However, some findings are emerging. A DoD systematic review indicated that active-duty lesbian, gay, and bisexual individuals may be at increased risk for sexual assault victimization (DoD, 2016c). DoD’s 2015 Health Related Behaviors Survey found that LGBT personnel were as likely as other personnel to receive routine medical care and less likely to be overweight, but more likely to engage in risky behaviors such as binge drinking, cigarette smoking, unprotected sex with a new partner, and having more than one sexual partner in the past year (Meadows et al., 2018, pp. xxx–xxxi). LGBT personnel were also more likely to report moderate or severe depression, lifetime history of self-injury, lifetime suicide ideation, lifetime suicide attempt, suicide attempt in the previous 12 months, lifetime history of unwanted sexual contact, or ever being physical abused (Meadows et al., 2018, p. xxxi). Although these highlights describe LGBT people as a group, of course their needs and experiences vary. For example, “transgender” refers to a gender identity, not a sexual orientation, and a ban against transgender military service was just reinstated.

Lessons from foreign military forces in which LGBT personnel have been integrated, which date from the 1970s (in 1974 in the Netherlands), indicate that LGBT integration has had no effect on readiness or effectiveness there (Belkin and McNichol, 2000–2001, 2000). Rather, environments which are inclusive of sexual orientations and gender identities are positively linked to mental health, well-being, and productivity among LGBT individuals, which in turn benefits morale, cohesion, and recruitment and retention (Polchar et al., 2014).

A hallmark of best military personnel practices is maintaining policies that are inclusive, especially in the context of international and multinational cooperation among diverse nations (e.g., NATO, 2016, p. 45). Relevant to LGBT personnel, best practices include intentional “top-down” leadership demanding respectful conduct, and attention to deployment environments in which LGBT service members may be at greater risk because of local attitudes or local laws, including criminal statutes against same-sex relationships or sexual practices (Polchar et al., 2014, p. 13, p. 50). The most inclusive military systems, including Australia’s, encourage and even require disclosure of sexual orientation within the context of national security (Polchar et al., 2014, p. 57).

The National Defense Research Institute Report (Rostker et al., 2010) concludes that the ability of LGBT persons to serve openly can increase unit trust and cohesion, enhance the well-being and performance of LGBT service members, and reduce LGBT vulnerability in out-of-country assignments and deployment environments (such as blackmail by enemy combatants), among other reasons. Common to foreign nations that have integrated LGBT service members are education and training related to fair treatment of all personnel and clear anti-discrimination policies (Azoulay et al., 2010).

Race and Ethnicity

Demographic trends in the general population indicate that the United States will become a majority-minority nation within the next generation. With only one percent of the U.S. population volunteering for military service, the current demographics of military personnel and their families do not reflect those of the population as a whole (see Chapter 3). Rather, racial and ethnic minorities, including immigrants, are more likely to consider military service than White people, and specific regions of the country, in particular several states with high percentages of Hispanics or Latinx, are over-represented (Bennett and McDonald, 2013; Council on Foreign Relations, 2015; also Elder et al., 2010). During the long wars, immigrant service members have provided critical language skills, including the roles of translator and interpreter, and offered needed cross-cultural expertise (Council on Foreign Relations, 2009; Stock, 2009).

Several scholars have concluded that the life-course impact of service for ethnic-minority families is “generally positive” and that service provides important opportunities to groups that might not have alternative pathways to socioeconomic independence and sustainability (Burland and Lundquist, 2013, p. 186). Black service members in the forces are accessing educational benefits through the GI bill at higher rates today than in earlier cohorts (Lutz, 2013, p. 75).

The scholarship on diversity and inclusion has made important contributions in the realm of exploring equal opportunity-related issues: accessions, mentors, promotions and assignments, distributions across occupations and paygrades, and discrimination and harassment (Asch et al., 2012; Booth and Segal, 2005; Lim et al., 2014; Military Leadership Diversity Commission, 2011; Parco and Levy, 2010; Rohall et al., 2017; Tick et al., 2015). All of this scholarship is important and relevant for service member and family well-being, although gaps in our understanding remain.

It is common for DoD surveys and academic studies of military family well-being to include race and ethnicity as variables and report on significant differences, but greater synthesis across the research is needed. For example,

several studies indicate that racial/ethnic minority status is linked to higher self-reported rates of PTSD (Burk and Espinoza, 2012; DeVoe et al., 2017; Meadows et al., 2018) and that the positive benefits service has on families’ well-being for ethnic-minority service members do not extend to combat veterans (MacLean, 2013). Other racial/ethnic differences include higher prevalence of overweight among Hispanics and non-Hispanic Blacks in the military (Reyes-Guzman et al., 2015) and various differences in health-related behaviors, such as smoking (non-Hispanic blacks were least likely to smoke) and hazardous and disordered drinking (more likely among non-Hispanic whites) (Meadows et al., 2018, p. xxxvii).

No synthesis across the literature has yet been carried out concerning how race and ethnicity relate to military family well-being. Additionally, little attention has been paid to exploring the priorities of racial and ethnic minority families to answer such questions as, What are the top problems and needs of minority service members and their families? and, Is the Military Family Readiness System addressing these problems and needs or helping minority service members and their families address them?

Families in the Exceptional Family Member Program

The Office of Special Needs was established in 2010¹⁹ to enhance and improve DoD support for military families with special medical or educational needs. The office operates in and oversees the Exceptional Family Member Program (EFMP), the provision of services pursuant to the Individuals with Disabilities Education Act (IDEA), and a DoD Advisory Panel on Community Support for Military Families with Special Needs (Office of Special Needs, 2018).

Enrollment in the EFMP is mandatory for active component service members who have a family member with special medical or educational needs (EFMP, 2016). Approximately 133,000 military family members are enrolled in the EFMP (Office of Special Needs, 2018; GAO, 2018b). The EFMP helps families in two ways:

1. Documenting family members’ special needs, so that the availability of necessary services is considered during personnel assignment decisions.
2. Identifying and accessing relevant information and military programs and services.

In a benchmark study of the EFMP (Bronfenbrenner Center for Translational Research, 2013), military families enrolled in the EFMP expressed

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¹⁹ Established in Title 10 of the U.S. Code, Sec. 1781c.

concerns regarding stigma surrounding special needs family members and military career advancement. Focus groups and interviews with service members, family members, and service providers across eight CONUS installations revealed that some families initially did not enroll in EFMP, disassociated from EFMP services, or hid their family member’s needs because of embarrassment and because of fears that they would miss out on assignments important for career advancement or reenlistment opportunities. Although current policy directs that assignments should be managed to prevent adverse impact on careers (DoD, 2017d), service members may still face difficult choices. To illustrate, an officer might have to decide whether to

• turn down a key command opportunity overseas or in a domestic remote and isolated location, because the area has limited resources to support the family member,
• take the career-enhancing assignment, but serve geographically separated from the family for 2 years, leaving someone else to care for the family member with special needs, or
• take the family member along, try to compensate for the resource limitations, hope the condition does not worsen, and if on an unaccompanied tour overseas, be responsible for the cost of sending the family member back.

Within EFMP families, members with special needs are not the only ones who may need assistance. For example, deployments can present additional challenges, as the nondeployed parent can become overwhelmed managing care for EFMP family members, on top of all of the other family and household responsibilities while the service member is away from home (Bronfenbrenner Center for Translational Research, 2013). The nondeployed parent (or other caregiver) may have to quit their job or reduce their work hours to manage, which in turn can negatively impact the family’s financial well-being. Especially in circumstances like these, the sole caregiver can have a dire need for respite care. Siblings may also become caregivers as well, assisting their brother or sister who, for example, has limited physical abilities or behavioral problems. While they may enjoy that role, it may also limit what else they are able to do in terms of extracurricular activities, socializing with friends, interacting with parents, or having time to themselves.

Each Service runs its own EFMP, so one of DoD’s roles is to help ensure consistency and successful implementation (Office of Special Needs, 2018). However, a recent GAO report raised questions about whether there were gaps in services based on wide variation in the ratio of EFMP staff to EFMP service members, the types of program activities, and the low number of

service plans given the number of enrollees and requirement that all should have plans (GAO, 2018). GAO recommended that DoD develop common performance metrics and evaluate the Services’ monitoring activities, and DoD agreed and plans to do so (GAO, 2018).

A recent study of EFMP family support providers provides some insight into the types of special needs in military families (Aronson et al., 2016). The study participants were EFMP professionals who help families document the special needs and connect them to information, services, and support groups. The researchers asked whether the providers worked with families dealing with any 1 of 13 specific special health care or educational needs. Most (93 to 94%) reported working with military dependents with autism and dependents with attention-deficit hyperactivity disorder (ADHD). Each of the following types of disabilities were encountered by more than 80 percent of these family support providers: emotional/behavioral disorder, speech and language disorder, developmental delay, asthma, and mental health problems (Aronson et al., 2016).

In the same study, the providers were asked to share their impression of the impact on EFMP families of each of 12 specific challenges (including educational concerns, child behavior problems, parent stress). Of the 12 challenges, 8 were perceived to have an impact ranging on average from “moderate extent” to “great extent.” Educational concerns about children were reported as the foremost issue. The next most prominent issues for families were navigating systems (e.g., school, community, or military), child behavior problems, parent mental health or stress, child care issues, and medical problems (Aronson et al., 2016).

Many of these concerns were exacerbated by the frequency of and associated stress of relocation. Lack of continuity associated with changing doctors, carrying over prescriptions, re-applying for referrals, creating new individualized education plans (IEPs), and the like can be stressful for both the families attempting to manage the care and support their loved one and the family member with special needs. Such delays leave the family member with special needs with gaps in necessary care. A recurring issue that EFMP family support providers reported, which related to their own work, was a lack of information sharing that would alert them to incoming families and their needs so that the providers could start assisting with the transition prior to the move.

Note that EFMP is not the only type of support for military family members with special needs, but it should be able to refer families to appropriate resources and help them understand their rights and protections. Figure 4-2 illustrates overlapping types of programs for children with special needs: (1) Exceptional Family Member (EFM) Program; (2) Individuals with Disabilities Education Act (IDEA) special education; and (3) school-related services or accommodation through Section 504 of the Rehabil-

itation Act of 1973 (MCEC, 2005, p. 29). Both IDEA and Section 504 aim to ensure that students with disabilities are able to receive a free and appropriate education.

Although this section tended to discuss “special needs” generally, keep in mind that this represents a great deal of variability in type, severity, and persistence of disability and variability in associated needs. It encompasses autism, blindness, deafness, learning disabilities, speech disorders, cerebral palsy, spina bifida, attention deficit hyperactivity disorder, and many other physical, mental and psychological disabilities, and of course dependents can have more than one, and families can have more than one member who has special needs.

For some families, the benefits and accommodations the military makes to support families with special needs are an incentive to remain on active duty. The advantages include medical benefits afforded to the EFMP family members and assistance coordinating with schools and other programs and services. They also include the service member having the ability to take time off of work to manage the special needs (although some supervisors might be more stringent) without worrying about getting fired or losing money the way one might in a civilian job if required to “clock out.” Even if a family member with special needs is high-functioning, the service member might need to take that dependent to appointments and work with the schools on developing an Individualized Education Program (IEP).

TRANSITION OUT OF MILITARY SERVICE

Military personnel and their family members transition away from military life for a wide variety of reasons, in different life stages, and after differing levels and types of exposure to military life. Box 4-7 summarizes some key characteristics of this transition, although they are just the tip of the iceberg in terms of the post-service adjustments and post-service trajectories of veterans and their families.

Service members may die as a result of military operations, accidents, suicide, or other causes that may or may not clearly relate to their service. Such deaths can be emotionally traumatic to the family and can lead to additional challenges, such as having to leave the military community (even having to move, if they live in military housing), and losing the military pay and benefits associated with service. Post-death benefits, such as the death gratuity, are one type of military benefit for which service members can designate nonmilitary dependents to be recipients, including nonmarital partners and parents.

Service members may separate from military service voluntarily or involuntarily. Some will choose or be required to leave before their initial term of service is complete, but most will face decisions about whether to begin an additional term of service. As the size of the military expands and contracts over time, due to the changing scope of missions and congressional authorizations for personnel, periodically individuals are required or incentivized to leave military service before their current term ends. Additionally, in the event of war, the military can issue a “stop loss” to prevent service members from leaving at the end of their contracts; or, if authorized by the Presidential Reserve Callup Authority, the military can call back to active-duty individuals who had already separated or retired but had not completed their period on “Individual Ready Reserve” status (e.g., as was done to provide ground forces for deployments to Iraq and Afghanistan).

Retirement has traditionally been possible after 20 years of service, once any terms of service have been met, such as obligations after receiving additional schooling. Former spouses may be awarded a portion of a retiree’s pay as a part of a divorce proceeding. As noted earlier, the new Blended Retirement System provides alternatives to this traditional system that resemble many private sector 401(k) plans.

After leaving the military, service members and their families may choose to stay in the same area as the last duty station, although those living in family housing will have to move off of the installation. Or they may move to pursue a job opportunity, live closer to relatives, live in a favorite part of the country, or live where there are other military-connected individuals and resources. The Transition to Veteran Policy Office (TVPO) is responsible for policy and implementation of the Transition Assistance Program (TAP),²⁰ operated by 300 Family Support Centers at military installations worldwide. TAP offers a number of services and resources including counseling, employment assistance, information on veterans’ benefits, and other employment and family support. An analysis of data on the use of support services administered by transition assistance centers is underway (GAO, 2019).

___________________

²⁰ For more information, see https://www.dodtap.mil/.

Some veterans use their GI Bill benefits to attend college after they leave the service. Many are drawn to the career focus and flexibility offered by for-profit educational institutions; however, some of those schools have been found to prey upon veterans and have high dropout rates and low postgraduation employment rates (Guo et al., 2016, p. 9).

Research on recent veteran populations finds that their workforce participation rates and unemployment are similar to the rates of comparable civilians, although personnel separating at a young age (18 to 24) appear to face some employment hurdles when initially transitioning (Guo et al., 2016, p. 2). Tax credits for hiring veterans appear to be both beneficial and cost-effective: one study found that a 2007 tax credit expansion resulted in the employment of 32,000 disabled veterans in 2007 and 2009 who would have otherwise been unemployed (Guo et al., 2016, p. 4).

Multiple studies have found that both service members and veterans earn more than their comparable civilian counterparts and that service members who worked in health care, communications, or intelligence occupations saw larger earnings in their post-military careers than other veterans (Guo et al., 2016, p. 5). One study that focused on women veterans’ civilian labor market earnings found that military service was even more of an advantage for racial and ethnic minority women than it was for White women veterans, so much so that it raised their earnings as high as, or in some cases higher than, White nonveterans’ earnings (Padavic and Prokos, 2017).

For veterans and their family members, the transition to civilian life can be made more difficult by physical disabilities or conditions, such as chronic pain, or by mental health challenges, such as posttraumatic stress disorder or major depression (which are discussed in Chapter 5). Multiple surveys suggest that veterans who served as officers have better health than those who were enlisted (MacLean and Edwards, 2010). Women veterans appear to be more likely to have a disability or function limitation than veterans who are men (Prokos and Cabage, 2017; Wilmoth et al., 2011). As veterans move from the DoD health care system to the VA, they may find challenges to maintaining continuity of care, and not all veterans who need treatment will receive it (IOM, 2013).

Yet studies of past generations of war veterans have found that the long-term outcomes of military service are positive. The benefits of military service include not only education and economic gains but also positive coping strategies, the ability to withstand stress, and other resilience factors that can promote lifelong health and well-being (Spiro et al., 2015).

SUMMARY

Military life can offer tremendous benefits but also significant challenges. Some who enter will thrive, others will struggle or fail. Not everyone

who enters will be willing or able to remain a military family member until the service members’ transition to civilian life. The ongoing work for DoD, however, is to help prevent, mitigate, and respond to the negative impact of stressors to promote the well-being, readiness, effectiveness, and retention of quality service members and their families. Some of the challenges mentioned above may extend to parents, grandparents, siblings, close friends, and others in service members’ personal networks, such as military separation from loved ones, concern about the safety of service members working in dangerous environments, and caring for service members’ children or seriously injured service members.

Some events specifically related to military life can impact not just the service member but also other individuals in the family and subsystems within the family. Most notably, these include

• pay and in-kind benefits, such as housing and health care
• PCS moves
• assignments to installations in other countries
• deployments, sea duty, and temporary duty away from home
• combat experience and exposure
• service-related mental and physical injuries and death
• career progression (or lack thereof), and
• separation from military service and transition to civilian life.

The opportunities and challenges of military life change as the size of the military expands or contracts; as the civilian economy improves or declines; as the number, length and nature of military operations changes; and as public knowledge and attitudes toward the military change.

These types of military experiences will vary across different subgroups and regions, too. For example, military life experiences such as frequency and length of deployments, options of installation assignments, and career progression are often linked to military occupation, and military occupations vary greatly in their personnel composition (e.g., by entry requirements, race, ethnicity, gender, and concentration in the active component or National Guard or Reserves). Additionally, some military families have significantly more privileges and resources than others. The differences in pay mean senior military officers are much more likely than junior enlisted personnel to be able to afford to locate their families in neighborhoods with greater resources and better schools; to hire help with housekeeping, yardwork, or tutoring; to be able to fly other family members out to visit; to pay for their children’s college education, and so on. Regardless of the resources a family may have, however, some installations are located in areas where there are few or low-quality resources, or where the resources are already overtaxed because the civilian population has great needs.

Thus, we reiterate here our call in Chapter 3 to be attentive to the ways intersectionality or overlapping statuses of numerous characteristics can shape how individual family members and families experience and interpret the events and features of military life.

It also bears repeating that we have more information on the life course of service members and military dependents than we do on partners, children who are not military dependents, and other military family members, as well as more information on historically majority subgroups in the military (e.g., men, Whites, heterosexuals).

Given finite resources and a vast array of possible challenges, the need is for DoD to find the best way to prioritize and focus its efforts to enhance the well-being of diverse military families, without compromising its ability to meet its missions. An important question to answer toward this end is: What are the most beneficial and meaningful types of interventions, guidance, and support that DoD could offer to achieve this?

CONCLUSIONS

CONCLUSION 4-1: Studies on the roles and impacts of nonmarital partners, ex-spouses, or ex-partners, parents, siblings, grandparents, and others in the personal networks of service members are scarce, despite the significant positive or negative influences those people could have or the important roles they could play in some situations, such as child custody disputes, respite child care, temporary guardianship of children during parents’ deployments, and other situations.

CONCLUSION 4-2: There is a lack of understanding of how military family well-being varies by race and ethnicity, the concerns of minority families, and whether the Department of Defense is sufficiently meeting these families’ needs. Scholarship on racial/ethnic diversity in the military tends to focus on equal opportunity issues for service members (such as discrimination and promotion rates), whereas findings concerning well-being are scattered widely across the literature.

CONCLUSION 4-3: The frequency of mandatory military moves and the associated stress of relocation create challenges for the continuity of care for active component military families, especially families who have members with special needs and must rely heavily upon community resources.

CONCLUSION 4-4: Since the end of the Cold War, the National Guard and Reserves have served at unprecedented levels, filling critical roles in disaster relief and homeland defense in the United States as well

as serving in military operations overseas. However, they face frequent family separations, changes in pay and benefits eligibility associated with shifting military statuses, and disruptions to civilian employment and business ownership, and they may not even live near a military community that could provide formal or informal support.

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