A comparative analysis of medically released men and women from the Canadian Armed Forces
Abstract: Introduction: Musculoskeletal (MSK) injuries and mental health (MH) disorders are the leading causes of medical attrition in the Canadian Armed Forces (CAF). Historically, medical attrition rates have been higher for women than men. In order to better understand the medical release trends of men and women, a descriptive analysis of the medical reasons for release was undertaken. Methods: Administrative data sources within the Department of National Defence were used to identify medically released personnel together with their primary medical diagnosis and demographic characteristics, including sex, age, and rank. The analysis included 5,180 Regular Force personnel medically released between April 1, 2014 and March 31, 2017. Results: While overall trends in the reasons for medical release were sometimes similar for men and women, statistically significant differences between the medical release reasons of men and women were found in several of the sub-groups considered. These sub-groups included non-commissioned members (NCMs), officers, Air personnel, and members who had not deployed in the 10 years prior to their release, as well as personnel in the earlier and later stages of their career. Discussion: An increased understanding of the differences between medically released men and women is important for the development of future injury and illness prevention strategies, which have the primary objective of improving the health and operational readiness of serving members, as well as a secondary objective of lowering medical attrition rates to improve overall retention in the CAF.
Abstract: Disordered eating is a prevalent and relevant health concern that remains understudied among U.S. military veterans. Avoidant/restrictive food intake disorder (ARFID) is a newly recognized feeding and eating disorder characterized by overly restrictive eating due to (a) picky eating, (b) lack of appetite, and (c) fear of aversive consequences related to eating. The Nine-Item ARFID Screen (NIAS) is a recently developed ARFID screening tool with initial validation studies demonstrating psychometric support. However, the psychometric properties of the NIAS have not been investigated in a veteran sample. To advance our understanding of ARFID screening tools that may be appropriate for use in veterans, the present study examined the factor structure of the NIAS using survey data from a large national sample of recently separated veterans (N = 1,486). Measurement invariance across key subgroups was tested in addition to exploring differential associations between the NIAS and related constructs. Results suggested that a three-factor model provided an excellent fit of the data and demonstrated scalar invariance across self-identified men and women, race and ethnicity, and sexual and gender minority (SGM) identity. Some subgroups had higher latent means on the picky eating (women, SGM, non-Hispanic Black), appetite (women, SGM), and fear (women) factors. The NIAS had some overlap with another measure of disordered eating and was moderately correlated with psychosocial impairment and mental health. Overall, the NIAS may be a useful screening tool for ARFID in veterans, given support for the three proposed subscales and equivalence across diverse identities.