Risk factors for medical disability in U.S. enlisted Marines: fiscal years 2001 to 2009

To assess factors associated with medical disability in the U.S. Marine Corps.

Case-control study enrolling 11,554 medical disability cases of U.S. enlisted Marines referred to the Physical Evaluation Board fiscal year 2001 to 2009 and 42,216 controls frequency matched to cases in a 4:1 ratio on year of accession into the service were analyzed utilizing bivariate and multivariate logistic regression analysis.

Increased age and body mass index at accession were associated with higher odds of medical disability. Females (odds ratio adjusted [OR(adj)] = 1.3, 95% confidence interval [CI] = 1.2-1.3) have higher odds of disability than males. "Healthy Warrior Effect" was observed in that those who deployed (OR(adj) = 0.48, 95% CI = 0.46-0.50) had decreased odds of medical disability than those who did not deploy. Medical waivers at accession (OR(adj) = 1.12, 95% CI = 1.01-1.23) increased the odds of medical disability.

Continued surveillance of the disability evaluation system is needed to help develop preventive measures and to help policy makers establish evidence-based policies on accession, deployment, and retention standards over the lifecycle of service members.