Gender Differences in Mental Health Screening Outcomes Among U.S. Marines in Combat Support Occupations

The role of women in the U.S. Military has expanded over the years. Recent policy changes allow for women to serve in all military occupations, including direct combat. Multiple studies have identified a higher risk of mental health problems with increasing levels of combat, but little is known regarding gender differences among specific combat support occupations.

A total of 15,900 U.S. Marines (1,065 women and 14,835 men) with a deployment between 2007 and 2009 were identified from electronic military records. A standard health questionnaire was completed at the end of deployment, which queried the service member on combat exposure and mental health. Mental health problems were defined as screening positive for post-traumatic stress disorder or depression, or receiving a mental health referral. Military occupation was categorized as electrical/mechanical repair, communications/intelligence, functional support/administration, and service/supply.

Overall, men reported more combat exposure than women. The communications/intelligence and service/supply occupations had the highest rates of combat exposure. After adjusting for combat exposure, previous diagnosis of anxiety or depression, deployment time, age, and military rank, women had higher odds than men for mental health problems in service/supply (odds ratio, 1.76; 95% confidence interval, 1.21-2.56) and communications/intelligence occupations (odds ratio, 1.60; 95% confidence interval, 1.01-2.52).

As women become fully integrated into the military, the study of health disparities becomes essential for medical planning purposes. Occupation-specific exposures should be considered, along with combat exposures, when determining a risk profile for adverse mental health outcomes among women and men after wartime deployment.