Differences in Disease Non-battle Injury Between Combatant Commands

Area of Science:

• Military medicine
• Epidemiology
• Public health surveillance

Background:

• Disease and non-battle injury (DNBI) represent a significant medical burden in deployed military populations.
• Understanding variations in DNBI rates across different operational theaters is crucial for effective healthcare planning.
• This study compares DNBI rates between the United States Africa Command (USAFRICOM) and United States Central Command (USCENTCOM).

Purpose of the Study:

• To determine if DNBI rates differ significantly between USAFRICOM and USCENTCOM.
• To compare the types of DNBI and evacuation rates within these two combatant commands.
• To identify potential command-specific factors influencing the DNBI burden.

Main Methods:

• Utilized data from January 1, 2017, to December 31, 2021.
• Acquired individual evacuation data from the United States Transportation Command Regulating and Command & Control Evacuation System.
• Compared proportions and evacuation rates of DNBI types between USAFRICOM and USCENTCOM using population and encounter data.

Main Results:

• USCENTCOM exhibited significantly higher outpatient and inpatient service utilization for mental disorders, musculoskeletal diseases, and neurologic conditions compared to USAFRICOM.
• USCENTCOM consistently demonstrated significantly lower evacuation rates than USAFRICOM across all analyzed years (2017-2021).
• Statistical analysis confirmed significant differences in evacuation rates, with P-values < .0001 for each year.

Conclusions:

• Evacuation rates for various DNBI categories are not uniform across different combatant commands (CCMDs).
• Command-specific environmental, operational, or policy factors likely influence the effectiveness of initiatives aimed at reducing the DNBI burden.
• Tailored strategies are necessary to address the unique challenges posed by DNBI in different military operational areas.