Patterning of Musculoskeletal Injuries in the U.S. Army: A Sociocentric Social Network Analysis

Area of Science:

• Military medicine
• Social network analysis
• Musculoskeletal injury epidemiology

Background:

• Musculoskeletal injuries (MSKIs) are a primary concern for U.S. soldier health and readiness.
• While physical and sociodemographic risk factors are known, the impact of social relationships, particularly social disconnection, on MSKIs is understudied.

Purpose of the Study:

• To investigate the association between social network characteristics and musculoskeletal injuries in U.S. Army combat arms units.
• To explore the role of social disconnection as a potential factor in MSKI development.

Main Methods:

• Cross-sectional sociocentric social network analysis was conducted on 776 soldiers across two Army combat arms units.
• Social interaction networks were mapped based on soldiers' self-reported socializing outside duty hours.
• Multiple logistic regression with quadratic assignment procedure analyzed injury status, accounting for network dependencies and known MSKI risk factors.

Main Results:

• Over 25% of soldiers reported duty-limiting MSKIs.
• Soldiers with MSKIs were significantly more likely to socialize with other injured soldiers (OR > 1.25, P < 0.05).
• Injured soldiers reported fewer social ties (0.76-1.5 fewer) compared to uninjured counterparts (P < 0.05).

Conclusions:

• Soldiers with MSKIs are non-randomly distributed within units, forming distinct subgroups.
• Social disconnection, indicated by fewer social ties, is associated with increased risk of MSKIs in soldiers.
• Further research is needed to elucidate the causal pathways between social dynamics and MSKIs, including social selection, influence, or bidirectional effects.