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Prevalence of Female Marines in the Ground Combat Element and Its Association With Musculoskeletal Injuries and
Katelyn Thomas1, Kerri Bortz2, Amanda Banaag3,4
1Department of Laboratory Animal Resources, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
Introduction:
In 2016, all military occupational specialties in the United States Marine Corps (USMC) were opened to women, including ground combat roles. Limited service-specific data exist regarding musculoskeletal injury (MSKI) and behavioral health (BH) outcomes among female Marines. This study evaluates the prevalence and risk of MSKI and BH diagnoses among female Marines in ground combat specialties (GCSs) compared with non-ground combat specialties (NGCSs).
Materials And Methods:
We conducted a retrospective cross-sectional analysis of all active duty female Marines from 2016 to 2023 using Military Health System data. MSKI and BH diagnoses were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes. Women with pregnancy-related diagnoses during or within 12 months before the study period were excluded. Multivariable logistic regression models were used to assess associations between occupational specialty and MSKI or BH diagnoses, adjusting for age, race and ethnicity, rank, body mass index, tobacco use, and alcohol/substance use.
Results:
A total of 30,280 active duty female Marines were identified for inclusion between January 2016 to December 2023; of whom 218 (0.7%) were in the GCS. The majority of females in the GCS were between the ages of 18-23 (58.7%), of White race (70.6%), and in an enlisted rank (78.9%). The prevalence of women in a GCS increased over the study period, from 16.9 per 1,000 in 2016 to 21.5 per 1,000 in 2023. Female Marines in GCS had no significant odds of MSKI diagnosis (OR = 1.09, 95% CI, = 0.80-1.49) or BH disorder (OR = 0.96, 95% CI, = 0.70-1.30) when compared to those in a non-GCS.
Conclusions:
Among active duty female Marines, assignment to a GCS was not associated with increased risk of MSKI or BH diagnoses. Despite occupational integration, the overall burden of MSKI and BH conditions remains substantial, underscoring the need for continued surveillance and targeted prevention strategies.
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